Article ViewAbstractThe Review of Diabetic Studies,2009,6,3,180-186.DOI:10.1900/RDS.2009.6.180Published:November 2009Type:Review Article Authors:Daniel Walcher, and Nikolaus Marx 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. Keywords:Arteriosclerosis, C-peptide, Diabetes, Inflammation, Lipoprotein, Reactive oxygen species, Smooth muscle cell, Vascular cellView:RevDiabeticStud-6-3-180.pdf (188.08 KB) PDFClick here to download the PDF file. Images Potential role of C-peptide in early atherogenesis in patients with insulin resistance and early type 2 diabetes mellitus ‹ Anti-Inflammatory Properties of C-Peptide up The Beneficial Effects of C-Peptide on Diabetic Polyneuropathy ›