Preserved C-peptide secretion in patients with type 1 diabetes and incipient chronic complications is associated with lo
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RESEARCH ARTICLE
Preserved C-peptide secretion in patients with type 1 diabetes and incipient chronic complications is associated with lower serum resistin and higher uric acid levels Tomislav Bulum 1,2 & Martina Tomić 1 & Sandra Vučković-Rebrina 1 & Vinko Roso 1 & Marijana Vučić Lovrenčić 3 & Lea Duvnjak 1,2 Received: 2 April 2020 / Accepted: 24 August 2020 # Springer Nature Switzerland AG 2020
Abstract Background and aims Previous studies suggested that long-term perseverance of beta-cell function in patients with type 1 diabetes (T1DM) is associated with lower incidence of microvascular complications. The objective of this study was to evaluate preserved C-peptide secretion in patients with T1DM without overt chronic complications and to explore associations with resistin and uric acid as biomarkers of microvascular complication pathogenesis. Materials and methods We assessed residual beta-cell function in 164 T1DM patients (male/female = 91/73; age/diabetes duration range = 18–70/1–30 years) using an ultrasensitive C-peptide ELISA assay with detection limit of 2.5 pmol/L and total coefficient of variation (CV) 5,8% (Mercodia, Sweden). Serum level of uric acid was measured by enzymatic method (AU680, Beckman Coulter, USA) while resistin concentration was determined by the ELISA assay (Biovendor, Czech Republic). Results C-peptide secretors had shorter diabetes duration (5.1 vs. 16 years; p < 0,001), lower resistin (4.53 vs. 4.93 mg/mL p = 0.045), and higher uric acid (259 vs 238 μmol/L, p = 0.048) level than T1DM patients with no detectable C-peptide levels, while no differences in routine anthropometric and laboratory variables, including HbA1c, were observed. Although the proportion of C-peptide secretors significantly decreased across categories of diabetes duration (70%, 38%, 17% and 15% for 30 < 300 mg/24 h, the first degree of peripheral neuropathy without vegetative neuropathy), all complications stationary at least three months before entering the study. Serum level of uric acid was measured by the enzymatic method (AU680, Beckman Coulter, USA) while resistin concentration was determined by the ELISA assay (Biovendor, Czech Republic). The C-peptide level was determined using an ultrasensitive C-peptide ELISA assay with a detection limit of 2.5 pmol/L and total coefficient of variation (CV) 5,8% (Mercodia, Sweden). Data are expressed as means ± SD for normally distributed values, as median with range for non-normally distributed values, and percentage. Patients were divided into two groups according to detectable C-peptide levels. Differences between groups were examined, depending on the nature of the data,
using parametric (t-test) or nonparametric tests (MannWhitney). Chi-square test was used to assess differences between categorical variables. The study protocol complied with the Declaration of Helsinki as well as with local institutional guidelines and was approved by the local ethics committees.
Results The characteristics of the study subjects are listed in Table 1. Mean/median values of majori
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