Low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: a cross-sectional study.
Low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: a cross-sectional study.
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DOI：
10.1186/1472-6823-10-6
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发表时间：
2010-04-18
影响因子：
2.7
通讯作者：
Hartmann A
中科院分区：
文献类型：
--
作者：
Hjelmesæth J;Røislien J;Nordstrand N;Hofsø D;Hager H;Hartmann A
低骨骼肌质量与胰岛素抵抗和代谢综合征有关。血清肌酐可以作为肌肉质量的替代标志物，并且低血清肌酐和2型糖尿病之间的可能关系最近已被证明。我们的目的是在白人病态肥胖受试者中验证这一发现。对1，017例肾小球滤过率估计值>60 ml/min/1.73 m2的连续病态肥胖患者进行的横断面研究。Logistic回归（单变量和多变量）用于评估血清肌酐与2型糖尿病患病率之间的相关性，包括通过实施广义加性模型（GAM）和分段线性回归对相关性中非线性的可能性进行统计学检验。可能的混杂变量，如年龄，糖尿病家族史，腰臀比，高血压，目前吸烟，血清镁，白蛋白尿和胰岛素抵抗（log HOMA-IR）进行了调整，在三个独立的多元logistic回归模型。未校正的GAM分析表明血清肌酐与糖尿病之间存在分段线性关系。血清肌酐水平每升高1 μmol/l，女性和男性的糖尿病风险分别降低6%（95% CI; 3%-8%）和7%（95% CI; 2%-13%），低于血清肌酐水平69和72 μmol/l。高于这些折点，血清肌酐浓度不会进一步降低几率。对不可改变和可改变的风险因素进行调整后，对女性和男性的分段影响基本不变。在包括血清镁、白蛋白尿和log HOMA-IR的完全校正模型中，男性的分段效应在统计学上不显著，但女性仍存在。肌酐水平低于中位数的患者患糖尿病的几率增加约50%（女性）和75%（男性）。低血清肌酐是白人病态肥胖患者2型糖尿病的预测因子，与年龄、性别、糖尿病家族史、人体测量指标、高血压和当前吸烟无关。需要对肥胖和非肥胖人群进行纵向研究，以调查血清肌酐是否与2型糖尿病有因果关系，如果是，它们是如何联系的。
Low skeletal muscle mass is associated with insulin resistance and metabolic syndrome. Serum creatinine may serve as a surrogate marker of muscle mass, and a possible relationship between low serum creatinine and type 2 diabetes has recently been demonstrated. We aimed to validate this finding in a population of Caucasian morbidly obese subjects. Cross-sectional study of 1,017 consecutive morbidly obese patients with an estimated glomerular filtration rate >60 ml/min/1.73 m2. Logistic regression (univariate and multiple) was used to assess the association between serum creatinine and prevalent type 2 diabetes, including statistically testing for the possibility of non-linearity in the relationship by implementation of Generalized Additive Models (GAM) and piecewise linear regression. Possible confounding variables such as age, family history of diabetes, waist-to-hip ratio, hypertension, current smoking, serum magnesium, albuminuria and insulin resistance (log HOMA-IR) were adjusted for in three separate multiple logistic regression models. The unadjusted GAM analysis suggested a piecewise linear relationship between serum creatinine and diabetes. Each 1 μmol/l increase in serum creatinine was associated with 6% (95% CI; 3%-8%) and 7% (95% CI; 2%-13%) lower odds of diabetes below serum creatinine levels of 69 and 72 μmol/l in women and men, respectively. Above these breakpoints the serum creatinine concentrations did not reduce the odds further. Adjustments for non-modifiable and modifiable risk factors left the piecewise effect for both women and men largely unchanged. In the fully adjusted model, which includes serum magnesium, albuminuria and log HOMA-IR, the piecewise effect for men was statistically non-significant, but it remained present for women. Patients with creatinine levels below median had approximately 50% (women) and 75% (men) increased odds of diabetes. Low serum creatinine is a predictor of type 2 diabetes in Caucasian morbidly obese patients, independent of age, gender, family history of diabetes, anthropometric measures, hypertension, and current smoking. Longitudinal studies of both obese and non-obese populations are needed to investigate whether serum creatinine may be causally linked with type 2 diabetes, and if so, precisely how they are linked.
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影响因子：
15.9
作者：
FERRANNINI, E;SMITH, JD;DEFRONZO, RA
通讯作者：
DEFRONZO, RA
影响因子：
9.8
作者：
HAFFNER, SM;STERN, MP;BERGMAN, RN
通讯作者：
BERGMAN, RN
影响因子：
13.6
作者：
de Jong, Paul E.;Curhan, Gary C.
通讯作者：
Curhan, Gary C.
影响因子：
9.3
作者：
Hjelmesaeth J;Hofsø D;Aasheim ET;Jenssen T;Moan J;Hager H;Røislien J;Bollerslev J
通讯作者：
Bollerslev J
影响因子：
5.1
作者：
Hofso, Dag;Jenssen, Trond;Hjelmesaeth, Joran
通讯作者：
Hjelmesaeth, Joran