Severity of liver echogenicity is correlated to serum c-peptide levels in type 2 diabetic patients

To investigate the correlation between liver echogenicity and serum C-peptide levels in type 2 diabetic patients treated with oral hypoglycaemic agents.

The study included 231 type 2 diabetic patients (114 men) with a mean age of 64.3 +/- 6.9 years and a mean diabetes duration of 8.5 +/- 3.2 years. Liver echogenicity was graded by ultrasound examination as follows: Grade 0 (normal liver texture), grade 1 (slight increase of liver echogenicity), grade 2 (moderate increase of liver echogenicity with impaired visualization of intrahepatic vessels and right hemi-diaphragm), grade 3 (marked increase of liver echogenicity with very poor visualization or non-visualization of intrahepatic vessels and right hemi-diaphragm). Serum C-peptide was measured both in fasting state (Fasting C-peptide, FCP) and after glucagon administration (Glucagon-stimulated C-peptide, GCP).

FCP (median; interquartile range) showed a significant difference (p=0.041) between patients with grade 0 (1.9 ng/dl; 1.1-2.7 ng/dl),grade 1 (2.7 ng/dl; 1.9-3.7 ng/dl), grade 2 (4.1 ng/dl; 2.6-5.1 ng/dl) and grade 3 (6.2 ng/dl; 4.6-7.5 ng/dl) liver echogenicity. GCP (median; interquartile range) also differed significantly (p=0.04) between patients with grade 0 (2.6 ng/dl; 1.8-3.3 ng/dl), grade 1 (4.3 ng/dl; 3.3-5 ng/dl), grade 2 (5.8 ng/dl; 4.6-6.9 ng/dl) and grade 3 (8.3 ng/dl; 6.6-9.5 ng/dl) liver echogenicity. In multiple regression analysis, both FCP and GCP showed significant (p < 0.05) positive correlations with waist circumference, triglycerides, WHR and liver echogenicity.

In type 2 diabetic patients treated with oral hypoglycaemic agents, liver echogenicity shows a significant positive correlation with serum C-peptide levels, both in fasting state and after glucagon administration.