C-peptide: A predictor of cardiovascular mortality in subjects with established atherosclerotic disease

• Published in: Diabetes & vascular disease research Vol. 14; no. 5; pp. 395 - 399
• Main Authors: Cardellini, Marina, Farcomeni, Alessio, Ballanti, Marta, Morelli, Monica, Davato, Francesca, Cardolini, Iris, Grappasonni, Giulia, Rizza, Stefano, Guglielmi, Valeria, Porzio, Ottavia, Pecchioli, Chiara, Menghini, Rossella, Ippoliti, Arnaldo, Federici, Massimo
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.09.2017
• Subjects: Aged; Atherosclerosis - blood; Atherosclerosis - diagnosis; Atherosclerosis - mortality; Biomarkers - blood; C-Peptide - blood; Cause of Death; Chronic Disease; Diabetes Mellitus - blood; Diabetes Mellitus - drug therapy; Diabetes Mellitus - mortality; Female; Humans; Hypoglycemic Agents - therapeutic use; Linear Models; Male; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Proportional Hazards Models; Registries; Risk Factors; Time Factors; atherosclerosis; Cardiovascular diseases; biomarkers; C-peptide
• ISSN: 1479-1641; 1752-8984; 1752-8984
• DOI: 10.1177/1479164117710446

Aim: Insulin resistance and type 2 diabetes are independent risk factors for cardiovascular diseases. Levels of C-peptide are increased in these patients and its role in the atherosclerosis progression was studied in vitro and in vivo over the past years. To evaluate the possible use of C-peptide as cardiovascular biomarkers, we designed an observational study in which we enrolled patients with mono- or poly-vascular atherosclerotic disease. Methods: We recruited 431 patients with stable atherosclerosis and performed a yearly follow-up to estimate the cardiovascular and total mortality and cardiovascular events. Results: We performed a mean follow-up of 56 months on 268 patients. A multivariate Cox analysis showed that C-peptide significantly increased the risk of cardiovascular mortality [Hazard Ratio: 1.29 (95% confidence interval: 1.02−1.65, p < 0.03513)] after adjustment for age, sex, diabetes treatment, estimated glomerular filtration rate and known diabetes status. Furthermore, levels of C-peptide were significantly correlated with metabolic parameters and atherogenic factors. Conclusion: C-peptide was associated with cardiovascular mortality independently of known diabetes status in a cohort of patients with chronic atherosclerotic disease. Future studies using C-peptide into a reclassification approach might be undertaken to consider its potential as a cardiovascular disease biomarker.