Normalized Creatinine-to-Cystatin C Ratio and Risk of Diabetes in Middle-Aged and Older Adults: The China Health and Retirement Longitudinal Study

Qiu，Shanhu1,2; Cai，Xue1; Xie，Bo1; Yuan，Yang1,3; Sun，Zilin1,3; Wu，Tongzhi4

2022-05-01

10.4093/dmj.2021.0074

Diabetes and Metabolism Journal   影响因子和分区

2233-6079

2233-6087

Background: Creatinine-to-cystatin C ratio is recently suggested to be a surrogate marker for sarcopenia. However, little is known about its association with diabetes. This study aimed to fill in this gap based on a large-scale prospective cohort. Methods: A population-based representative sample of 5,055 participants aged ≥45 years from the China Health and Retirement Longitudinal Study was enrolled between 2011 and 2012 and followed at least once during the subsequent surveys at 2013, 2015, or 2018. Creatinine-to-cystatin C ratio was calculated and normalized by body weight. Incident diabetes was ascertained by plasma glucose, glycosylated hemoglobin, self-reported history, or use of anti-diabetic drugs. Logistic regression analysis and mediation analysis were employed. Results: During follow-up, 634 participants developed diabetes. The risk of diabetes was gradually and significantly decreased with increased normalized creatinine–cystatin C ratio. The multivariable-adjusted odds ratio for diabetes was 0.91 (95% confidence interval, 0.83 to 0.99) per 1 standard deviation higher of normalized creatinine-to-cystatin C ratio, and this relationship remained significant after controlling for muscle strength. The risk reduction in diabetes was significantly larger in participants with normal-weight and high normalized creatinine-to-cystatin C ratio compared with those with overweight/obesity and high normalized creatinine-to-cystatin C ratio (Pinteraction=0.01). Insulin resistance and inflammation appeared to be key mediators accounting for the observed relationship between normalized creatinine-to-cystatin C ratio and risk of diabetes, with their mediating effect being 93.1% and 22.0%, respectively. Conclusion: High normalized creatinine-to-cystatin C ratio is associated with reduced risk of diabetes in middle-aged and older adults.

Creatinine Cystatin C Diabetes mellitus Insulin resistance Longitudinal studies Muscle strength

SCI

英语

其他

WOS:000812328500011

2-s2.0-85131270470

Scopus

1.Institute of Diabetes,Zhongda Hospital,School of Medicine,Southeast University,Nanjing,China
2.Department of Endocrinology,Shenzhen People’s Hospital,The Second Clinical Medical College of Jinan University,The First Affiliated Hospital,Southern University of Science and Technology,Shenzhen,China
3.Department of Endocrinology,Zhongda Hospital,Southeast University,Nanjing,China
4.Adelaide Medical School,Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health,The University of Adelaide,Adelaide,Australia

Qiu，Shanhu,Cai，Xue,Xie，Bo,et al. Normalized Creatinine-to-Cystatin C Ratio and Risk of Diabetes in Middle-Aged and Older Adults: The China Health and Retirement Longitudinal Study[J]. Diabetes and Metabolism Journal,2022,46(3):476-485.

Qiu，Shanhu,Cai，Xue,Xie，Bo,Yuan，Yang,Sun，Zilin,&Wu，Tongzhi.(2022).Normalized Creatinine-to-Cystatin C Ratio and Risk of Diabetes in Middle-Aged and Older Adults: The China Health and Retirement Longitudinal Study.Diabetes and Metabolism Journal,46(3),476-485.

Qiu，Shanhu,et al."Normalized Creatinine-to-Cystatin C Ratio and Risk of Diabetes in Middle-Aged and Older Adults: The China Health and Retirement Longitudinal Study".Diabetes and Metabolism Journal 46.3(2022):476-485.