2023年 · 第103卷第15期

C-peptide and insulin are derived from the same precursor, and the function of pancreatic beta cells is often assessed using blood levels of C-peptide. Recent studies have suggested that C-peptide has biological activity, can alleviate hyperglycemia-induced inflammation and reduce the risk of diabetic complications, and has been regarded as a therapeutic strategy to prevent type 1 diabetic vascular disease. However, some studies have shown that elevated C-peptide levels can increase the risk of arteriosclerosis and cardiovascular death in patients with type 2 diabetes and non-diabetic adult populations. The association of C-peptide with cardiovascular disease is not clear and remains controversial. Therefore, the study conducted a two-phase study for patients with a history of type 2 diabetes and people without a history of diabetes. The first phase was a cross-sectional study to analyze the correlation between C peptide levels and cardiovascular markers high-sensitivity troponin T (cTnT) and high-sensitivity C-reactive protein (hs-CRP); The second phase was a retrospective cohort study to analyze the association of C-peptide levels with cardiovascular events. The study used the LOESS method to analyze the optimal cutoff value for C-peptide levels and restriction cubic splines to analyze the hazard ratio for C-peptide. In order to exclude the influence of confounding factors such as insulin and blood glucose levels, the study further used sensitivity analysis for subjects with different levels of blood glucose metabolism and different levels of insulin resistance.

Prolactinoma is the most common pituitary adenoma, mainly occurring in women of childbearing age, and one of its clinical manifestations is abnormal bone metabolism. In previous studies, dual-energy X-ray absorptiometry (DXA) has been used to determine the area bone density (aBMD), but this method can only provide two-dimensional information of bone quality. While high-resolution peripheral quantitative computed tomography (HR-pQCT) provides non-invasive assessment of three-dimensional bone microstructure while providing quantitative information missing from DXA. To evaluate the three-dimensional bone microstructure of patients with prolactinoma and explore its influencing factors, this study enrolled 31 patients with prolactinoma (7 males and 24 females) who attended Peking Union Medical College Hospital from May 2019 to January 2020, and measured multiple bone microstructural parameters of the distal radius and distal tibia and calculated Z-scores by the second-generation HR-pQCT system; Among them, 19 patients also used DXA method to measure the aBMD of lumbar spine and femoral neck; At the same time, for each patient, two healthy subjects with matching age and sex were selected.