1. C-peptide: A predictor of cardiovascular mortality in subjects with established atherosclerotic disease
- Author
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Chiara Pecchioli, Massimo Federici, Iris Cardolini, Francesca Davato, Arnaldo Ippoliti, Alessio Farcomeni, Valeria Guglielmi, Marina Cardellini, Stefano Rizza, Monica Morelli, Giulia Grappasonni, Ottavia Porzio, Marta Ballanti, and Rossella Menghini
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,Time Factors ,Endocrinology, Diabetes and Metabolism ,atherosclerosis ,biomarkers ,c-peptide ,cardiovascular diseases ,internal medicine ,endocrinology, diabetes and metabolism ,cardiology and cardiovascular medicine ,030209 endocrinology & metabolism ,Settore MED/11 - Malattie dell'Apparato Cardiovascolare ,Type 2 diabetes ,Settore MED/22 - Chirurgia Vascolare ,03 medical and health sciences ,chemistry.chemical_compound ,endocrinology ,0302 clinical medicine ,Insulin resistance ,Predictive Value of Tests ,Risk Factors ,Diabetes mellitus ,Internal medicine ,Cause of Death ,medicine ,Diabetes Mellitus ,Humans ,Hypoglycemic Agents ,Registries ,C-peptide ,Cardiovascular diseases ,diabetes and metabolism ,Cardiovascular mortality ,Aged ,Proportional Hazards Models ,C-Peptide ,business.industry ,Atherosclerotic disease ,Middle Aged ,medicine.disease ,Atherosclerosis ,030104 developmental biology ,Endocrinology ,chemistry ,Chronic Disease ,Multivariate Analysis ,Linear Models ,Female ,business ,Biomarkers - Abstract
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.We recruited 431 patients with stable atherosclerosis and performed a yearly follow-up to estimate the cardiovascular and total mortality and cardiovascular events.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, p0.03513)] 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.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.
- Published
- 2017