Urinary C-peptide/creatinine ratio: A useful biomarker of insulin resistance and refined classification of type 2 diabetes mellitus.

Abstract

BACKGROUND:

The urinary C-peptide/creatinine ratio (UCPCR) is low in patients with type 1 diabetes mellitus, but it has not been well characterized in patients with type 2 diabetes mellitus (T2DM). We aimed to measure the UCPCRs in patients with T2DM and explore the relationships among UCPCR, insulin resistance (IR), and chronic vascular complications of diabetes.

METHODS:

A cross-sectional study was performed of 1299 Chinese hospitalized patients with T2DM. Binary logistic regression was used to evaluate the relationships between the chronic vascular complications of diabetes and UCPCR. K-means analysis was used to allocate participants to subgroups with five to six variables (age at diagnosis, body mass index [BMI], glycosylated hemoglobin, homoeostasis model assessment 2-estimated beta-cell function (HOMA2-B), and HOMA2-insulin resistance (HOMA2-IR), with or without UCPCR).

RESULTS:

UCPCR positively correlated with HOMA2-IR (r = 0.448, P < .001). After adjustment for sex, age, duration of diabetes, and other cardiovascular risk factors, UCPCR was positively associated with diabetic kidney disease (DKD) (odds ratio [OR] = 1.198, 95% CI 1.019-1.408, P = .029) and coronary heart disease (CHD) (OR = 1.312, 95% CI 1.079-1.594, P = .006). When UCPCR was added, cluster analysis using the six variables identified five subgroups of T2DM, characterized by differing age at diagnosis, BMI, beta-cell function, IR, and prevalence of vascular complications.

CONCLUSIONS:

UCPCR is positively associated with IR, DKD, and CHD and represents a promising biomarker that could refine the classification of T2DM.

• Authors: Yanai Wang, Xiantong Zou, Xiaoling Cai, Wei Liu, Ling Chen, Rui Zhang, Lingli Zhou, Siqian Gong, Ying Gao, Simin Li, Yingying Luo, Xueyao Han, Linong Ji
• Journal: Journal of diabetes (J Diabetes) Vol. 13 Issue 11 Pg. 893-904 (Nov 2021) ISSN: 1753-0407 [Electronic] Australia
• PMID: 34051046 (Publication Type: Journal Article)
• Copyright: © 2021 Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd.

Chemical References

• Biomarkers
• Blood Glucose
• C-Peptide
• Glycated Hemoglobin A
• hemoglobin A1c protein, human
• Creatinine

Topics

• Biomarkers (urine)
• Blood Glucose (analysis)
• C-Peptide (urine)
• Cardiovascular Diseases (etiology, pathology, urine)
• Creatinine (urine)
• Cross-Sectional Studies
• Diabetes Mellitus, Type 2 (classification, complications)
• Female
• Follow-Up Studies
• Glucose Intolerance (etiology, pathology, urine)
• Glycated Hemoglobin (analysis)
• Humans
• Insulin Resistance
• Male
• Middle Aged
• Prognosis