Objective To assess the association between low serum creatinine levels and an increased risk of type 2 diabetes mellitus and dysglycemia.
Research design and methods We conducted a retrospective cohort study of 3313 Japanese male workers aged 30–55 years, who underwent annual health check-ups during 2001–2008 and showed no type 2 diabetes mellitus, and underwent follow-up examinations until March 2013. Dysglycemia was defined as a fasting plasma glucose concentration of ≥110 mg/dL (6.1 mmol/L), or a non-fasting plasma glucose concentration of ≥140 mg/dL (7.8 mmol/L). A Cox proportional model was used to calculate HRs and 95% CIs for developing type 2 diabetes mellitus or dysglycemia.
Results During the median 6.7-year follow-up, there were 207 cases of incident type 2 diabetes mellitus and 596 cases of incident dysglycemia, including 115 cases of type 2 diabetes mellitus among the subjects with normal glucose concentrations at baseline. After adjustment for age, body mass index and known diabetes risk factors, the multivariable HR of type 2 diabetes mellitus for the lowest category of serum creatinine (<0.7 mg/dL) vs the highest category (0.9–1.1 mg/dL) was 1.9 (95% CI 1.2 to 2.9; P for trend 0.03). The multivariable HRs of dysglycemia for the lowest category of serum creatinine versus the highest category was 1.5 (95% CI 1.1 to 1.9; P for trend 0.01).
Conclusions Low serum creatinine levels were associated with an increased risk of type 2 diabetes mellitus and dysglycemia.
- risk factor
- serum creatinine
- type 2 diabetes mellitus
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Contributors MT was the lead author, conceived the original idea for the study, collected the data, performed the data analyses and wrote the manuscript. HI revised the manuscript, contributed to the interpretation of the data and added critical comments. IM, YS, MH-T, AK, TO and MK were involved in data collection and revised the manuscript and contributed with comments. HI was responsible for the overall supervision and contributed to the data analysis and the manuscript. All authors had access to the data, commented on the manuscript drafts and approved the final version.
Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Obtained.
Ethics approval Osaka Center for Cancer and Cardiovascular Disease.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The datasets generated during and/or analyzed during the current study are not publicly available due to restrictions based on privacy regulations and informed consent of the participants, but are available from the corresponding author on reasonable request.
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