Postprandial C-peptide to glucose ratio as a predictor of beta-cell function and its usefulness for staged management of type 2 diabetes

作者：Lee Eun Young; Hwang Sena; Lee Seo Hee; Lee Yong ho; Choi A Ra; Lee Youngki; Lee Byung Wan; Kang Eun Seok; Ahn Chul Woo; Cha Bong Soo; Lee Hyun Chul^*

来源：Journal of Diabetes Investigation, 2014, 5(5): 517-524.

DOI：10.1111/jdi.12187

• C-peptide
• Pancreatic -cell
• Type2 diabetes mellitus

Aims/IntroductionType2 diabetes is characterized by progressive deterioration of -cell function. Recently, it was suggested that the C-peptide-to-glucose ratio after oral glucose ingestion is a better predictor of -cell mass than that during fasting. We investigated whether postprandial C-peptide-to-glucose ratio (PCGR) reflects -cell function, and its clinical application for management of type2 diabetes.
Materials and MethodsWe carried out a two-step retrospective study of 919 Korean participants with type2 diabetes. In the first step, we evaluated the correlation of PCGR level with various markers for -cell function in newly diagnosed and drug-naive patients after a mixed meal test. In the second step, participants with well-controlled diabetes (glycated hemoglobin <7%) were divided into four groups according to treatment modality (groupI: insulin, groupII: sulfonylurea and/or dipeptityl peptidaseIV inhibitor, groupIII: metformin and/or thiazolidinedione and groupIV: diet and exercise group).
ResultsIn the first step, PCGR was significantly correlated with various insulin secretory indices. Furthermore, PCGR showed better correlation with glycemic indices than homeostatic model assessment of -cell HOMA-). In the second step, the PCGR value significantly increased according to the following order: groupI, II, III, and IV after adjusting for age, sex, body mass index and duration of diabetes. The cut-off values of PCGR for separating each group were 1.457, 2.870 and 3.790, respectively (P<0.001).
ConclusionsWe suggest that PCGR might be a useful marker for -cell function and an ancillary parameter in the choice of antidiabetic medication in type2 diabetes.

• 出版日期2014-9