Chinese women with a history of gestational diabetes and a higher concentration of serum C-peptide are more likely to develop prediabetes and type 2 diabetes in the 5 years after delivery, according to findings published in the Journal of Diabetes and Its Complications.
“Our study suggested that elevated C-peptide levels may be a predictor of diabetes and prediabetes,” Gang Hu, MD, MPH, PhD, associate professor at the Chronic Disease Epidemiology Laboratory at Pennington Biomedical Research Center in Baton Rouge, Louisiana, told Endocrine Today. “We can use the C-peptide levels to screen high-risk people for diabetes and prediabetes.”
In a cross-sectional study, Hu and colleagues analyzed data from 1,263 women with a history of gestational diabetes at 1 to 5 years after delivery from the Tianjin Gestational Diabetes Mellitus Prevention Program, a randomized controlled trial conducted among women with gestational diabetes living in six urban districts in Tianjin, China. Pregnant women were enrolled for screenings for gestational diabetes between 1999 and 2008; included women had a final visit between August 2009 and July 2011. The cohort was stratified by four levels of serum C-peptide: 0% to 33%; 34% to 66%; 67% to 90% and at least 90%. Researchers used logistic regression analysis to assess the associations of C-peptide and the risk for developing prediabetes or type 2 diabetes.
Within the cohort, 401 (32%) developed prediabetes and 83 (6.6%) developed type 2 diabetes. Plasma C-peptide values for the cohort ranged from 0.2 mg/dL to 6.52 mg/dL (mean, 1.38 mg/dL).
Researchers found that women in the highest quartile of C-peptide concentration had nearly three times greater odds of developing prediabetes compared with those in the lowest quartile (OR = 2.91; 95% CI, 1.75-4.84) and four times greater odds for developing type 2 diabetes (OR = 4.06; 95% CI, 1.6-10.3) after adjusting for multiple factors, including age, years after delivery, family history of diabetes, energy intake and BMI. Results persisted after additional adjustment for fasting insulin (P for trend < .0001).
In restricted cubic spline models, researchers observed a positive, linear association between C-peptide as a continuous variable and the risks for prediabetes and type 2 diabetes, with results persisting when stratified by healthy weight and overweight participants. – by Regina Schaffer
The authors report no relevant financial disclosures.