Urinary C-Peptide to Creatinine Ratio (UCPCR) as Indicator for Metabolic Risk in Apparently Healthy Adults-A BioPersMed Cohort Study

Background: C-peptide is produced in equimolar amounts with insulin frompancreatic beta cells, and thus is a fundamental biomarker for beta cell function. A non-invasive urinary C-peptide-to-creatinine ratio (UCPCR) has attracted attention as a biomarker formetabolic conditions. However, the UCPCR as an indicative risk predictor for prediabetes is still being investigated. Methods: We aimed to characterize UCPCRs in healthy people using American Diabetes Association (ADA) criteria and to evaluate theirmetabolic outcomes over time. A total of 1022 participants of the Biomarkers in Personalized Medicine cohort (BioPersMed) were screened for this study. Totals of 317 healthy with normal glucose metabolism, 87 prediabetic, and 43 diabetic subjects were included. Results: Prediabetic participants had a significantly higher UCPCR median value than healthy participants (p < 0.05). Dysglycaemia of healthy baseline participants was measured twice over 4.5 +/- 0.9 years; 25% and 30% were detected with prediabetes during follow-ups, predicted by UCPCR both for the first (p < 0.05) and the second visit (p < 0.05), respectively. This is in good agreementwith the negative predictiveUCPCR value of 60.2% based on logistic regression. UCPCR levelswere equal in both sexes. Conclusion: UCPCRmeasurements provide an indicative approach formetabolic risk, representing a potential use for prevention andmonitoring of impaired glucosemetabolism.

Automated summary

The urinary C-peptide-to-creatinine ratio (UCPCR) is a useful biomarker for predicting the risk of prediabetes. Higher UCPCR values in healthy individuals are associated with an increased likelihood of developing prediabetes. During follow-up, UCPCR values can predict the occurrence of prediabetes.