Background: C-peptide is a by-product of insulin biosynthesis released in
the circulation in amount equimolar with that of insulin; therefore C-peptide
has been used as an index of insulin secretion and its potential role as a
predictor of pancreatic and colorectal cancer and kidney disease have been
questioned. The relation between C-peptide and diabetic complications attracted
the attention of many investigators but not well established yet. The aim of
the present study was to explore the relationship between the level of
C-peptide and the diabetic microvascular complications in Sudanese patients.
Patients and Methods: One hundred and eighty-one type 2 diabetic patients, 61%
males and 39% females, aged more than 30 years were recruited from different
Khartoum hospitals and studied cross-sectionally. Levels of blood C-peptide and
HbA1C were measured with commercially available ELISA kit, and the diabetic
complications were determined subjectively by experienced physicians. Results:
Patients with no complications showed the highest prevalence 33.7% followed by
peripheral neuropathy 33.1%, retinopathy 21.2% and finally nephropathy 11%. Both
no-complications (9.05 ± 3.288) and retinopathy (9.10 ± 3.34) groups showed
similar level of C-peptide, P value = 0.939. While nephropathy group (5.50 ± 3.73)
and peripheral neuropathy (6.60 ± 3.02) showed significantly low levels as compared
to that of no complication, P value = 0.000. On the other hand, level of HbA1C
showed difference between retinopathy and nephropathy when compared to no
complication group but not the peripheral neuropathy. Conclusion: The results
of the present study suggest that the most prevalent diabetic complication in
Sudanese patients is peripheral neuropathy, and the association between
C-peptide and diabetic complications is more prominent with nephropathy and peripheral
neuropathy rather than retinopathy.
Cite this paper
Adam, K. M. , Tajelsir, S. and Aowad, D. A. (2016). Correlation between C-Peptide Level and Chronic Microvascular Complications in Type 2 Diabetes Mellitus Sudanese Patients. Open Access Library Journal, 3, e2634. doi: http://dx.doi.org/10.4236/oalib.1102634.
Balla, S.A., Abdalla, A.A., Elmukashfi, T.A.
and Ahmed, H.A. (2014) Hypertension among Rural Population in Four
States: Sudan 2012. Global Journal of Health
Science, 6, 206. http://dx.doi.org/10.5539/gjhs.v6n3p206
Muninarayana, C., Balachandra, G., Hiremath, S., Iyengar, K.
and Anil, N. (2010) Prevalence and Awareness Regarding Diabetes
Mellitus in Rural Tamaka, Kolar. International
Journal of Diabetes in Developing Countries, 30, 18. http://dx.doi.org/10.4103/0973-3930.60005
Mbanya, J.C. and Sobngwi, E.
(2003) Diabetes
in Africa. Diabetes Microvascular and Macrovascular Disease in Africa. Journal of Cardiovascular Risk, 2, 97-102. http://dx.doi.org/10.1177/174182670301000204
Noubiap, J.J.N., Naidoo,
J. and Kengne, A.P. (2015) Diabetic
Nephropathy in Africa: A Systematic Review. World
Journal of Diabetes, 6, 759-773. http://dx.doi.org/10.4239/wjd.v6.i5.759
Kengne, A.P., Sobngwi, E., Echouffo-Tcheugui, J.B.
and Mbanya, J.C. (2013) New Insights on Diabetes Mellitus and Obesity in
Africa—Part 2: Prevention, Screening and Economic Burden. Heart, 99, 1072-1077. http://dx.doi.org/10.1136/heartjnl-2013-303773
Tesfaye, S.,
Stevens, L.,
Stephenson, J., et al., on Behalf of the EURODIAB IDDM Study Group (1996) The
Prevalence of Diabetic Neuropathy and Its Relation to Glycaemic Control and Potential
Risk Factors: The EURODIAB IDDM Complications Study. Diabetologia, 39, 1377-1384. http://dx.doi.org/10.1007/s001250050586
Dyck, P.J., Kratz, K.M., Karnes, J.L., et al. (1993)
The Prevalence by Staged Severity of Various Types of Diabetic Neuropathy,
Retinopathy, and Nephropathy in a Population-Based Cohort: The Rochester Diabetic
Neuropathy Study. Neurology, 43, 817-824. http://dx.doi.org/10.1212/WNL.43.4.817
Bos, M.
and Agyemang, C. (2013)
Prevalence and Complications of Diabetes Mellitus in Northern Africa, a Systematic
Review. BMC Public Health, 13, 387. http://dx.doi.org/10.1186/1471-2458-13-387
Palmer, J.P.,
Fleming, G.A.,
Greenbaum, C.J., et al. (2004) C-Peptide Is the Appropriate Outcome Measure
for Type 1 Diabetes Clinical Trials to Preserve Beta-Cell Function: Report of
an ADA Workshop, 21-22 October 2001. Diabetes,
53, 250-264.
Gross, J.L.,
de Azevedo, M.J.,
Silveiro, S.P.,
Canani, L.H.,
Caramori, M.L. and Zelmanovitz, T. (2005) Diabetic Nephropathy: Diagnosis, Prevention,
and Treatment. Diabetes Care, 28, 164-176.
Sari, R. and Balci, M.K. (2005) Relationship between C Peptide and Chronic
Complications in Type-2 Diabetes Mellitus. Journal
of the National Medical Association, 97, 1113-1118.
Lev-Ran, A., Hwang, D., Barseghian, G.
and Hill, L.R. (1986)
Control of Noninsulin Dependent Diabetes Is Not Correlated with Endogenous
Insulin Secretion. Diabetes
& Metabolism, 12, 325-328.
Johansson, J., Ekberg, K., Shafqat, J., et al. (2002)
Molecular Effects of Proinsulin C-Peptide. Biochemical
and Biophysical Research Communications, 295, 1035-1040. http://dx.doi.org/10.1016/S0006-291X(02)00721-0
Hills, C.E.,
Brunskill, N.J. and Squires, P.E. (2010)
C-Peptide as a Therapeutic Tool in Diabetic Nephropathy. American Journal of Nephrology, 31, 389-397. http://dx.doi.org/10.1159/000289864
Michaud, D.S.,
Wolpin, B.,
Giovannucci, E.,
Liu, S.,
Cochrane, B.,
Manson, J.E.,
Pollak, M.N.,
Ma, J. and Fuchs, C.S. (2007)
Prediagnostic Plasma C-Peptide and Pancreatic Cancer Risk in Men and Women. Cancer
Epidemiology, Biomarkers &
Prevention, 16, 2101. http://dx.doi.org/10.1158/1055-9965.EPI-07-0182
Ma, J.,
Giovannucci, E.,
Pollak, M.,
Leavitt, A.,
Tao, Y.,
Gaziano, J.M. and Stampfer, M.J. (2004) A Prospective Study of Plasma C-Peptide and
Colorectal Cancer Risk in Men. Journal of
the National Cancer Institute, 96, 546-553. http://dx.doi.org/10.1093/jnci/djh082
Patel, N.,
Taveira, T.H.,
Choudhary, G.,
Whitlatch, H. and Wu, W.-C. (2012) Fasting Serum C-Peptide Levels Predict Cardiovascular and Overall Death
in Nondiabetic Adults. Journal of the
American Heart Association, 1, e003152. http://dx.doi.org/10.1161/jaha.112.003152
Elmahdi, E.M.,
Kaballo, A.M. and Mukhtar, E.A. (1991)
Features of Non-Insulin-Dependent Diabetes Mellitus (NIDDM) in the Sudan. Diabetes Research and Clinical Practice,
11, 59-63. http://dx.doi.org/10.1016/0168-8227(91)90142-Z
Suzuki, K.,
Watanabe, K.,
Motegi, T. and Kajinuma, H. (1989)
High Prevalence of Proliferative Retinopathy in Diabetic Patients with Low
Pancreatic B-Cell Capacity. Diabetes
Research and Clinical Practice, 6, 45-52. http://dx.doi.org/10.1016/0168-8227(89)90056-9
Inukai, T., Matsutoma, R., Tayama, K., Aso, Y. and Takemura, Y. (1999) Relation between the Serum Level of C Peptide
and Risk Factors for Coronary Heart Disease and Diabetic Microangiopathy in Patients
with Type-2 Diabetes Mellitus. Experimental
and Clinical Endocrinology & Diabetes, 107, 40-45. http://dx.doi.org/10.1055/s-0029-1212071
Madsbad, S., Laurtzen, E., Faber, O.K. and
Binder, C. (1986)
The Effect of Residual Beta-Cell Function on the Development of Diabetic
Retinopathy. Diabetic Medicine, 3, 42-45. http://dx.doi.org/10.1111/j.1464-5491.1986.tb00704.x
Kim, B.-Y., Jung,
C.-H.,
Mok, J.-O., Kang, S.-K. and Kim, C.-H. (2012)
Association between Serum C-Peptide Levels and Chronic Microvascular
Complications in Korean Type 2 Diabetic Patients. Acta Diabetologica, 49, 9-15. http://dx.doi.org/10.1007/s00592-010-0249-6
Nilsson, P.,
Lundgren, H.,
Soderstrom, M.,
Fagerstrom, K.O. and Nilsson-Ehle, P. (1996) Effects of Smoking Cessation on Insulin and
Cardiovascular Risk Factors—A Controlled Study of 4 Months’
Duration. Journal of Internal Medicine, 240, 189-194. http://dx.doi.org/10.1046/j.1365-2796.1996.16844000.x