Inverse relationship between glomerular hyperfiltration and C-peptide level in Type 1 diabetes


Background: Increased glomerular filtration rate (GFR) commonly develops in early diabetes and is closely correlated with the development of diabetic nephropathy. Objective: The aim was to study the relationship between GFR, C-peptide level and other parameters at diagnosis of Type 1 diabetes. Methods: We determined GFR, Cpeptide level, glycated hemoglobin (HbA1c), body mass index (BMI) SDS and loss of weight at diagnosis of Type 1 diabetes in 495 children (231 females). Linear and multiple regression analysis was used to test for the associations between GFR and other parameters. Results: In the 495 patients, GFR median (interquartile range) was increased vs normal values (p = 0.0001). GFR was significantly negatively correlated with age (p < 0.001) and C-peptide level (p = 0.001), and positively correlated with weight loss (p = 0.02). The multiple regression analysis showed that age (p = 0.001) and C-peptide level (p = 0.05) were independently and negatively related to GFR. Conclusions: This study shows that, at onset of Type 1 diabetes, higher the GFR, younger the age and lower the C-peptide level are. The role of this hyperfiltration in the development of later nephropathy and the putative preventive effect of C-peptide administration need to be evaluated.

Share and Cite:

Messaaoui, A. , Tenoutasse, S. , Mélot, C. and Dorchy, H. (2014) Inverse relationship between glomerular hyperfiltration and C-peptide level in Type 1 diabetes. Journal of Diabetes Mellitus, 4, 50-53. doi: 10.4236/jdm.2014.41009.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Cambier, P. (1934) Application de la théorie de Rehberg à l’étude clinique des affections rénales et du diabète. Annals of Medicine, 35, 273-299.
[2] Dorchy, H. (2004) Screening for subclinical complications in young Type 1 diabetic patients: Experience acquired in Brussels. Pediatric Endocrinology Reviews, 1, 380-403.
[3] Morgensen, C.E. (1986) Early glomerular hyperfiltration in insulin-dependent diabetes and late nephropathy. Scandinavian Journal of Clinical & Laboratory Investigation, 46, 201-206.
[4] Rudberg, S., Persson, B. and Dahlquist, G. (1992) Increased glomerular filtration rate as a predictor of diabetic nephropathy-an 8-year prospective study. Kidney International, 41, 822-828.
[5] Morgensen, C. (1994) Glomerular hyperfiltration in human diabetes. Diabetes Care, 17, 770-775.
[6] Wojcikowski, C., Maier, V., Dominiak, K., Fussganger, R. and Pfeiffer, E. (1983) Effects of synthetic rat C-peptide in normal and diabetic rats. Diabetologia, 25, 288-290. BF00279945
[7] Nordquist, L., Brown, R., Fasching, A., Persson, P. and Palm, F. (2009) Proinsulin C-peptide reduces diabetesinduced glomerular hyperfiltration via efferent arteriole dilation and inhibition of tubular sodium reabsorption. Renal Physiology—American Journal of Physiology, 297, F1265-F1272.
[8] Russell, C., Bischoff, P., Kontzen, F., Rowel, K., Yester, M., Lloyd, L., Tauxe, W. and Dubovsky, E. (1985) Measurement of glomerular filtration rate: Single injection plasma clearance method without urine collection. Journal of Nuclear Medicine, 26, 1243-1247.
[9] Cole, T., Freeman, J. and Preece, M. (1990) Body mass index reference curves for the UK, 1990. Archives of Disease in Childhood, 73, 17-24.
[10] Couper, J., Hudson, I., Werther, G., Warne, G., Court, J. and Harrison, L. (1991) Factors predicting residual beta-cell function in the first year after diagnosis of childhood Type 1 diabetes. Diabetes Research and Clinical Practice, 11, 9-16.
[11] Christiansen, J., Frandsen, M. and Parving, H. (1981) Effect of intravenous glucose infusion on renal fuction in normal man and in insulin-dependent diabetics. Diabetologia, 21, 368-373.
[12] Skott, P., Vaag, A., Hother-Nielsen, O., Andersen, P., Bruun, N., Giese, J., Beck-Nielsen, H. and Parving, H. (1991) Effects of hyperglycemia on kidney function, atrial natriuretic factor and plasma rennin in patients with insulin-dependent diabetes mellitus. Scandinavian Journal of Clinical & Laboratory Investigation, 51, 715-727.
[13] Morgensen, C. and Anderson, M. (1975) Increased kidney size and glomerular filtration rate in untreated juvenile diabetes: Normalization by insulin treatment. Diabetologia, 11, 221-224.
[14] The DCCT/EDIC Research Group (2011) Intensive diabetes therapy and glomerular filtration rate in Type 1 diabetes. The New England Journal of Medicine, 365, 2366-2376. NEJMoa1111732
[15] Magee, G., Bilous, R., Cardwell, C., Hunter, S., Kee, F. and Fogarty, D. (2009) Is hyperfiltration associated with the future risk of developing diabetic nephropathy? A meta-analysis. Diabetologia, 52, 691-697.
[16] Johansson, B., Sjoberg, S. and Wahren, J. (1992) The influence of human C-peptide on renal function and glucose utilization in Type 1 (insulin-dependent) diabetic patients. Diabetologia, 35, 121-128.
[17] Nordquist, L. and Wahren, J. (2009) C-peptide: The missing link in diabetic nephropathy? The Review of Diabetic Studies, 6, 203-210.
[18] Johansson, B., Borg, K., Fernqvist-Forbes, E., Kernell, A., Odergren, T. and Wahren, J. (2000) Benefical effects of C-peptide on incipient nephropathy and neuropathy in patients with Type 1 diabetes mellitus. Diabetic Medicine, 17, 181-189. 00274.x
[19] Samnegard, B., Jacobson, S., Jaremko, G., Johansson, B. and Sjoquist, M. (2001) Effects of C-peptide on glomerular and renal size and renal function in diabetic rats. Kidney International, 60, 1258-1265.
[20] Nath, K., Kren, S. and Hostetter, T. (1986) Selective role of glomerular capillary pressure in progressive glomerular dysfunction. The Journal of Clinical Investigation, 78, 1199-1205.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.