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C-peptide predicts all-cause and cardiovascular death in a cohort of individuals with newly diagnosed type 2 diabetes. The Skaraborg diabetes register
Husensjo Hlth Care Ctr, Sweden; Lund Univ, Sweden.
Narhalsan Norrmalm Hlth Ctr, Sweden; Univ Gothenburg, Sweden.
Lund Univ, Sweden.
UNSW Sydney, Australia.
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2019 (English)In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 150, p. 174-183Article in journal (Refereed) Published
Abstract [en]

Aims

To study the association between baseline level of C-peptide and all-cause death, cardiovascular death and cardiovascular complications among persons with newly diagnosed type 2 diabetes.

Methods

The Skaraborg Diabetes Register contains data on baseline C-peptide concentrations among 398 persons <65 years with newly diagnosed type 2 diabetes 1996–1998. National registries were used to determine all-cause death, cardiovascular death and incidence of myocardial infarction and ischemic stroke until 31 December 2014. The association between baseline C-peptide and outcomes were evaluated with adjustment for multiple confounders by Cox regression analysis. Missing data were handled by multiple imputation.

Results

In the imputed and fully adjusted model there was a significant association between 1 nmol/l increase in C-peptide concentration and all-cause death (HR 2.20, 95% CI 1.49–3.25, p < 0.001, number of events = 104), underlying cardiovascular death (HR 2.69, 1.49–4.85, p = 0.001, n = 35) and the composite outcome of underlying cardiovascular death, myocardial infarction or ischemic stroke (HR 1.61, 1.06–2.45, p = 0.027, n = 90).

Conclusions

Elevated C-peptide levels at baseline in persons with newly diagnosed type 2 diabetes are associated with increased risk of all-cause and cardiovascular mortality. C-peptide might be used to identify persons at high risk of cardiovascular complications and premature death.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 150, p. 174-183
Keywords [en]
Type 2 diabetes mellitus; C-peptide; Mortality; Cardiovascular diseases; Cohort studies; Cause of death
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-157555DOI: 10.1016/j.diabres.2019.03.014ISI: 000467689500021PubMedID: 30878389Scopus ID: 2-s2.0-85063081718OAI: oai:DiVA.org:liu-157555DiVA, id: diva2:1328652
Note

Funding Agencies|Skaraborg Research and Development Council; Skaraborg Institute for Research and Development; Skaraborg Primary Care Research and Development Council; Swedish Society of Medicine; Skane County Councils Research and Development Foundation; Esther Olssons and Anna Jonssons Foundation; Gorthons Foundation; Swedish Heart and Lung Foundation; Medical Faculty of Lund University; Skane University Hospital; Novo Nordisk Foundation

Available from: 2019-06-22 Created: 2019-06-22 Last updated: 2019-06-25Bibliographically approved

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Rådholm, Karin

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