Banu BÖYÜK, Yıldız Okuturlar, Erdoğan Uludağ, Hande Atalay, Savaş Güzel, Aslan Çelebi

Tip 2 diyabetes mellituslu hastalarda C peptid ile mikroalbuminüri ilişkisi

Amaç: Son dönem çalışmaları C peptitin diyabetik nefropatide yararlı etkileri olduğunu öne sürmektedir. Bu çalışmada tip 2 diyabetes mellitus (T2DM) hastalarında gözlenen mikroalbuminüri ile serum C peptit düzeylerinin ilişkili olup olmadığını analiz etmeyi amaçladık.Gereç ve Yöntem: Bu amaçla 184 tip 2 diyabet hastası ve 46 sağlıklı kontrol çalışmaya alındı. Hastaların klinik özellikleri ve rutin biyokimyasal tetkiklerine ek olarak serum C peptit seviyeleri kaydedildi. Serum C peptit normal aralığı 1.1-4.4 olarak kabul edildi. Hastalardan 24 saatlik idrar toplanarak araştırıldı ve 30-300 mg aralığı mikroalbuminuri olarak kaydedildi. Değişkenler arasındaki ilişkiyi ortaya koymak amacıyla Pearson korelasyon analizi kullanıldı.Bulgular: Tip 2 diyabet hastaları sağlıklı control grubu ile karşılaştırıldığında C peptit düzeyleri arasında anlamlı farklılık saptanmadı. Pearson korelasyon analizinde C peptit düzeyleri, insulin ve mikroalbuminuri arasında pozitif korelasyon olduğu görüldü. Bununla birlikte C –peptit ve diğer değişkenler arasında anlamlı bir ilişki bulunmadı.Sonuç: Bu çalışmada serum C peptit düzeyleri ile mikroalbuminüri varlığının ilişkili olduğunu gösterdik. Bulgular C peptitin T2DM hastalarında renal komplikasyonları ile ilişkili olduğunu ortaya koymaktadır

Anahtar Kelimeler:

c peptid, mikroalbuminüri, diyabet

Association between C-peptide level and microalbuminuria in patients with type 2 diabetes mellitus

Purpose: Latest studies suggest that C-peptide may have a beneficial biological role on diabetic nephropathy. The aim of this study is to analyze whether there is an association between serum C-peptide level and microalbuminuria in type 2 diabetes mellitus (T2DM).Materials and Methods: We enrolled 184 T2DM patents and 46 healthy subjects in this study. Clinical variables and routine biochemical tests along with serum C peptide levels measured after an overnight fasting. Serum C peptide levels between 1.1 and 4.4 accepted as normal. 24-hour-urine samples were investigated and values between 30-300mgwere recorded as microalbuminuria. Pearson correlation analysis were used to determine associations between continuous variables.Results: C peptide levels were not significantly difference in T2DM patients compared to healthy controls. Serum C peptide levels showed positive correlation with insülin and microalbminuria with the Pearson correlation analysis. However, there was no significant association between other variables and C peptide levels.Conclusion: A correlation was found between microalbuminuria and serum C-peptide in this present study. Findings suggest C-peptide is related with renal complications of T2DM patients.

Keywords:

C peptide, microalbuminuria, diabetes,

PDF

___

1. Özata M, Yönem A. Diyabetes Mellitus Tanısı, Sınıflaması, Klinik Özellikler. Istanbul, Medikal Yayıncılık, 2006.
2. Brodoff BN, Bleicher SJ. Diabetes Mellitus and Obesity. Baltimore, Williams and Wilkins, 1982 3. Yenigün M. Her Yönüyle Diabetes Mellitus. İstanbul, Nobel Tıp Kitabevi. 1995.
4. Mogensen C, Andersen MI. Increased kidney size and glomerular filtration rate in untreated juvenile diabetes: normalisation by insulin treatment. Diabetologia. 1975;11:221-24.
5. Sandahl-Christiansen J, Frandsen M, Parving H. The effect of intravenous insulin infusion on kidney function in insulin-dependent diabetes mellitus. Diabetologia. 1981;20:199-204
6. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499-502.
7. Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S et al. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006;145:247-54.
8. Johansson BL, Borg K, Fernqvist-Forbes E, Kernell A, Odergren T, Wahren J. Beneficial effects of C-peptide on incipient nephropathy and neuropathy in patients with Type 1 diabetes mellitus. Diabet Med. 2000;17:181-9.
9. Kitabchi AE. Proinsulin and C-peptide: a review. Metabolism. 1977;26:547-87..
10. Regeur La. Plazma C-peptid. Scand J Clin Lab Invest. 1978;38:771-75.
11. Chowta MN, Adhikari PM, Chowta NK, Shenoy AK, D'Souza S. Serum C peptide level and renal function in diabetes mellitus.Indian J Nephrol. 2010;20:25-8.
12. Mogensen C, Andersen MI. Increased kidney size and glomerular filtration rate in untreated juvenile diabetes: normalisation by insulin treatment. Diabetologia. 1975;11:221-24.
13. Sandahl-Christiansen J, Frandsen M, Parving H. The effect of intravenous insulin infusion on kidney function in insulin-dependent diabetes mellitus. Diabetologia. 1981;20:199-204.
14. Friedman E, Sheih SD, Hirsch S, Boshell B. No supranormal glomerular filtration (GFR) in type II (non-insulindependent) diabetes. Am Soc Nephrol. 1981;14:102.
15. Schmitz A, Gundersen H, Österby R. Glomerular morphology by light microscopy in non-insulin-dependent diabetes mellitus. Diabetes. 1988;37:38-43.
16. Johansson BL, Kernell A, Sjoberg S, Wahren J. Influence of combined C-peptide and insulin administration on renal function and metabolic control in diabetes type 1. J Clin Endocrinol Metab. 1993;77:976-81.
17. Johansson BL, Sjoberg S, Wahren J. The influence of human C-peptide on renal function and glucose utilization in type 1 (insulin-dependent) diabetic patients. Diabetologia. 1992;35:121-8.
18. Johansson BL, Borg K, Fernqvist-Forbes E, Kernell A, Odergren T, Wahren J. Beneficial effects of C-peptide on incipient nephropathy and neuropathy in patients with type 1 diabetes mellitus. Diabet Med. 2000;17:181-9.
19. Samnegard B, Jacobson SH, Jaremko G, Johansson BL, Sjöquist M. Effects of C-peptide on glomerular and renal size and renal function in diabetic rats. Kidney Int. 1981;60:1258–65.
20. Rebsomen L, Pitel S, Boubred Fa. C-peptide replacement improves weight gain and renal function in diabetic rats. Diabetes Metab. 2006;32:223-8.
21. D’Amaro PJ. Evolution of C-reactive protein as a cardiac risk factor: Lab Med. 2005;36:234-8.
22. Lee CC, Adler IA, Sandhu MS, Sharp SJ, Forouhi NG, Erqou S et al. Association of C reactive protein with type 2 diabetes: prospective analysis and meta-analysis. Diabetologia. 2009;52:1040-47.
23. McLaughlin T, Abbasi F, Lamendola C, Liang L, Reaven G, Schaaf P et al. Differentiation between obesity and insülin resistance in the association with C-reactive protein. Circulation. 2002;106:2908-12.
24. Rebsomen L, Pitel S, Boubred Fa. C-peptide replacement improves weightgain and renal function in diabetic rats. Diabetes Metab. 2006;32:223-28.
25. Rebsomen L, Khammar A, Raccah D, Tsimaratos M. C-Peptide effects on renal physiology and diabetes. Exp Diabetes Res. 2008;2008:281536.