Relationship between fasting serum C-peptide level and heart function in patients with or without diabetes mellitus and chronic heart failure
10.3760/cma.j.issn.1008-6315.2020.01.011
- VernacularTitle: 空腹血清C肽水平与伴或不伴糖尿病慢性心力衰竭患者心功能的关系
- Author:
Zhiqiang LI
1
;
Yonghua FU
;
Zhongsheng ZHU
;
Chunyan HU
Author Information
1. Department of Cardiology, Shanghai Pudong Hospital&Fudan University Pudong Medical Center, Shanghai 201399, China
- Publication Type:Journal Article
- Keywords:
Chronic heart failure;
Diabetes mellitus;
Serum C-peptide;
N-terminal B-type natriuretic peptide;
Cardiac function
- From:
Clinical Medicine of China
2020;36(1):45-51
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the relationships between admission fasting serum C-peptide concentration and cardiac function status in chronic heart failure (CHF) patients with or without diabetes.
Methods:From July 2017 to December 2018, 262 CHF patients with or without diabetes in the Department of Cardiology of Pudong hospital in Shanghai were analyzed.Their cardiac function was classified as New York Heart Association (NYHA) grade Ⅱ to Ⅳ, and they were divided into diabetes group (80 cases) and non diabetes group (182 cases). At the same time, 62 subjects without diabetes and heart disease were randomly selected as the control group.To analyze the relationship between fasting serum C-peptide level and cardiac function in diabetic and nondiabetic CHF patients.
Results:(1)The fasting plasma glucose and serum C-peptide concentrations of diabetes group paitents were(8.7±2.9) mmol/L and(0.78±0.67) nmol/L respectively, the nondiabetes group paitents were(5.8±1.67) mmol/L and(0.56±0.61)nmol/L respectively, the control group were(5.1±0.69) mmol/L and(0.16±0.12)nmol/L respectively.The difference in the three groups was statistically significant(all P<0.001). The levels of fasting blood glucose and serum C-peptide in diabetic group were significantly higher than those in non diabetic group and control group (all P<0.01). The levels of fasting blood glucose and serum C-peptide in non diabetic group were significantly higher than those in control group (P<0.05 or P<0.01). The left ventricular ejection fraction (LVEF) in diabetic group was(44.1±8.3)%, and those in non diabetic group and control group were(46.7±7.2)% and(64.8±3.8)%.The difference in the three groups was statistically significant(<0.001). The LVEF of diabetic group was significantly lower than that of non diabetic group and control group (all P<0.01), and the CRP of diabetic group was (1.39±0.91) mg/L, the N-terminal pro-B-type natriuretic peptide (pro-BNP) was (1 771.3±23.1) ng/L, the hemoglobin was (125.6±16.7) g/L in the diabetic group, and (1.22±0.73) mg/L, (1 659.2±19.3) ng/L, (126.1±16.5) g/L in the non diabetic group, respectively, and (0.85±0.72) mg/L, (87.2±17.2) ng/L, (136.4±15.2) g/L in the control group, respectively.The differences among the three groups were statistically significant (P<0.001). CRP and pro-BNP in the diabetic group and non diabetic group were significantly higher than those in the control group (all P<0.01), and hemoglobin levels were significantly lower than those in the control group(all P<0.01). There were no statistically significant differences in CRP, pro-BNP and hemoglobin between the diabetic group and non diabetic group (all P>0.05). (2) In all patients with heart failure, diabetes mellitus and non diabetes heart failure, the levels of serum C-peptide were (1.05±0.85), (1.17±0.82), (0.99±0.86) nmol/L in NYHA Ⅳ group, and (0.53±0.22), (0.52±0.20), (0.54±0.23) nmol/L in NYHA Ⅲ group, and (0.32±0.09), (0.32±0.11), (0.31±0.09) nmol/L in NYHA Ⅱ group.After adjustment of age, gender, smoking, insulin secretion and hypoglycemic drugs, body mass index, blood pressure, total bilirubin (TBIL), alanine aminotransferase (ALT), creatinine, blood glucose, blood lipid, white blood cell count (WBC) and hemoglobin level by covariance analysis, all patients with heart failure The level of serum C-peptide in NYHA Ⅳ group was significantly higher than that in Ⅲ group (all P<0.01) and Ⅱ group (all P<0.01). In all patients with heart failure and non diabetic heart failure, the level of serum C-peptide in NYHA Ⅲ group was significantly higher than that in Ⅱ group (all P<0.05). There was no significant difference in serum C-peptide between all patients with heart failure, diabetes mellitus and non diabetes heart failure (all P>0.05) (3) Using multiple linear regression analysis, the adjustment factors included age, gender, smoking, BMI, blood pressure, TBIL, alt, creatinine, blood glucose, blood lipid, WBC and hemoglobin levels.The results showed that the serum C-peptide level was positively correlated with pro-BNP in all patients with heart failure, diabetes and non diabetes heart failure (β: 0.006, 95%CI -0.016-0.028 , P=0.007; β: 0.117, 95%CI-0.042-0.277 , P=0.006; β: 0.411, 95%CI-0.149-0.971 , P=0.023), negatively correlated with LVEF(β: -0.122, 95%CI-0.285-0.041, P=0.004; β: -0.008, 95%CI-0.032-0.016, P=0.010; β: -0.065, 95%CI-0.139-0.011, P=0.036).
Conclusion:The level of fasting serum C-peptide was significantly increased in patients with CHF and non-diabetic patients, and was related to the severity of heart failure.
