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C-peptide Predicts the Remission of Type 2 Diabetes After Bariatric Surgery

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Abstract

Background

C-peptide is a surrogate of the pancreatic beta cell mass. However, the clinical significance of C-peptide in a diabetic patient after bariatric surgery has not been studied clearly.

Methods

From February 2005 to January 2009, a total of 205 (124 females and 81 males) consecutive morbidly obese patients with type 2 diabetes mellitus (T2DM) enrolled in a surgically supervised weight loss program with at least 1 year follow-up were examined. Among them, 147 patients (71.7%) received gastric bypass procedures, while the other 58 patients (28.3%) received restrictive-type procedures.

Results

The mean C-peptide before the surgery was 5.3 ± 3.5 ng/ml. One hundred nineteen patients (58.0%) had an elevated C-peptide (>4 ng/ml), while 2 patients (1.0%) had a low C-peptide (<1.0 ng/ml). Multivariate analysis confirmed that waist circumference, triglycerides, and HbA1c were the independent predictors for the elevation of C-peptide. It was observed that the mean C-peptide levels decreased to 1.7 ± 0.9 ng/ml 1 year after bariatric surgery with a mean reduction of 64.1%. One year after surgery, 160 patients (78.0%) out of a total of 205 patients had a remission of their T2DM. Patients in the bypass group had a higher diabetes remission rate (91.2%; 134 out of 147) in comparison to patients in the restrictive group (44.8%; 26 out of 58, p < 0.001). The diabetes remission rates for those with preoperative C-peptide <3, 3–6, and > 6 ng/ml were 26 out of 47 (55.3%), 87 out of 108 (82.0%), and 47 out of 52 (90.3%), p < 0.001, respectively.

Conclusions

Baseline C-peptide is commonly elevated in morbidly obese patients with T2DM. There was a marked reduction in C-peptide after a significant weight reduction 1 year after surgery with a T2DM remission rate of 78.0%. Thus, bariatric surgery is recommended for obesity-related T2DM patients with elevated C-peptide.

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Acknowledgments

This work was supported by the grant from Ming-Shen General Hospital (97-A-01).

Conflicts of Interest

No other conflicts of interest relevant to this article were reported.

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Correspondence to Wei-Jei Lee.

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Lee, WJ., Chong, K., Ser, KH. et al. C-peptide Predicts the Remission of Type 2 Diabetes After Bariatric Surgery. OBES SURG 22, 293–298 (2012). https://doi.org/10.1007/s11695-011-0565-0

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