{"id":215,"date":"2025-06-11T12:28:31","date_gmt":"2025-06-11T12:28:31","guid":{"rendered":"https:\/\/analizesanocare.ro\/?post_type=product&#038;p=215"},"modified":"2025-08-08T13:57:39","modified_gmt":"2025-08-08T13:57:39","slug":"c-peptid","status":"publish","type":"product","link":"https:\/\/analizesanocare.ro\/en\/analiz\u0103\/c-peptid\/","title":{"rendered":"C-Peptid"},"content":{"rendered":"<div class=\"info-content content-informatii-generale\">\n<h2><strong>Informa\u0163ii generale Peptidul C<\/strong><\/h2>\n<p>Peptidul C (connecting peptide \u2013 formula molecular\u0103 C<sub>112<\/sub>H<sub>179<\/sub>N<sub>35<\/sub>O<sub>46<\/sub>) este alc\u0103tuit dintr-un lan\u0163 de 31 aminoacizi cu o greutate molecular\u0103 de aproximativ 3021 daltoni \u015fi reprezint\u0103 por\u0163iunea mijlocie a moleculei de proinsulin\u0103<sup>1<\/sup>. \u00cen procesul de biosintez\u0103 a insulinei, peptidul C rezult\u0103 din clivajul proteolitic al moleculei precursoare proinsulina \u015fi este stocat \u00een granulele secretorii ale complexului Golgi din celulele beta ale pancreasului.<\/p>\n<p>Insulina \u015fi peptidul C sunt secreta\u0163i \u00een cantit\u0103\u0163i equimolare \u015fi intr\u0103 \u00een circula\u0163ie prin vena port\u0103<sup>3;4<\/sup>. In ficat cel pu\u0163in 50% din insulin\u0103 se leag\u0103 de receptori \u015fi ini\u0163iaz\u0103 ac\u0163iunile specifice hepatice \u015fi apoi este degradat\u0103<sup>5<\/sup>. Moleculele de insulin\u0103 ce trec pasajul hepatic ajung \u00een marea circula\u0163ie unde se leag\u0103 de receptorii periferici ai insulinei.<\/p>\n<p>Spre deosebire de insulin\u0103, peptidul C nu sufer\u0103 degradare hepatic\u0103, nici periferic\u0103, dar este \u00eendep\u0103rtat de c\u0103tre rinichi, cu o frac\u0163iune excretat\u0103 nemodificat\u0103 \u00een urin\u0103. De aceea peptidul C are un timp de \u00eenjum\u0103t\u0103\u0163ire mai lung decat insulina (30-35 minute fa\u0163\u0103 de 5-10 minute) \u015fi raportul molar dintre insulina circulant\u0103 \u015fi peptidul C circulant este &lt;1. De asemenea nivelurile sale sunt mai pu\u0163in fluctuante dec\u00e2t cele ale insulinei.<\/p>\n<p>P\u00e2n\u0103 nu demult, peptidul C era privit doar ca parametru de laborator, dar studii recente au demonstrat c\u0103 are propriul s\u0103u profil de activitate, mai ales asupra celulelor endoteliale \u015fi a sintezei de oxid nitric (NO), important pentru microcircula\u0163ia normal\u0103<sup>4<\/sup>.<\/p>\n<h2><strong>Recomand\u0103ri pentru determinarea peptidului C<\/strong><\/h2>\n<ul>\n<li>evaluarea pacien\u0163ilor cu hipoglicemii \u00e0 jeun;<\/li>\n<li>determinarea secre\u0163iei reziduale a pancreasului la diabeticii insulino-dependen\u0163i, mai ales \u00een faza de introducere a insulinei;<\/li>\n<li>suspiciune de rezisten\u0163\u0103 la insulin\u0103;<\/li>\n<li>diferen\u0163ierea diabetului de tip I \u015fi de tip II<sup>1;2;4<\/sup>.<\/li>\n<\/ul>\n<p><strong>Preg\u0103tire pacient <\/strong>\u2013\u00e0 jeun (pe nem\u00e2ncate \u2013 minim 7 ore)<sup>1<\/sup>.<\/p>\n<p><strong>Specimen recoltat <\/strong>\u2013 s\u00e2nge venos<sup>1<\/sup>.<\/p>\n<p><strong>Recipient de recoltare <\/strong>\u2013 vacutainer f\u0103r\u0103 anticoagulant, cu\/f\u0103r\u0103 gel separator<sup>1<\/sup>.<\/p>\n<p><strong>Prelucrare necesar\u0103 dup\u0103 recoltare <\/strong>\u2013se separ\u0103 serul prin centrifugare; se lucreaz\u0103 serul proasp\u0103t; dac\u0103 acest lucru nu este posibil, serul se p\u0103streaz\u0103 la 2-8\u00b0C sau la -20\u00b0C<sup>1<\/sup>.<\/p>\n<p><strong>Volum prob\u0103<\/strong> \u2013 minim 0.5 mL ser<sup>1<\/sup>.<\/p>\n<p><strong>Cauze de respingere<\/strong> <strong>a probei <\/strong>\u2013 specimen hemolizat<sup>1<\/sup>.<\/p>\n<p><strong>Stabilitate prob\u0103 <\/strong>\u2013serul separat este stabil 24 ore la 2-8\u00b0C; 1 lun\u0103 la -20\u00b0C; nu decongela\u0163i\/recongela\u0163i<sup>1<\/sup>.<\/p>\n<p><strong>Metod\u0103<\/strong> \u2013 ECLIA.<\/p>\n<h2><strong>Valori de referin\u0163\u0103 C-Peptid<\/strong><\/h2>\n<p>1.1-4.4 ng\/ml<\/p>\n<p>Factori de conversie ng\/mLx 0.33333=nmol\/L ; nmol\/Lx 3.0=ng\/mL1.<\/p>\n<p><strong>Limita de detec\u0163ie<\/strong> \u2013 0.02 ng\/mL1.<\/p>\n<h2><strong>Interpretarea rezultatelor<\/strong><\/h2>\n<p>Pacien\u0163ii cu neoplasme secretoare de insulin\u0103 au niveluri ridicate de insulin\u0103 endogen\u0103 \u015fi peptid C; din contr\u0103, pacien\u0163ii cu hipoglicemie factitia au niveluri sc\u0103zute de peptid C \u00een prezen\u0163a nivelului crescut de insulin\u0103 seric\u0103 (exogen\u0103).<\/p>\n<p>\u00cen cazul unei toleran\u0163e sc\u0103zute la glucoz\u0103, o cre\u015ftere a peptidului C \u00een timpul testului de toleran\u0163\u0103 la glucoz\u0103 orienteaz\u0103 spre insulinorezisten\u0163\u0103.<\/p>\n<p>Diferen\u0163ierea \u00eentre diabetul de tip I \u015fi de tip II se face prin determinarea simultan\u0103 a glucozei \u015fi peptidului C la testul oral de toleran\u0163\u0103 la glucoz\u0103. Concentra\u0163iile de peptid C sunt sc\u0103zute la tipul I \u015fi normale\/crescute la tipul II. Importan\u0163a este diferen\u0163ierea dintre diabetul de tip I latent sau tardiv autoimun (LADA), care prezint\u0103 concentra\u0163ii sc\u0103zute de autoanticorpi specifici, de diabetul de tip II<sup>1;2;4<\/sup>.<\/p>\n<p><strong>Limite \u015fi interferen\u0163e<\/strong><\/p>\n<div>Nivelurile de peptid C sunt crescute la pacien\u0163ii cu <a href=\"https:\/\/www.synevo.ro\/durerea-renala-sindromul-insuficienta-renala\/\" data-wpel-link=\"internal\">insuficien\u0163\u0103 renal\u0103<\/a> cronic\u0103.<\/div>\n<div>In evaluarea hipoglicemiei, determinarea insulinei \u015fi a peptidului C nu sunt utile dac\u0103 glucoza seric\u0103 este mai mare de 60 mg\/dL.<\/div>\n<p>\u2022 Interferen\u0163e analitice<\/p>\n<p>Pot produce interferen\u0163e cu unele componente ale kit-ului \u015fi conduce la rezultate neconcludente urm\u0103toarele:<\/p>\n<div>\u2013 tratamentul cu biotin\u0103 \u00een doze mari (&gt;5 mg\/zi); de aceea se recomand\u0103 ca recoltarea de s\u00e2nge s\u0103 se fac\u0103 dupa minimum 8 ore de la ultima administrare;<\/div>\n<div>\u2013 titrurile foarte crescute de anticorpi anti-streptavidina \u015fi anti-ruteniu<sup>1<\/sup>.<\/div>\n<div><\/div>\n<p><strong>Bibliografie<\/strong><\/p>\n<div>1. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate. 2023. Ref Type: Catalog.<\/div>\n<div>2. Laboratory Corporation of America. Directory of Services and Interpretive Guide. C-peptide <a href=\"https:\/\/www.labcorp.com\" target=\"_blank\" rel=\"noopener nofollow external noreferrer\" data-wpel-link=\"external\">www.labcorp.com<\/a> 2010. Ref Type: Internet Communication.<\/div>\n<div>3. Lothar Thomas. Insulin, C-peptide, proinsulin. In Clinical Laboratory Diagnostics-Use and Assessment of Clinical Laboratory Results. TH-Books Verlagsgesellschaft mbH, Frankfurt \/Main, Germany, 1 Ed.,1998 153-154.<\/div>\n<div>4. Mayo Clinic\/Mayo Medical LaboratoriesTest Catalogs and Guides. C-peptide. <a href=\"https:\/\/www.mayomedicallaboratories.com\" target=\"_blank\" rel=\"noopener nofollow external noreferrer\" data-wpel-link=\"external\">www.mayomedicallaboratories.com<\/a>. Ref Type:Internet Communication.<\/div>\n<div>5. Mukhtar I. Khan, Ruth S. Weinstock. Carbohydrates. In Henry\u201ds clinical diagnosis and management by laboratory methods, Ed., 2010, 185-189.<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Informa\u0163ii generale Peptidul C Peptidul C (connecting peptide \u2013 formula molecular\u0103 C112H179N35O46) este alc\u0103tuit dintr-un lan\u0163 de 31 aminoacizi cu o greutate molecular\u0103 de aproximativ 3021 daltoni \u015fi reprezint\u0103 por\u0163iunea mijlocie a moleculei de proinsulin\u01031. \u00cen procesul de biosintez\u0103 a insulinei, peptidul C rezult\u0103 din clivajul proteolitic al moleculei precursoare proinsulina \u015fi este stocat \u00een [&hellip;]<\/p>\n","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false},"product_brand":[],"product_cat":[115,36],"product_tag":[],"class_list":["post-215","product","type-product","status-publish","product_cat-hormoni-de-glicoreglare","product_cat-markeri-endochrini","first","instock","shipping-taxable","purchasable","product-type-simple"],"acf":[],"_links":{"self":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product\/215","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/types\/product"}],"wp:attachment":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/media?parent=215"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_brand?post=215"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_cat?post=215"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_tag?post=215"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}