C-peptide as a new hypertensive factor in patients with type 2 diabetes mellitus

Abstract

In type1 DM,the administration of C-peptide definition, protects against nephropathy. In type2 DM, it has been related with hyperlipidaemia and hypertension although its relationship has not been clarified with respect to Insulin Resistance (IR). 1. To study the differential characteristics in a type2 DM without insulin treatment according to fasting C peptide levels.2. To confirm the existence of a correlation between these levels and Blood Pressure (BP) control and IR.3. To clarify if C-peptide levels correlate with endothelial dysfunction evaluated by PAI-1 levels. N=105, 56M, 49F, aged 38–82 .72 with Hypertension, 51 dyslipemia and 16 smokers. LDLc, triglycerides, creatinine, fasting plasma glucose and HbA1c – HITACHI. PAI-1 Menarini ELISA. Oxidized-LDL (oxLDL) Mecordia ELISA. Plasma insulin- Immulite. DPC. IR: HOMA score.C-peptide-Immulite2000. Systolic Blood Pressure (SBP) and Diastolic Blood Pressure by 24-hour Ambulatory Blood Pressure Monitoring (ABPM). Spacelabs 90207. Statistical analysis: t-Student, Chi Square. 1.The population with C-peptide levels >3 had comparable age, HbA1c and LDLc, but had higher BMI (p<0.05), waist circumference (p=0.036), triglycerides (p=0.005) and IR (p=0.039)than population with C-peptide 1-3 ng/ml 2. The group with high C-peptide levels had greater DBP (p=0.001). C-peptide influences DBP in an independent way to that of IR(patients with DBP>75 mmHg, C-peptide 3.85+-0.64 vs 2.18+-0.23, in patients with DBP <=75 mmHg;p=0.009; IR with non significant differences).3. The group with C-peptide levels >3 had greater oxidative stress (p=0.005) and there is a linear correlation between C-peptide and PAI-1 levels; (p=0.033). 1.In type2 DM patients without insulin treatment, high C-peptide levels correlate with anthropometric parameters, IR and hypertriglyceridemia, but not with the age, LDLc, and HbA1c 2. C-peptide influences 24h DBP, independent of IR association.3. Patients with high levels of C-peptide had greater endothelial dysfunction and oxidative stress. However, we cannot rule out the implication of BP control and hypertriglyceridemia in this process.