1458-P: Association of Serum Creatinine Levels and Risk of Type 2 Diabetes Mellitus in Korea

Abstract

Low skeletal muscle is known to be associated with insulin resistance and suggested as a potential risk factor for type 2 diabetes mellitus (T2DM). Serum creatinine is the primary metabolite of creatine in the skeletal muscle and used as a surrogate of muscle mass. Therefore, low serum creatinine levels may be associated with the risk of T2DM. However, there were few studies about the association between serum creatinine levels and the risk of T2DM in Korea. We aimed to evaluate the association between serum creatinine levels and the risk of T2DM in Korea. We analyzed a total of 264,832 nondiabetic adults older than 30 years of age who had undergone a national health examination from 2002 to 2012 in the Korean National Health Insurance Service Cohort. The serum creatinine was divided into four categories (<0.70, 0.70∼0.89, 0.90∼1.19, ≥1.20 mg/dl for men, <0.60, 0.60∼0.79, 0.80∼1.09, ≥1.10 mg/dl for women). Hazard ratios for T2DM were calculated using Cox proportional hazards models. In men, serum creatinine levels and the risk for T2DM showed an inverse J-shaped association, with the lowest risk among men with serum creatinine between 0.90 and 1.19 mg/dl. This inverse J-shaped association between serum creatinine level and the risk for T2DM was confirmed after adjustment for age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting plasma glucose. In women, subjects with highest serum creatinine level had the highest risk of T2DM. However, serum creatinine was not significantly associated with the risk of T2DM after adjustment for age, BMI, SBP, DBP, and fasting plasma glucose. Lower serum creatinine was significantly associated with an increased risk of T2DM in men with creatinine below 1.20 mg/dl even after adjustment for age, BMI, SBP, DBP, and fasting plasma glucose. Highest creatinine level was significantly associated with an increased risk of T2DM in women, however, this association disappeared after adjustment for age, BMI, SBP, DBP, and fasting plasma glucose. Disclosure D. Song: None. H. Lee: None. Y. Hong: None. Y. Sung: None.