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Relationship between C peptide release level in arginine test and type 2 diabetes mellitus with asymptomatic peripheral neuropathy
Received:March 24, 2019  Revised:May 31, 2019  Click here to download the full text
Citation of this paper:张丽娥,常薪霞,卞 华,董继宏,颜红梅,夏明锋,李小英.Relationship between C peptide release level in arginine test and type 2 diabetes mellitus with asymptomatic peripheral neuropathy[J].Chinese Journal of Clinical Medicine,2019,26(4):513-517
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张丽娥,常薪霞,卞 华,董继宏,颜红梅,夏明锋,李小英 1.复旦大学附属中山医院内分泌科上海 2000322.内蒙古自治区巴彦淖尔市临河区妇幼保健院内科巴彦淖尔 0150003.复旦大学附属中山医院神经内科上海 200032 
Abstract:Objective:To investigate the value of C peptide release level in screrning and diagnosis of type 2 diabetes mellitus with asymptomatic diabetic peripheral neuropathy (DPN). Methods:A total of 600 cases of type 2 diabetic inpatients without neurological symptoms were enrolled from the Department of Endocrinology, Zhongshan Hospital from January to December, 2016. Each patient received complete history taking, physical examination, serum biochemical examination, arginine stimulation test, and electromyogram (EMG) examination. Results:Among the 600 cases of diabetic inpatients, 307 patients (51.2%) was diagnosed as asymptomatic DPN by EMG, among whom 173 cases (28.8%) had distal symmetric polyneuropathy (DSPN) and 134 cases (22.3%) had focal asymmetric DPN. Patients with asymptomatic DPN were older and had longer disease course and poorer glucose control. Arginine stimulated release of C peptide was significantly decreased in patients with asymptomatic DPN (P<0.05). Further analyses showed that reduction of C peptide level was an independent risk factor for asymmetric DSPN (P<0.01) but not for focal DPN. The area under the ROC curve for the combination of fasting C peptide with age, gender, course of diabetes, and HbA1c in diagnosing asymmetric DSPN was 0.758 (95%CI 0.720 to 0.792, P=0.032). Conclusions:Reduced arginine stimulated C peptide level is an independent risk factor for asymptomatic DSPN, and may indicate latent DSPN in type 2 diabetes patients.
keywords:type 2 diabetes  asymptomatic diabetic peripheral neuropathy  electromyogram  C peptide  arginine test
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