S Kashima1, K Inoue2, M Matsumoto3, K Akimoto4. 1. Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-0037, Japan. Electronic address: saori.ksm@gmail.com. 2. Department of Community Medicine, Chiba Medical Center, Teikyo University School of Medicine, Chiba, Japan. Electronic address: kojanc@gmail.com. 3. Department of Community Based Medical System, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-0037, Japan. Electronic address: matmo10@jb3.so-net.ne.jp. 4. Akimoto Occupational Health Consultant Office, 4F Aoyama building, 2-11-13 Minami Aoyama, Minato-ku, Tokyo 107-0062, Japan. Electronic address: ac97zr@bma.biglobe.ne.jp.
Abstract
AIM: Type 2 diabetes (T2D) is a risk factor for muscle loss and subsequent frailty. The reverse association, however, may also happen. This study examined whether serum creatinine level, an indicator of muscle mass, predicted diabetes development. In addition, a role for body mass index (BMI) as an effect modifier of creatinine levels was evaluated. METHODS: This cohort study included 9667 subjects without diabetes or hypertension and with normal creatinine levels at baseline. Multiple-adjusted hazard ratios (HRs) for associations between baseline creatinine and diabetes development were estimated using the Cox proportional-hazards model. Stratified analyses based on BMI were also performed. RESULTS: During the follow-up period (mean: 5.6 years), 287 (5.5%) men and 115 (2.3%) women developed T2D. HR in men with serum creatinine≤0.7mg/dL compared with 0.9-1.2mg/dL was 1.40 (95% CI: 1.05-1.87) after adjusting for age, BMI, blood pressure and fasting plasma glucose at baseline, whereas the adjusted HR in women with creatinine≤0.5mg/dL compared with 0.7-1.1mg/dL was 1.69 (95% CI: 1.04-2.76). In a subgroup analysis stratified by BMI, interactions between BMI and baseline creatinine levels for T2D were statistically significant in women with the lowest creatinine levels (P=0.08 for interaction). CONCLUSION: Low serum creatinine levels, a surrogate marker of muscle mass, predict T2D development in both genders, even after excluding the effect of diabetic and prediabetic glomerular hyperfiltration. BMI modified the association between creatinine and diabetes development in women.
AIM: Type 2 diabetes (T2D) is a risk factor for muscle loss and subsequent frailty. The reverse association, however, may also happen. This study examined whether serum creatinine level, an indicator of muscle mass, predicted diabetes development. In addition, a role for body mass index (BMI) as an effect modifier of creatinine levels was evaluated. METHODS: This cohort study included 9667 subjects without diabetes or hypertension and with normal creatinine levels at baseline. Multiple-adjusted hazard ratios (HRs) for associations between baseline creatinine and diabetes development were estimated using the Cox proportional-hazards model. Stratified analyses based on BMI were also performed. RESULTS: During the follow-up period (mean: 5.6 years), 287 (5.5%) men and 115 (2.3%) women developed T2D. HR in men with serum creatinine≤0.7mg/dL compared with 0.9-1.2mg/dL was 1.40 (95% CI: 1.05-1.87) after adjusting for age, BMI, blood pressure and fasting plasma glucose at baseline, whereas the adjusted HR in women with creatinine≤0.5mg/dL compared with 0.7-1.1mg/dL was 1.69 (95% CI: 1.04-2.76). In a subgroup analysis stratified by BMI, interactions between BMI and baseline creatinine levels for T2D were statistically significant in women with the lowest creatinine levels (P=0.08 for interaction). CONCLUSION: Low serum creatinine levels, a surrogate marker of muscle mass, predict T2D development in both genders, even after excluding the effect of diabetic and prediabetic glomerular hyperfiltration. BMI modified the association between creatinine and diabetes development in women.
Authors: Jialing Huang; Marcela Covic; Cornelia Huth; Martina Rommel; Jonathan Adam; Sven Zukunft; Cornelia Prehn; Li Wang; Jana Nano; Markus F Scheerer; Susanne Neschen; Gabi Kastenmüller; Christian Gieger; Michael Laxy; Freimut Schliess; Jerzy Adamski; Karsten Suhre; Martin Hrabe de Angelis; Annette Peters; Rui Wang-Sattler Journal: Metabolites Date: 2021-02-03