Relationship Between Serum Creatinine to Cystatin C Ratio and Subclinical Atherosclerosis in Patients with Type 2 Diabetes

Overview

Journal BMJ Open Diabetes Res Care

Specialty Endocrinology

Date 2022 Jun 23

PMID 35738823

Authors

Yoshitaka Hashimoto

Fuyuko Takahashi

Takuro Okamura

Takafumi Osaka

Hiroshi Okada

Takafumi Senmaru

Saori Majima

Emi Ushigome

Naoko Nakanishi

Mai Asano

Masahide Hamaguchi

Masahiro Yamazaki

Michiaki Fukui

Affiliations

Soon will be listed here.

Abstract

Introduction: Sarcopenia index (SI), calculated by (serum creatinine/cystatin C)×100, is reported to be associated with sarcopenia. Few studies reported the association between SI and subclinical atherosclerosis. We evaluated the association between SI and subclinical atherosclerosis, assessed by brachial-ankle pulse wave velocity (baPWV).

Research Design And Methods: One hundred seventy-four patients with type 2 diabetes were included in this cross-sectional study. The relationship between SI and baPWV was assessed by Pearson's correlation coefficient. To calculate area under the receiver operator characteristic (ROC) curve (AUC) of SI for the presence of subclinical atherosclerosis, which was defined as baPWV >1800 cm/s, ROC analysis was performed. Logistic regression analyses were performed to assess the effect of SI on the prevalence of subclinical atherosclerosis adjusting for covariates.

Results: Mean age, duration of diabetes, baPWV, and SI were 66.9 (10.1) years, 17.7 (11.6) years, 1802 (372) cm/s, and 77.6 (15.8), respectively. There was an association between SI and baPWV (men; r=-0.25, p=0.001, and women; r=-0.37, p=0.015). The optimal cut-off point of SI for the presence of subclinical atherosclerosis was 77.4 (sensitivity=0.72, specificity=0.58, p<0.001, AUC 0.66 (95% CI: 0.57 to 0.74)). In addition, SI was associated with the prevalence of subclinical atherosclerosis (adjusted OR 0.95, 95% CI: 0.91 to 0.99, p=0.015).

Conclusions: SI is associated with the prevalence of subclinical atherosclerosis in patients with type 2 diabetes.

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References

Sakai R, Hashimoto Y, Ushigome E, Miki A, Okamura T, Matsugasumi M . Late-night-dinner is associated with poor glycemic control in people with type 2 diabetes: The KAMOGAWA-DM cohort study. Endocr J. 2018; 65(4):395-402. DOI: 10.1507/endocrj.EJ17-0414. View

Rizk J, Streja E, Wenziger C, Shlipak M, Norris K, Crowley S . Serum Creatinine-to-Cystatin-C Ratio as a Potential Muscle Mass Surrogate and Racial Differences in Mortality. J Ren Nutr. 2021; 33(1):69-77. DOI: 10.1053/j.jrn.2021.11.005. View

Campos A, Moura F, Santos S, Freitas W, Sposito A . Sarcopenia, but not excess weight or increased caloric intake, is associated with coronary subclinical atherosclerosis in the very elderly. Atherosclerosis. 2017; 258:138-144. DOI: 10.1016/j.atherosclerosis.2017.01.005. View

Kawamori R . Asymptomatic hyperglycaemia and early atherosclerotic changes. Diabetes Res Clin Pract. 1998; 40 Suppl:S35-42. DOI: 10.1016/s0168-8227(98)00041-2. View

Hashimoto Y, Hamaguchi M, Kaji A, Sakai R, Osaka T, Inoue R . Intake of sucrose affects gut dysbiosis in patients with type 2 diabetes. J Diabetes Investig. 2020; 11(6):1623-1634. PMC: 7610116. DOI: 10.1111/jdi.13293. View

Shin J . Low serum creatinine to cystatin C ratio is independently associated with sarcopenia and high carotid plaque score in patients with type 2 diabetes. Nutr Metab Cardiovasc Dis. 2022; 32(6):1454-1462. DOI: 10.1016/j.numecd.2022.02.005. View

He N, Zhang Y, Zhang L, Zhang S, Ye H . Relationship Between Sarcopenia and Cardiovascular Diseases in the Elderly: An Overview. Front Cardiovasc Med. 2021; 8:743710. PMC: 8695853. DOI: 10.3389/fcvm.2021.743710. View

Lu Y, Tsai Y, Chou R, Kuo C, Chang C, Huang P . Serum creatinine to cystatin C ratio is associated with major adverse cardiovascular events in patients with obstructive coronary artery disease. Nutr Metab Cardiovasc Dis. 2021; 31(5):1509-1515. DOI: 10.1016/j.numecd.2021.01.024. View

Einarson T, Acs A, Ludwig C, Panton U . Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovasc Diabetol. 2018; 17(1):83. PMC: 5994068. DOI: 10.1186/s12933-018-0728-6. View

10.

Jung C, Joo Y, Kim H, Han S, Yoo T, Kang S . Creatinine-Cystatin C Ratio and Mortality in Patients Receiving Intensive Care and Continuous Kidney Replacement Therapy: A Retrospective Cohort Study. Am J Kidney Dis. 2020; 77(4):509-516.e1. DOI: 10.1053/j.ajkd.2020.08.014. View

11.

Grundy S, Benjamin I, Burke G, Chait A, Eckel R, Howard B . Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation. 1999; 100(10):1134-46. DOI: 10.1161/01.cir.100.10.1134. View

12.

Okubo N, Yoshida T, Tanaka K, Okada N, Hosoi K, Ohara M . Serum creatinine to cystatin C ratio reflects preoperative and early postoperative walking ability in older patients with hip fracture. J Cachexia Sarcopenia Muscle. 2022; 13(2):945-954. PMC: 8977951. DOI: 10.1002/jcsm.12940. View

13.

Lin Y, Chang I, Liou H, Wang C, Lai Y, Kuo C . Serum indices based on creatinine and cystatin C predict mortality in patients with non-dialysis chronic kidney disease. Sci Rep. 2021; 11(1):16863. PMC: 8377030. DOI: 10.1038/s41598-021-96447-9. View

14.

Palanca A, Castelblanco E, Betriu A, Perpinan H, Soldevila B, Valdivielso J . Subclinical atherosclerosis burden predicts cardiovascular events in individuals with diabetes and chronic kidney disease. Cardiovasc Diabetol. 2019; 18(1):93. PMC: 6639953. DOI: 10.1186/s12933-019-0897-y. View

15.

Curry S, Krist A, Owens D, Barry M, Caughey A, Davidson K . Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment With the Ankle-Brachial Index: US Preventive Services Task Force Recommendation Statement. JAMA. 2018; 320(2):177-183. DOI: 10.1001/jama.2018.8357. View

16.

Osaka T, Hamaguchi M, Hashimoto Y, Ushigome E, Tanaka M, Yamazaki M . Decreased the creatinine to cystatin C ratio is a surrogate marker of sarcopenia in patients with type 2 diabetes. Diabetes Res Clin Pract. 2018; 139:52-58. DOI: 10.1016/j.diabres.2018.02.025. View

17.

van Popele N, Grobbee D, Bots M, Asmar R, Topouchian J, Reneman R . Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke. 2001; 32(2):454-60. DOI: 10.1161/01.str.32.2.454. View

18.

von Haehling S, Ebner N, Santos M, Springer J, Anker S . Muscle wasting and cachexia in heart failure: mechanisms and therapies. Nat Rev Cardiol. 2017; 14(6):323-341. DOI: 10.1038/nrcardio.2017.51. View

19.

Lin Y, Chen S, Lai Y, Wang C, Kuo C, Liou H . Serum creatinine to cystatin C ratio predicts skeletal muscle mass and strength in patients with non-dialysis chronic kidney disease. Clin Nutr. 2019; 39(8):2435-2441. DOI: 10.1016/j.clnu.2019.10.027. View

20.

Tang T, Zhuo Y, Xie L, Wang H, Yang M . Sarcopenia index based on serum creatinine and cystatin C is associated with 3-year mortality in hospitalized older patients. Sci Rep. 2020; 10(1):1260. PMC: 6985114. DOI: 10.1038/s41598-020-58304-z. View