Relationship Between C-peptide Levels And Atrial Fibrillation In Type 2 Diabetes

BackgroundAtrial fibrillation is one of the common clinical arrhythmias.Atrial fibrillation is the main cause of systemic arterial vascular embolism and acute heart failure.The mechanism of atrial fibrillation is still unclear,and is related to advanced age,cardiac structural remodeling,oxidative stress,autonomic neuropathy,and microRNA.With the change of social lifestyle and the age of population aging,the number of people suffering from atrial fibrillation may increase rapidly,so early identification of risk factors for atrial fibrillation will benefit more patients.Meta-analysis shows that type 2 diabetes mellitus(T2DM)is one of the independent risk factors for atrial fibrillation,which may be related to metabolic syndrome,oxidative stress and sympathetic activation,The incidence of T2 DM complicated with atrial fibrillation is about 34.%.C-peptide,also known as connecting peptide(CP),is a 31-amino acid peptide hormone,which is composed of insulin and insulin,and the secretion of C-peptide and insulin in blood is parallel and is not affected by exogenous insulin.The C-peptide is determined to reflect the secretory function of islet B cells.In recent years,studies have found that C-peptide has anti-oxidative stress,anti-apoptosis,improvement of autonomic function,reduction of glomerular filtration rate and promotion of sugar utilization.There is a common mechanism between the role of learning and the occurrence and development of atrial fibrillation.Therefore,it is suggested that C peptide may be involved in the hypothesis of the occurrence and development of atrial fibrillation in patients with T2 DM.At present,there are few studies on the relationship between the occurrence of atrial fibrillation and the metabolic marker C peptide in patients with type 2 diabetes mellitus.To determine the association between the two and to explore more risk factors for T2 DM complicated with atrial fibrillation,the following studies were conducted.ObjectiveTo study the changes of C-peptide level in diabetes with atrial fibrillation,to explore initially whether there is a correlation between C-peptide and atrial fibrillation,and to find more influencing factors for T2 DM combined with atrial fibrillation.MethodsThe patients diagnosed with type 2 diabetes mellitus in the Department of Internal Medicine at the First Affiliated Hospital of Zhengzhou University from January 2016 to January 2018 were selected in accordance with the diagnostic and classification criteria proposed by the WHO General Diabetes Expert Committee(2005)and excluded from hypertension and severe illness.Anemia,congenital heart disease,dilated cardiomyopathy,valvular heart disease,hyperthyroidism or hypothyroidism,severe hepatic and renal insufficiency,coronary atherosclerotic heart disease,coronary artery bypass graft(coronary artery bypass graft,CABG)and so on were selected in 107 cases.According to whether or not concurrent atrial fibrillation,the selected patients were divided into atrial fibrillation group(n=27cases)and type 2 diabetes non-atrial fibrillation group(n=80cases).Patients who meet the criteria are continuously included and baseline clinical data of the patients are recorded: basic information,laboratory tests,and other auxiliary examinations,and data analysis is performed on the basis of statistical knowledge.Result1.The age of atrial fibrillation group was higher than that of non-atrial fibrillation group,the difference was statistically significant(P=0.017).There was no significant difference in the duration of diabetes,male-female ratio and body mass index between the two groups(P>0.05).The t-test of two independent samples showed that there were no significant differences between the two groups of fasting C-peptide,2-hour C-peptide,C-peptide difference,fasting blood glucose,uric acid,cholesterol,triglyceride,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol.P>0.05;there was significant difference between the two groups in glycosylated hemoglobin and serum total bilirubin;the difference of ventricular septum,left atrial diameter,left ventricular diameter,left ventricular end-diastolic volume,and left ventricular end-systolic volume was statistically significant.Significance,above P<0.05.2.Different fasting C-peptide levels are not the same as the probability of atrial fibrillation.Fasting C-peptide,2-hour C-peptide was positively correlated with body mass index and uric acid,P<0.05;fasting C-peptide,2-hour C-peptide was negatively correlated with glycosylated hemoglobin,P<0.05,and fasting C-peptide was negatively correlated with HDL-C.3.In patients with type 2 diabetes,the risk of atrial fibrillation increased with the increase of left atrial diameter,P<0.05.The fasting C-peptide concentration,2-hour C-peptide and C-peptide difference were not risk factors for atrial fibrillation,P>0.05.ConclusionThis study concluded that C-peptide may not be a risk factor or a protective factor for T2 DM complicated with atrial fibrillation.The biological role of C-peptide needs further study;Obvious reconstruction of left heart tissue is an pathological change of T2 DM complicated with atrial fibrillation,the increase of left atrial diameter is an independent risk factor for T2 DM complicated with atrial fibrillation.