C-peptide level concomitant with hypoglycemia gives better performances than insulin for the diagnosis of endogenous hyperinsulinism: a single-center study of 159 fasting trials
Authors' conclusion
A C-peptide level 0.3 nmol/L concomitant with a hypoglycemia <2.3 mmol/L appears as the best criterion to make the diagnosis of endogenous hyperinsulinism. Insulin level can be underestimated on hemolyzed blood samples, frequently observed in fasting trial, and thus shows lower diagnostic performances.
Study context
- Population
- All patients who performed a fasting trial in Cochin Hospital Endocrinology Department, February 2012–August 2022; 26 with and 133 without endogenous hyperinsulinism26 with, 133 without EH
- Participants
- 159 patients
- Comparison
- C-peptide vs insulin vs glycemia nadir cutoffs for diagnosis of endogenous hyperinsulinism
- Outcome
- Optimized diagnostic cutoffs of glycemia, insulin and C-peptide for endogenous hyperinsulinism
Methodological detailssingle-centre, retrospective
- Single-centre
- Retrospective
Performance
As reported in the abstract
Diagnostic performance (ROC) for endogenous hyperinsulinism · fasting trial
| Test or model | Cutoff | Sensitivity | Specificity |
|---|---|---|---|
| Glycemia nadir | 2.3 mmol/L | 100% | 81% |
| Insulin | 3.1 mUI/L | 96% | 92% |
| C-peptide | 0.30 nmol/L | 96% | 100% |
Cutoff
Glycemia nadir2.3 mmol/L
Insulin3.1 mUI/L
C-peptide0.30 nmol/L
Sensitivity
Glycemia nadir100%
Insulin96%
C-peptide96%
Specificity
Glycemia nadir81%
Insulin92%
C-peptide100%
Further findings
Insulin/glycemia and C-peptide/glycemia ratios at glycemia nadir
- Ratios did not show better diagnostic performances than C-peptide alone
Original publication
C-peptide level concomitant with hypoglycemia gives better performances than insulin for the diagnosis of endogenous hyperinsulinism: a single-center study of 159 fasting trials. Eur J Endocrinol. Published 9 February 2023. doi:10.
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