European Journal of Epidemiology

, Volume 28, Issue 9, pp 771–774 | Cite as

Serum C-peptide levels as an independent predictor of diabetes mellitus mortality in non-diabetic individuals

  • Jin-Young Min
  • Kyoung-Bok Min
Letter to the Editor

Connecting-peptide (C-peptide), a byproduct of proinsulin, is co-secreted with insulin in equimolar amounts from pancreatic β cells. Insulin is extracted by the liver and has a half-life of 3–5 min, whereas C-peptide is subjected to negligible first-pass metabolism by the liver and has a twofold to fivefold longer half-life than insulin and therefore, serves as a surrogate for endogenous insulin secretion [1]. C-peptide has been considered biologically inert and only clinically useful for identifying type 1 and type 2 diabetes mellitus [1].

However, accumulating evidence supports a potential role for C-peptide as a bioactive peptide. In type 1 diabetic patients or animals, C-peptide administration improves many complications, such as neuropathy, nephropathy, and microvascular function [2, 3], indicating a beneficial effect of high C-peptide levels on diabetes-induced complications. On the other hand, in subjects with type 2 diabetes or with normal glucose tolerance, elevated C-peptide...


Normal Glucose Tolerance Diabetes Mortality Estimate Insulin Resistance Link Mortality File Baseline Insulin Resistance 
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We thank members of the National Center for Health Statistics (NCHS) of the Centers for Disease Control (CDC) and Prevention and the participants who enrolled in the study. This work was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (Grant Number, 2012R1A1A3017058).

Conflict of interest



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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.Department of Epidemiology, Institute of Health and EnvironmentSeoul National UniversitySeoulRepublic of Korea
  2. 2.Department of Occupational and Environmental MedicineAjou University School of MedicineSuwonRepublic of Korea

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