PT  - JOURNAL ARTICLE
AU  - Yang, Qing
AU  - Zhang, Mei
AU  - Sun, Peng
AU  - Li, Yanying
AU  - Xu, Huichao
AU  - Wang, Kejun
AU  - Shen, Hongshan
AU  - Ban, Bo
AU  - Liu, Fupeng
TI  - Cre/CysC ratio may predict muscle composition and is associated with glucose disposal ability and macrovascular disease in patients with type 2 diabetes
AID  - 10.1136/bmjdrc-2021-002430
DP  - 2021 Nov 01
TA  - BMJ Open Diabetes Research & Care
PG  - e002430
VI  - 9
IP  - 2
4099  - http://drc.bmj.com/content/9/2/e002430.short
4100  - http://drc.bmj.com/content/9/2/e002430.full
SO  - BMJ Open Diab Res Care2021 Nov 01; 9
AB  - Introduction Since the ratio of creatinine to cystatin C (Cre/CysC) can reflect muscle volume, it has been proven to be a predictor of sarcopenia in patients with or without diabetes. Here, we investigated the predictive value of Cre/CysC for the skeletal muscle composition and its correlations with glucose disposal ability and diabetic complications in patients with type 2 diabetes.Research design and methods The skeletal muscle index (SMI) and mean skeletal muscle attenuation (MMA) values of 193 patients with type 2 diabetes were obtained through analyses of CT images at the lumbar 3 level.Results Serum Cre/CysC was significantly correlated with both the SMI (r=0.375, p<0.001) and MMA (r=0.378, p<0.001). Multiple stepwise linear regression analysis demonstrated that Cre/CysC was the only biochemical predictor of the SMI (β=0.48 (95% CI 0.02 to 0.94)) and MMA (β=0.57 (95% CI 0.14 to 1.01)). Furthermore, the fat mass index (FMI) was significantly associated with the MMA (r=−0.481, p<0.001) but not the SMI (r=0.101, p=0.164). In the diabetic complications analysis, Cre/CysC was significantly lower in patients with cardiovascular disease (95% CI (−1.47 to –0.22), p=0.008) and lower extremity arterial disease (95% CI (−1.44 to –0.29), p=0.004). Moreover, in the 100 g steamed bun test, Cre/CysC was significantly correlated with glucose levels at 60 min (r=−0.162, p=0.045), 120 min (r=−0.287, p<0.001) and 180 min (r=−0.313, p<0.001).Conclusions Cre/CysC may be a valuable predictor of skeletal muscle composition in type 2 diabetes. Patients with a higher Cre/CysC may have a better ability to dispose of postprandial glucose and are at a lower risk of macrovascular disease.Data sharing not applicable as no datasets generated and/or analyzed for this study. The datasets generated and analysed during the current study are not publicly available but are available from the corresponding author on reasonable request.