A recent study from Chinese researchers has shed light on the complex relationship between fasting C-peptide (FCP) levels and diabetic retinopathy (DR) in individuals with type 2 diabetes. According to findings from Dr. Jicai Ma and colleagues at Jilin University’s Second Hospital in Changchun, FCP demonstrates a non-linear association with DR risk, with a protective effect observed at lower concentrations, but an unclear role at higher levels.
The study, which analyzed data from 1,661 patients with type 2 diabetes, reveals that FCP levels below a threshold of 4.11 ng/mL are inversely related to DR risk. Specifically, for every 1 ng/mL increase in FCP below this threshold, the risk of developing DR was reduced by 24%. However, above this level, the researchers observed a non-significant trend suggesting a potential increased risk of DR, with no clear protective effect.
C-peptide, a byproduct of insulin secretion, serves as a marker for insulin production and β-cell health. Researchers explained that changes in FCP levels in patients with DR could reflect not only a decline in β-cell function but also the degree of insulin resistance, which plays a significant role in the development of diabetes-related complications.
The study revealed that the relationship between FCP and DR is not straightforward. While C-peptide has protective properties, such as preventing oxidative stress and maintaining endothelial cell integrity, excessive FCP may lead to adverse effects, potentially negating its protective role. This dual influence of C-peptide suggests that its effects on DR may be optimal within a specific range, beyond which it could contribute to further complications.
The researchers conclude that while FCP can reduce the risk of DR at lower levels, its role becomes ambiguous above the 4.11 ng/mL threshold. Further studies are needed to explore the intricate mechanisms behind this dual effect and to better understand how FCP levels influence DR progression in type 2 diabetes.
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