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Human C-peptide. Part II: Clinical studies

W Beischer, E Heinze, L Keller

    Klinische Wochenschrift
    |August 1, 1976
    PubMed
    Summary

    Human C-peptide (IMCP) is a more accurate measure of beta-cell secretion than insulin (IMI). IMCP levels in diabetic patients indicate varying degrees of beta-cell function, even in those treated with insulin.

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    Area of Science:

    • Endocrinology
    • Metabolic Research
    • Clinical Chemistry

    Background:

    • Human C-peptide, a byproduct of insulin synthesis, circulates in higher molar concentrations than insulin.
    • Assessing beta-cell function is crucial for managing diabetes and related metabolic disorders.
    • Existing methods for measuring insulin may not fully reflect endogenous insulin production.

    Purpose of the Study:

    • To evaluate human C-peptide as a superior indicator of beta-cell secretion compared to insulin.
    • To determine immunomeasurable C-peptide (IMCP) levels in healthy individuals and diabetic patients.
    • To investigate the dynamic response of IMCP and immuno-measurable insulin (IMI) to glucose stimulation.

    Main Methods:

    • Radioimmunoassay (RIA) was used to determine C-peptide and insulin levels in serum.
    • Gel filtration was employed to analyze the molecular weight and distribution of C-peptide and insulin.
    • Fasting serum samples and stimulated samples (intravenous glucose or glucose-glibenclamide) from healthy subjects and diabetic patients were analyzed.

    Main Results:

    • C-peptide (MW 3025) elutes before insulin (MW 5808) on gel filtration and exhibits higher molar concentrations in healthy subjects.
    • Average fasting IMCP in healthy subjects was 1.8 ng/ml, approximately fivefold higher than IMI on a molar basis.
    • IMCP and IMI responses to stimulation differed, suggesting distinct metabolic pathways.
    • In insulin-treated juvenile diabetics, IMCP levels were often undetectable or subnormal, with no post-breakfast rise.
    • Adult diabetics showed a range of IMCP levels, with impaired beta-cell stimulation response to glucose-glibenclamide.

    Conclusions:

    • Human C-peptide is a more reliable marker of beta-cell secretory activity than insulin in peripheral venous serum.
    • IMCP levels provide valuable insights into beta-cell function in various diabetic populations, including those on insulin therapy.
    • Differences in peripheral metabolism between C-peptide and insulin explain their distinct dynamic patterns during stimulation tests.

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