A novel model for predicting diabetes remission after bariatric surgery based on the measurement of C-peptide and creatinine in serum: A pilot study
A novel model for predicting diabetes remission after bariatric surgery based on the measurement of C-peptide and creatinine in serum: A pilot study
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基于血清中 C 肽和肌酐测量的预测减肥手术后糖尿病缓解的新模型：一项试点研究
DOI：
10.1016/j.numecd.2023.12.008
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Colosimo S
中科院分区：
文献类型：
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作者：
Colosimo S
背景和目的减肥手术对肥胖患者的2型糖尿病(T2D)是有效的，尽管有相当一部分患者在手术后即使在显著减轻体重和代谢改善后仍未达到糖尿病缓解。C-肽是β细胞功能和胰岛素分泌的有价值的标志物，但在解释T2D患者的测量结果时必须考虑肾功能。本研究旨在探讨肥胖症和T2 D患者减肥手术后血清C肽水平与糖尿病缓解和血糖达标率的关系。方法与结果收集84例接受Roux-en-Y胃旁路手术(RYGB)的肥胖者和T2D患者的前瞻性数据。多因素二项回归模型显示，Ln(C-肽/肌酐)和年龄与6个月T2D缓解显著相关。受试者工作特性分析(AUROC)预测缓解的曲线下面积(AUROC)为0.87，比仅基于C肽水平的AUROC(0.75)更准确。同样的模型也能够预测HbA1c达到7%(53 mmol/mol)的目标(AUROC 0.96)。结论Ln(C-肽/肌酐)比值可以作为预测RYGB手术后T2D缓解和目标实现的有用工具，能更准确地反映肥胖患者的β细胞功能。
Background and aimsBariatric surgery is effective for treating type 2 diabetes (T2D) in patients with obesity, although a significant proportion of these patients do not achieve diabetes remission after the surgery even after significant weight loss and metabolic improvement. C-peptide is a valuable marker of beta cell function and insulin secretion, but renal function must be considered when interpreting measurements in patients with T2D. The study aims to investigate the association of serum levels of C-peptide adjusted for creatinine with diabetes remission and glycemic target achievement after bariatric surgery in patients with obesity and T2D.Methods and resultsProspective data from a cohort of 84 patients with obesity and T2D submitted to Roux-en-Y gastric bypass (RYGB) were collected at baseline and at least a 6-month follow up. A multivariate binomial regression model showed that Ln(C-peptide/creatinine) and age were significantly associated with 6-month T2D remission. The area under the curve for the receiver operating characteristic analysis (AUROC) to predict remission was 0.87, and more accurate than the AUROC based on C-peptide levels alone (0.75). The same model was also able to predict achieving an HbA1c target of 7 % (53 mmol/mol) (AUROC 0.96).ConclusionIn conclusion, Ln(C-peptide/creatinine) ratio could be a useful tool in predicting T2D remission and target achievement after RYGB surgery, providing a more accurate reflection of beta cell function in bariatric patients.