The serum creatinine to cystatin C ratio predicts bone fracture in patients with type 2 diabetes: The Fukuoka Diabetes Registry

被引：28

作者：

Komorita, Yuji ^{[1
,2
]}

Iwase, Masanori ^{[1
,3
]}

Fujii, Hiroki ^{[4
]}

Ide, Hitoshi ^{[1
,5
]}

Ohkuma, Toshiaki ^{[1
,6
]}

Jodai-Kitamura, Tamaki ^{[1
]}

Sumi, Akiko ^{[1
]}

Yoshinari, Masahito ^{[1
]}

Nakamura, Udai ^{[1
]}

Kitazono, Takanari ^{[1
]}

机构：

[1] Kyushu Univ, Grad Sch Med Sci, Dept Med & Clin Sci, Fukuoka, Fukuoka, Japan

[2] Fukuoka Dent Coll, Div Internal Med, Fukuoka, Fukuoka, Japan

[3] Hakujyuji Hosp, Ctr Diabet, Fukuoka, Fukuoka, Japan

[4] Kyushu Univ, Grad Sch Med Sci, Ctr Cohort Studies, Fukuoka, Fukuoka, Japan

[5] Kyushu Dent Univ, Sch Oral Hlth Sci, Div Gen Internal Med, Kitakyushu, Fukuoka, Japan

[6] Univ New South Wales, George Inst Global Hlth, Sydney, NSW, Australia

来源：

DIABETES RESEARCH AND CLINICAL PRACTICE | 2018年 / 146卷

基金：

日本学术振兴会;

关键词：

Serum creatinine; Cystatin C; Sarcopenia; Fracture; Type; 2; diabetes; Cohort study; OLDER-ADULTS; POSTMENOPAUSAL WOMEN; SURROGATE MARKER; RISK; SARCOPENIA; MORTALITY; OBESITY; MASS; ASSOCIATION; PREVALENCE;

D O I：

10.1016/j.diabres.2018.10.021

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims: Sarcopenia is involved in the pathogenesis of increased fracture risk associated with diabetes. The serum creatinine to cystatin C (Cr/CysC) ratio has been reported as a surrogate marker for muscle mass. We aimed to prospectively investigate the relationship between the Cr/CysC ratio and fracture risk. Methods: We followed 1911 postmenopausal women and 2689 men with type 2 diabetes (mean age, 66 years) for a median of 5.3 years, and divided into Cr/CysC ratio quartiles by sex. The primary outcome was fragility fractures and the secondary outcome was any fracture. Results: Fragility fractures occurred in 192 participants, and any fracture occurred in 645 participants. Multivariate-adjusted hazard ratios (95% CI) for fragility fractures were 2.15 (1.19-3.88) (Q1), 1.63 (0.89-2.98) (Q2), 1.34 (0.72-2.51) (Q3) and 1.0 (ref.) (Q4) in post-menopausal women, and 1.75 (0.64-4.50) (Q1), 2.09 (0.83-5.26) (Q2), 1.56 (0.58-4.18) (Q3) and 1.0 (ref.) (Q4) in men. Those for any fracture were 1.46 (1.07-1.98) (Q1), 1.33 (0.98-1.81) (Q2), 1.40 (1.03-1.88) (Q3) and 1.0 (ref.) (Q4) in postmenopausal women, and 2.33 (1.54-3.54) (Q1), 2.02 (1.54-3.04) (Q2), 1.13 (0.71-1.78) (Q3) and 1.0 (ref.) (Q4) in men. Conclusions: A lower Cr/CysC ratio is a significant risk factor for fractures in patients with type 2 diabetes. (C) 2018 Elsevier B.V. All rights reserved.

引用

页码：202 / 210

页数：9

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