Diabetes, Vol 39, Issue 11 1445-1450, Copyright © 1990 by American Diabetes Association
Wisconsin Epidemiologic Study of Diabetic Retinopathy. XII. Relationship of C-peptide and diabetic retinopathy
R Klein, SE Moss, BE Klein, MD Davis and DL DeMets
Department of Ophthalmology, University of Wisconsin School of Medicine, Madison.
The relationship between plasma C-peptide and the frequency and severity of
diabetic retinopathy was examined in a population-based study in Wisconsin
in 1984-1986. Individuals with younger- (n = 835) and older- (n = 940)
onset diabetes were included. C-peptide was measured by radioimmunoassay
with Heding's M1230 antiserum. Retinopathy was determined from stereoscopic
fundus photographs. The highest frequencies and most severe retinopathy
were found in insulin-using individuals with undetectable or low plasma
C-peptide (less than 0.3 nM), whereas the lowest frequencies of retinopathy
were found in older-onset overweight individuals not using insulin. In
older-onset individuals using insulin, having no detectable C-peptide was
significantly associated with the presence of proliferative retinopathy.
Otherwise, within each group (younger onset using insulin, older onset
using insulin, and older onset not using insulin), after controlling for
other characteristics associated with retinopathy, there was no
relationship between higher levels of C-peptide and lower frequency of or
less severe retinopathy.