C-Peptide Is Independently Associated with an Increased Risk of Coronary Artery Disease in T2DM Subjects: A Cross-Sectional Study.
C-Peptide Is Independently Associated with an Increased Risk of Coronary Artery Disease in T2DM Subjects: A Cross-Sectional Study.
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C 肽与 T2DM 受试者冠状动脉疾病风险增加独立相关：一项横断面研究
DOI：
10.1371/journal.pone.0127112
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Chen L
中科院分区：
文献类型：
--
作者：
Wang L;Lin P;Ma A;Zheng H;Wang K;Li W;Wang C;Zhao R;Liang K;Liu F;Hou X;Song J;Lu Y;Zhu P;Sun Y;Chen L
目的C-肽是2型糖尿病(T2 DM)患者亚临床动脉粥样硬化的标志物，但其在冠心病(CAD)中的作用尚不清楚，尤其是在不同体重指数(BMI)的糖尿病患者中。设计与方法这项横断面研究包括501例T2 DM患者。首先，所有受试者被分成两组：CAD组和非CAD组。然后，用二元Logistic回归分析确定所有患者的冠心病危险因素。为了阐明肥胖的作用，我们根据BMI将所有受试者重新分为两组(肥胖组和非肥胖组)。最后，采用二元Logistic回归分析，确定各体重组的冠心病危险因素。结果冠心病患者除高血压、胰岛素抵抗、高胆固醇、半胱氨酸-C(Cys-C)和估计肾小球滤过率(EGFR)降低等传统危险因素外，还表现出较高的BMI和空腹C-肽水平。Logistic回归分析显示，空腹C肽(OR=1.513，p=0.005)、胰岛素治疗(OR=1.832，p=0.027)、高血压(OR=1.987，p=0.016)和高脂血症(OR=4.159，p<；0.001)显著增加T2 DM患者临床冠心病的风险，与年龄、性别、糖尿病病程、吸烟和饮酒状况、空腹胰岛素和血糖、低血糖发作、尿A和表皮生长因子受体无关。此外，在肥胖(OR=1.488，p=0.049)和非肥胖(OR=1.686，p=0.037)糖尿病组中，经多项调整后，C-肽与冠心病风险增加相关。结论无论肥胖与否，C-肽均与T2 DM患者的冠心病风险增加有关。
Objective C-peptide has been reported to be a marker of subclinical atherosclerosis in type 2 diabetes mellitus (T2DM) patients, whereas its role in coronary artery disease (CAD) has not been clarified, especially in diabetics with differing body mass indices (BMIs). Design and Methods This cross-sectional study included 501 patients with T2DM. First, all subjects were divided into the following two groups: CAD and non-CAD. Then, binary logistic regression was used to determine the risk factors for CAD for all patients. To clarify the role of obesity, we re-divided all subjects into two additional groups (obese and non-obese) based on BMI. Finally, binary logistic regression was used to determine the risk factors for CAD for each weight group. Results The patients with CAD showed a higher BMI and fasting C-peptide level in addition to an increased prevalence of traditional risk factors for CAD, such as hypertension, insulin resistance, higher cholesterol, cysteine-C (Cys-C) and lower estimated glomerular filtration rate (eGFR). Logistic regression analysis showed that fasting C-peptide (OR=1.513, p=0.005), insulin treatment (OR=1.832, p=0.027) hypertension (OR=1.987, p=0.016) and hyperlipidemia (OR=4.159, p<0.001) significantly increased the risk of clinical CAD in the T2DM patients independent of age, gender, diabetes duration, smoking and alcohol statuses, fasting insulin and glucose, hypoglycemic episodes, UA and eGFR. Additionally, in both of the obese (OR=1.488, p=0.049) and non-obese (OR=1.686, p=0.037) DM groups, C-peptide was associated with an increased risk of CAD after multiple adjustments. Conclusions C-peptide is associated with an increased CAD risk in T2DM patients, no matter whether they are obese or not.
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