Involvement of C-peptide in the progression of type 2 diabetes mellitus through triglyceride-centered lipid metabolism
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Purpose
Fasting C-peptide (FCP), which is co-secreted with insulin, plays a critical role in the pathogenesis of diabetic complications as both deficient and excessive secretion are associated with adverse outcomes. This study aimed to determine the relationship between FCP levels and lipid metabolism disorders—particularly those reflected by triglyceride (TG) levels—and related clinical indicators.
Method
A total of 607 patients (median age 63 years) were included and categorized into four groups according to their FCP levels. Pearson’s correlation analysis was performed to evaluate the relationships between FCP and other clinical variables. The area under the receiver operating characteristic curve was used to evaluate the predictive performance of TG, uric acid (UA), and fasting blood glucose levels for elevated FCP. Univariate and multivariate logistic regression analyses were used to identify independent risk factors influencing FCP levels.
Results
The prevalence of diabetic kidney disease was 42.36%. TG levels, TG-glucose index (TyG), and atherogenic index of plasma (AIP) varied significantly among the four groups ( P < 0.01). FCP showed significant correlations with TG, TyG, AIP, UA, and creatinine (all P < 0.001). Stratified analysis indicated that each unit increase in TG or UA was associated with a significant rise in FCP (both P < 0.001). Moreover, TG level was identified as an independent risk factor for elevated FCP ( P = 0.013).
Conclusion
In patients with type 2 diabetes mellitus (T2DM), FCP levels are closely associated with dysregulation of lipid metabolism, characterized by elevated TG levels that may promote target organ damage. These findings suggest that C-peptide supplementation may not be beneficial for delaying the progression of T2DM or its complications.
