Relationship between c-peptide levels and mortality in diabetes mellitus patients

Objective:The C-peptide level is a substance that is produced at the same time as insulin, used as a marker of endogenous insulin secretion, and formed in the same way as insulin is synthesized. C-peptide is a good display for beta cell function. We aimed to retrospectively investigate the effect of c-peptide level on mortality in patients with diabetes mellitus. Methods: Diabetes patients who applied to the endocrinology outpatient clinic of the Dicle University Medical Faculty in 2012 were screened in the database and 1000 DM patients with c-peptide, LDL cholesterol, HbA1c, proteinuria, creatinine, creatinine clearance, urea and glucose levels measured during the initial admission were included in the study. Patients who did not study c-peptide levels were excluded. Patients were then categorized. Two main groups were divided into the dying and living patients. Deaths were grouped into vascular causes and deaths due to other causes. Results: 392 (39.2%) of the patients were male and 608 (60.8%) were female and the mean age was 57. Patients were divided into two groups: the patient group who died and the patient group who was living. The number of patients died was 146 (14.6%) and the number of living patients was 844 (75.4%). C-peptide levels were found to be higher in patients who died (3,5 ± 2,7 ng / ml) than those who survived (2,9 ± 1,7 ng / ml) and statistically significant (p = 0.018). The mean age (66 ± 11) years, insulin resistance (1,80 ± 0,2), urea level (54,4 ± 32,3 mg / dl), creatinine clearance rate (66,59 ± 29,19 ml / minute), proteinuria (105,6 ± 16,1 mg / dl) was detected. In living patients, the mean age was 56 ± 13 years, insulin resistance (1,7 ± 0,19), urea level (34,02 ± 17,8 mg / dl) creatinine clearance (92,90 ± 16,77 ml / (36.3 ± 73.9 mg / dl) was detected. In the univariate analysis between the living and the dying patients; (P <0.05, OR = 1.135), proteinuria (p <0.01, OR = 1.005), glucose (p <0.01, OR = 1.002), urea (p <0.01, OR = 1.032) 0.01, OR = 1.070) and C-peptide homo-IR (p <0.01, OR = 3.174) were found to be statistically significant. The level of creatinine clearance (p <0.01, OR = 0.996) was statistically significant. Multivariate analysis showed statistically significant increases in urea (p <0.01, OR = 1.025) and age (p <0.01, OR = 1.056). In a univariate analysis of patients who died of vascular causes and other patients who were included in the study, urea (p <0.01, OR = 1.026) and age (p <0.01, OR = 1.073) were statistically significant. Low creatinine clearance (p <0.01, OR = 0.972) was statistically significant. In multivariate analysis, the elevation of urea (p <0.01, OR = 1.039) was statistically significant. Univariate analysis between patients who died for other reasons and other patients who were included in the study; (p <0.05, OR = 1.129), creatinine (p = 0.023, OR = 1.063), OR = 1.022), age (p <0.01, OR = 1.056), c-peptide homo-IR , OR = 3.049), and the height was statistically significant. Low creatinine clearance (p <0.01, OR = 0.971) was statistically significant. In multivariate analysis, proteinuria (p <0.01, OR = 1.007) was statistically significant Conclusion: C-peptide level was higher in mortality group. However, this was not statistically significant. Our study suggests that mortality of c-peptide level is not an effective parameter for predicting. Key words: Diabetes mellitus, c-peptide, mortality