C-Peptide in the Vessel Wall

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Abstract
The Review of Diabetic Studies,2009,6,3,180-186.
Published:November 2009
Type:Review Article
Authors:
Author(s) affiliations:

Daniel Walcher1 and Nikolaus Marx2

1Department of Internal Medicine II, Cardiology, University of Ulm, Germany.

2Department of Internal Medicine I, Cardiology, University of Aachen, Germany.

Abstract:

Patients with insulin resistance and early type 2 diabetes exhibit an increased sensitivity to develop a diffuse and extensive pattern of arteriosclerosis leading to a remarkable increase in vascular complications, including myocardial infarction and stroke. The accelerated atherosclerosis in these patients is likely to be multifactorial. In this review, we introduce the new hypothesis that C-peptide could play a role as a mediator of lesion development. Patients with type 2 diabetes show increased levels of the proinsulin cleavage product C-peptide, and in the past few years, various groups have examined the effect of C-peptide in vascular cells as well as its potential role in lesion development. Recent data suggest that C-peptide deposits in the vessel wall could promote the recruitment of monocytes and CD4-positive lymphocytes in early arteriosclerotic lesions. Furthermore, C-peptide induces proliferation of vascular smooth muscle cells, a critical step in atherogenesis and restenosis formation. The present review summarizes this new pathophysiological aspect and discusses the potential relevance for lesion development.