Cre/CysC ratio may predict muscle composition and is associated with glucose disposal ability and macrovascular disease in patients with type 2 diabetes

Yang, Qing; Zhang, Mei; Sun, Peng; Li, Yanying; Xu, Huichao; Wang, Kejun; Shen, Hongshan; Ban, Bo; Liu, Fupeng

doi:10.1136/bmjdrc-2021-002430

Cited by 10 publications

(13 citation statements)

References 45 publications

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“…It has been increasingly used in the screening of sarcopenia in diabetic and non-diabetic patients. Our previous studies have shown that the Cre/CysC can predict not only the muscle mass but also muscle density in patients with T2DM (24). Based on the close correlation between muscle and bone health, we further confirmed that Cre/CysC could be used as an independent predictor of BMD in the LS, FN, and TH.…”

Section: Discussionsupporting

confidence: 80%

Association between the ratio of serum creatinine to cystatin C and bone mineral density in Chinese older adults patients with type 2 diabetes mellitus

et al. 2022

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BackgroundThe ratio of creatinine to cystatin C (Cre/CysC), a marker of muscle function and muscle mass, can be used to predict sarcopenia in different populations. Since sarcopenia is closely associated with osteoporosis, this study investigated the association between Cre/CysC and bone mineral density (BMD) in patients with type 2 diabetes mellitus (T2DM).MethodThis cross-sectional study included 391 Chinese patients with T2DM. General information, biochemical indicators, and the BMD of lumbar spine (LS), femoral neck (FN), and total hip (TH) were measured.ResultsPearson correlation analysis showed that Cre/CysC was significantly positively correlated with the BMD of LS (r = 0.170, p = 0.001), FN (r = 0.178, p < 0.001), and TH (r = 0.205, p < 0.001). The results of stepwise linear regression suggested that Cre/CysC was the only biochemical predictor of the BMD at three sites (LS: β = 0.137, p = 0.01; FN: β = 0.097, p = 0.038; TH: β = 0.145, p = 0.002).ConclusionIn older patients with T2DM, high Cre/CysC value is independently positively associated with BMD and hence, Cre/CysC may serve as a valuable marker of osteoporosis.

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Section: Discussionsupporting

confidence: 80%

Association between the ratio of serum creatinine to cystatin C and bone mineral density in Chinese older adults patients with type 2 diabetes mellitus

et al. 2022

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“…Consistent with our data, the correlations between the SI and skeletal muscle mass in previous reports were not high. The correlation coefficients in a study by Yang et al, who evaluated the correlations of the SI with the CT value and cross-sectional areas of muscles at the L3 level, were r = 0.378 and r = 0.375, 40 while that in a study by Hirai et al, who reported the correlations between the SI and the skeletal muscle mass using BIA, was r = 0.44. 41 Although we showed that the SI was a good predictor of postoperative functional outcome, given that there are not always correlations between the skeletal muscle mass and physical performance in older individuals, 42 the SI should be cautiously used as a surrogate maker for the evaluation of sarcopenia.…”

Section: Discussionmentioning

confidence: 91%

Serum creatinine to cystatin C ratio reflects preoperative and early postoperative walking ability in older patients with hip fracture

Okubo

Yonetani

Tanaka

et al. 2022

J cachexia sarcopenia muscle

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Background The sarcopenia index (SI), calculated as the ratio of serum creatinine to cystatin C levels, reflects skeletal muscle mass and strength. Patients with hip fracture (HF) and sarcopenia have poor functional outcomes, and many require long‐term care after surgery. We hypothesized that the SI can predict preoperative and early postoperative functional outcomes. Methods Preoperative serum creatinine and cystatin C were measured to calculate the SI for patients with surgically treated HF (n = 130, mean age: 87.8 ± 6.9 years). Walking ability before and 2 weeks after surgery was assessed, and patients were dichotomized into independent and assistance groups. To assess the validity of the SI, we examined its correlation with the quality [computed tomography (CT) value] and quantity (cross‐sectional area) of the muscles around the hip on the non‐operated side, which were preoperatively measured using CT. Receiver operating characteristic (ROC) analysis was performed to evaluate the prognostic value of the SI. Results The SI of the preoperative independent (n = 77) and assistance groups (n = 53) significantly differed (70.2 ± 12.4 and 60.1 ± 9.8, respectively, P < 0.000001). At 2 weeks after surgery, the SI was significantly higher in the independent group (n = 31, 73.0 ± 14.9) than in the assistance group (n = 99, 64.0 ± 10.7, P = 0.0003). In the preoperative independent group, 28 could walk independently after surgery (SI: 74.8 ± 14.0) while 49 required assistance (SI: 67.7 ± 10.6, P = 0.01). For patients with femoral neck fracture (FNF), the SIs were significantly higher in the postoperative independent group (78.6 ± 15.7) than in the postoperative assistance group (63.2 ± 10.9, P = 0.002). Logistic regression analysis showed that the odds ratio (95% confidence interval) of the SI for postoperative walking ability was 0.95 (0.91–0.99, P = 0.03). The correlations of SIs with CT values and cross‐sectional areas were as follows: iliopsoas at the apex of the femoral head, r = 0.40, P < 0.001 and r = 0.49, P < 0.001, respectively; rectus femoris at the level of the lessor trochanter, r = 0.26, P = 0.007 and r = 0.37, P < 0.001, respectively. ROC analysis for predicting postoperative walking ability in preoperative independent patients with HF and FNF revealed areas under the curve (95% confidence interval) of 0.63 (0.50–0.76) and 0.80 (0.65–0.96), respectively. Conclusions In patients with HF, the SI correlated with preoperative walking ability and could predict postoperative walking ability. Among patients who could walk independently before surgery, those with high SIs could walk independently early in the postoperative period. The SI is beneficial for estimating walking ability in patients with HF.

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“…Our study demonstrated that both the peak GH and IGF-1 SDS are independent predictors of SMA in children and adolescents of short stature. SMA is a comprehensive marker that determines both SMI and FMI, and the GH/IGF-1 axis may regulate muscle density through complex mechanisms ( 48 , 49 ).…”

Section: Discussionmentioning

confidence: 99%

Association Between the Growth Hormone/Insulin-Like Growth Factor-1 Axis and Muscle Density in Children and Adolescents of Short Stature

Yang

et al. 2022

Front. Endocrinol.

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ObjectiveTo evaluate the association between the growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis and muscle density in children and adolescents of short stature.MethodsParticipants were children and adolescents of short stature hospitalized in the Affiliated Hospital of Jining Medical University between January 2020 and June 2021. All participants had CT scan images available. We performed an analysis of the images to calculate the muscle density or skeletal muscle attenuation (SMA), skeletal muscle index (SMI), and fat mass index (FMI). Bioelectrical impedance analysis (BIA) was used to ensure that chest CT is a credible way of evaluating body composition.ResultsA total of 297 subjects were included with the mean age of 10.00 ± 3.42 years, mean height standard deviation score (SDS) of -2.51 ± 0.53, and mean IGF-1 SDS of -0.60 ± 1.07. The areas of muscle and fat tissues at the fourth thoracic vertebra level in the CT images showed strong correlation with the total weights of the participants (R2 = 0.884 and 0.897, respectively). The peak of GH was negatively associated with FMI (r = - 0.323, P <.01) and IGF-1 SDS was positively associated with SMI (r = 0.303, P <.01). Both the peak GH and IGF-1 SDS were positively associated with SMA (r = 0.244, P <.01 and r = 0.165, P <.05, respectively). Multiple stepwise linear regression analysis demonstrated that the GH peak was the predictor of FMI (β = - 0.210, P < .01), the IGF-1 SDS was the predictor of SMI (β = 0.224, P < .01), and both the peak GH and IGF-1 SDS were predictors of SMA (β = 0.180, P < .01 and β = 0.222, P < .01).ConclusionsA chest CT scan is a credible method of evaluating body composition in children and adolescents of short stature. In these patients, peak GH and IGF-1 SDS are independent predictors of muscle density and the GF/IGF-1 axis may regulate body composition through complex mechanisms.

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Cre/CysC ratio may predict muscle composition and is associated with glucose disposal ability and macrovascular disease in patients with type 2 diabetes

Cited by 10 publications

References 45 publications

Association between the ratio of serum creatinine to cystatin C and bone mineral density in Chinese older adults patients with type 2 diabetes mellitus

Association between the ratio of serum creatinine to cystatin C and bone mineral density in Chinese older adults patients with type 2 diabetes mellitus

Serum creatinine to cystatin C ratio reflects preoperative and early postoperative walking ability in older patients with hip fracture

Association Between the Growth Hormone/Insulin-Like Growth Factor-1 Axis and Muscle Density in Children and Adolescents of Short Stature

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