Prognostic value of creatinine-to-cystatin c ratio in patients with type 2 diabetes mellitus: a cohort study

Abstract

Background The serum creatinine-to-cystatin C ratio (Scr/Scys) has been suggested as a surrogate marker of muscle mass and a predictor of adverse outcomes in many diseases. However, the prognostic value of Scr/Scys in patients with type 2 diabetes mellitus (T2DM) is unknown. The aim of this study is to assess the prognostic value of Scr/Scys in patients with T2DM. Methods In this retrospective observational study, we enrolled 3668 T2DM patients undergoing coronary angiography (CAG). Serum creatinine (Scr) and serum cystatin C (Scys) levels were measured at admission. The study population was separated into low muscle mass (low-MM) and normal muscle mass (normal-MM) groups by Scr/Scys cut-off point. The association between muscle mass and long-term all-cause mortality was examined using Cox regression analysis. Results During a median follow-up of 4.9 (3.0–7.1) years, a total of 352 (9.6%) patients died. The mortality was higher in patients with low-MM as compared with patients with normal-MM (11.1% vs. 7.3%; p < 0.001). Low muscle mass was associated with increased risk for long-term all-cause mortality, regardless of whether Scr/Scys were used as a continuous variable (adjusted hazard ratio: 1.08 [95% confidence interval (CI) 1.03 to 1.13]; p = 0.009) or a categorial variable (adjusted hazard ratio: 1.36 [95% CI 1.03 to 1.75]; p = 0.021). Conclusion Low muscle mass assessed by Scr/Scys was associated with increased risk of long-term all-cause mortality in diabetic patients.

Cystatin C as A Prognostic Biomarker to Monitor Renal Function in Liver Cirrhosis: A Narrative Review

“…Fluctuations in CysC levels have also been observed in response to changes in thyroid status and the use of steroids. Factors such as high CRP levels and smoking have been identified to affect CysC metabolism as well [5,9,13]. Supporting this, a study by Barr et al further corroborated that chronic inflammation may contribute to the suboptimal performance of CysC GFR equations [20].…”

Diabetes Mellitus Should Be Considered While Analysing Sarcopenia-Related Biomarkers

“…It was also related to subclinical atherosclerosis [158] and increased risk of fractures [159] in T2DM subjects, as well as to osteoporosis in T2DM male patients [160]. A low serum creatinine-to-cystatin C ratio was associated with a higher risk of all-cause mortality in diabetic patients [161]. A higher SI normalised by body weight was associated with a reduced risk of T2DM in middle-aged and older subjects [77].…”

Creatinine-to-cystatin C ratio and body composition predict response to PD-1 inhibitors-based combination treatment in metastatic gastric cancer

“…as a simplified method for diagnosing sarcopenia in patients ( 6 ). Since then, CCR has been extensively studied and established as a biomarker for the prognosis in patients with critically illness ( 7 , 8 ), hypertension ( 9 ), type 2 diabetes ( 10 , 11 ) and cancer ( 12 – 17 ). Recently, a retrospective study reported that low CCR was an independent biomarker of poor prognosis in non-small cell lung cancer (NSCLC) patients treated with PD-1 monotherapy ( 18 ).…”