P-475: C-peptide as a new hypertensive factor in patients with type 2 diabetes mellitus

Abstract

Introduction:

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).

Objectives:

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.

Methods:

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.

Results:

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).

Conclusions:

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.

C-Peptide, Hypertension, Type 2 Diabetes