Creatinine-to-body weight ratio is a predictor of incident diabetes: a population-based retrospective cohort study

Jiacheng He

doi:10.1186/s13098-021-00776-8

Abstract

PurposeCreatinine to body weight (Cre/BW) ratio is considered the independent risk factor for incident type 2 diabetes mellitus (T2DM), but research on this relationship is limited. The relationship between the Cre/BW ratio and T2DM among Chinse individuals is still ambiguous. This study aimed to evaluate the correlation between the Cre/BW ratio and the risk of T2DM in the Chinese population.MethodsThis is a retrospective cohort study from a prospectively collected database. We included a total of 200,658 adults free of T2DM at baseline. The risk of incident T2DM according to Cre/BW ratio was estimated using multivariable Cox proportional hazards models, and a two-piece wise linear regression model was developed to find out the threshold effect.ResultsWith a median follow-up of 3.13 ± 0.94 years, a total of 4001 (1.99%) participants developed T2DM. Overall, there was an L-shaped relation of Cre/BW ratio with the risk of incident T2DM (P for non-linearity < 0.001). When the Cre/BW ratio (× 100) was less than 0.86, the risk of T2DM decreased significantly as the Cre/BW ratio increased [0.01 (0.00, 0.10), P < 0.001]. When the Cre/BW ratio (× 100) was between 0.86 and 1.36, the reduction in the risk of developing T2DM was not as significant as before [0.22 (0.12, 0.38), P < 0.001]. In contrast, when the Cre/BW ratio (× 100) was greater than 1.36, the reduction in T2DM incidence became significantly flatter than before [0.73 (0.29,1.8), P = 0.49].ConclusionThere was an L-shaped relation of Cre/BW ratio with incidence of T2DM in general Chinese adults. A negative curvilinear association between Cre/BW ratio and incident T2DM was present, with a saturation effect predicted at 0.86 and 1.36 of Cre/BW ratio (× 100).

Highlights

Diabetes, an ever-growing health problem, places a heavy economic burden on individuals and society [1,2,3,4]
The following variables were included in the dataset: sex, age, body mass index (BMI), drinking status, smoking status, family history of diabetes, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), triglyceride (TG), fasting plasma glucose (FPG), Serum creatinine (Cre), aspartate aminotransferase (AST), alanine aminotransferase (ALT), systolic blood pressure (SBP), diastolic blood pressure (DBP), incident diabetes at follow-up, and follow-up time
Using the univariate Cox proportional hazard model, we identified age, height, weight, SBP, DBP, FPG, TC, TG, Low density lipoprotein (LDL), Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), blood urea nitrogen (BUN), Cre, and family history of diabetes as being positively related to future risk of diabetes

Summary

Introduction

An ever-growing health problem, places a heavy economic burden on individuals and society [1,2,3,4]. China has the heaviest burden of diabetes mellitus worldwide with nearly a quarter of the world’s diabetes patients living in China. In 2013, the prevalence of adult diabetes. Previous studies have shown that obesity is a significant risk factor for diabetes [7,8,9]. Diabetes accelerates muscle mass through hyperglycemia, insulin resistance (IR), and inflammatory cytokines [10]. A recent study showed that decreased muscle mass is closely related to IR [11]. Muscle mass is an important target for the prevention and treatment of T2DM

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