Association of serum C-peptide with all-cause and cardiovascular disease mortality in ultrasound-defined nonalcoholic fatty liver disease |
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| Institution: | 1. Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Shushan District, Hefei, Anhui, China,;2. Department of Gastroenterology, Traditional Chinese Medical Hospital of Taihe Country, No 59, Tuanjie West Road, Taihe County, Fuyang 236600, Anhui Province, China;1. CHU Rennes, Univ Rennes, F-35000 Rennes, France;2. Department of Public Health, University Hospital of Pontchaillou, Rennes, France;3. CHU Rennes, Univ Rennes, INSERM, CIC1414, Institut NUMECAN (Nutrition Metabolism and Cancer), F-35000 Rennes, France;4. CHU Rennes, Paediatric unit, Hôpital Sud, Rennes, France;5. Observatoire Regional De Santé Bretagne, Rennes, France;6. CHU Brest, Univ Brest, F-29000 Brest, France;1. Department of Infectious Diseases, Affiliated Hospital of Weifang Medical University, Weifang 261031 Shandong, China;2. Imaging Center, Affiliated Hospital of Weifang Medical University, Weifang 261031 Shandong, China;1. Institut Curie, Versailles Saint-Quentin University - Paris Saclay University, Saint-Cloud, France;2. Institut Mutualiste Montsouris, Paris-Saclay University, Paris, France;3. Department of Gastroenterology, Rennes University Hospital, University of Rennes 1, INSERM Unité 1242, Rennes, France;4. BresMed Health Solutions Pvt. Ltd., India;5. Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France, Bourgogne Franche-Comté University, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France;1. Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, Universidade de Passo Fundo (UPF), Passo Fundo-RS, Brazil;2. Departamento de Estatística, Universidade Federal do Rio Grande do Sul, Porto Alegre-RS, Brazil;3. Faculdade de Medicina, UPF, Passo Fundo, Brazil;4. Clínica EndoDiagnóstico, Passo Fundo, Brazil;5. Clínica Endopasso, Passo Fundo, Brazil;1. Department of Emergency Medicine, the Second Affiliated Hospital and Yuying Children''s Hospital of Wenzhou Medical University, Wenzhou, China;2. Department of Anorectal Surgery, The Second Affiliated Hospital and Yuying Children''s Hospital of Wenzhou Medical University, Wenzhou, China;3. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;4. Department of Gastrointestinal Surgery, Shanghai Tenth People''s Hospital Affiliated to Tongji University, Shanghai, China |
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| Abstract: | ObjectiveTo determine the prognostic value of C-peptide in long-term nonalcoholic fatty liver disease (NAFLD) mortality.MethodsA total of 4670 participants with NAFLD were enrolled in this study. Multivariable Cox regression models evaluated the links between C-peptide levels and all-cause and cardiovascular disease (CVD) mortality risk using adjusted hazard ratios (aHR). In addition, a two?piecewise Cox model with penalized splines was adapted to investigate the nonlinear relationships between C-peptide and mortality.ResultsAfter a mean follow?up period of 20 years, 1714 deaths from all causes were recorded. In an adjusted Cox regression analysis, using the low C-peptide group as the reference (quartile 1), higher C-peptide (quartile 4) was notably associated with increased all-cause mortality (aHR =1.39; 95% CI: 1.18–1.65) and CVD death (aHR = 1.97; 95% CI: 1.41–2.76). Spline analyses demonstrated that the association between C-peptide levels and all-cause mortality was U-shaped, with a threshold value of 0.41 nmol/L. Below the threshold, every one-unit increment in C-peptide had a 70% reduced risk of all-cause death (aHR = 0.30, 95% CI: 0.1–0.7). Above the threshold, the C-peptide levels were associated with a higher probability of all-cause death (aHR = 1. 3, 95% CI:1.2–1.4).ConclusionsIn the US NAFLD population defined by ultrasound, a U-shaped association was detected between baseline serum C-peptide level and all-cause mortality. |
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