Fasting serum C-peptide level may not be low in young-onset diabetes

Mobarak Hosen, N. Sultana, M. Hasan, S. Jahan, Mohammad Jahangir-Alam, Shadequl Islam, S. Rahman, N. Tanvi, M. Fariduddin, M. Hasanat
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Abstract

Background: Diabetes mellitus (DM) is one of the growing health problems among the young population. Secretory defect of insulin is an important cause, and it can be assessed by measuring fasting serum C-peptide level. Aim: The aim of this article is to assess fasting serum C-peptide in young-onset DM individuals. Materials and Methods: This case–control study was conducted in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from March 2015 to February 2017. For this purpose, 40 individuals with DM (irrespective of DM type; age range: 11–29 years) were enrolled as case and an equal number of young healthy individuals as control. Demographic profiles, clinical profiles, and serum C-peptide were recorded in a standard and pre-tested structured datasheet. C-peptide was measured by the chemiluminescent immunometric assay. Results: Median fasting C-peptide was 2.67 [interquartile range (IQR) 1.06–4.07, range 0.12–20.0] ng/mL in diabetes individuals, whereas it was 2.19 (IQR 1.36–2.94, range 0.44–9.85) ng/mL in the control group; the difference was insignificant (P = 0.331). Waist circumference (WC) was significantly higher in the young diabetes group in comparison to that of control subjects and so were the plasma glucose values and diastolic blood pressure (P < 0.05 for all). Diabetic participants with low C-peptide group had significantly lower body mass index (BMI) and WC and higher fasting plasma glucose (FPG) and HbA1c in comparison to others (P < 0.05 for all); whereas the high C-peptide group had opposite body indices (higher BMI and WC) and glycemic parameters (lower FPG and HbA1c) (P < 0.05 for all). The classic hyperglycemic symptoms were more common in the low C-peptide group (P = 0.029). In participants with diabetes, C-peptide positively correlated with BMI and WC, whereas it showed a negative correlation with age (P < 0.05 for all). In the control group, C-peptide positively correlated with WC only (P = 0.018). Conclusion: The level of fasting serum C-peptide in diabetic subjects was similar to healthy controls, and it was higher in those subjects who had higher BMI, WC, and lower age.
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年轻发病的糖尿病患者空腹血清c肽水平可能不低
背景:糖尿病(DM)是日益严重的青少年健康问题之一。胰岛素分泌缺陷是其重要原因,可通过测定空腹血清c肽水平进行评估。目的:本文的目的是评估空腹血清c肽在年轻发病糖尿病个体。材料与方法:本病例对照研究于2015年3月至2017年2月在Bangabandhu Sheikh Mujib医科大学(BSMMU)内分泌科进行。为此,40名糖尿病患者(不论糖尿病类型);年龄范围:11-29岁)作为病例,同样数量的年轻健康个体作为对照。人口统计资料、临床资料和血清c肽记录在标准和预先测试的结构化数据表中。用化学发光免疫测定法测定c肽。结果:糖尿病患者空腹c肽中位数为2.67[四分位数间距(IQR) 1.06 ~ 4.07,范围0.12 ~ 20.0]ng/mL,对照组为2.19 (IQR 1.36 ~ 2.94,范围0.44 ~ 9.85)ng/mL;差异不显著(P = 0.331)。青年糖尿病组腰围、血糖、舒张压均显著高于对照组(P < 0.05)。低c肽组糖尿病参与者的体重指数(BMI)和WC明显低于其他组,空腹血糖(FPG)和糖化血红蛋白(HbA1c)明显高于其他组(P < 0.05);而高c肽组的身体指数(BMI和WC)和血糖指标(FPG和HbA1c)则相反(P < 0.05)。低c肽组的典型高血糖症状更为常见(P = 0.029)。糖尿病患者c肽与BMI、WC呈正相关,与年龄呈负相关(均P < 0.05)。对照组c肽仅与WC呈正相关(P = 0.018)。结论:糖尿病患者空腹血清c肽水平与健康对照组相近,BMI、WC高、年龄低者血清c肽水平较高。
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