The serum creatinine to cystatin C ratio predicts bone fracture in patients with type 2 diabetes: The Fukuoka Diabetes Registry
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 ri...
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| Veröffentlicht in: | Diabetes research and clinical practice 2018-12, Vol.146, p.202-210 |
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| creator | Komorita, Yuji Iwase, Masanori Fujii, Hiroki Ide, Hitoshi Ohkuma, Toshiaki Jodai-Kitamura, Tamaki Sumi, Akiko Yoshinari, Masahito Nakamura, Udai Kitazono, Takanari |
| description | 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.
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.
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 postmenopausal 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.
A lower Cr/CysC ratio is a significant risk factor for fractures in patients with type 2 diabetes. |
| doi_str_mv | 10.1016/j.diabres.2018.10.021 |
| format | Article |
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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.
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 postmenopausal 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.
A lower Cr/CysC ratio is a significant risk factor for fractures in patients with type 2 diabetes.</description><identifier>ISSN: 0168-8227</identifier><identifier>EISSN: 1872-8227</identifier><identifier>DOI: 10.1016/j.diabres.2018.10.021</identifier><identifier>PMID: 30391334</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Aged ; Cohort study ; Creatinine - blood ; Cystatin C ; Cystatin C - blood ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - complications ; Female ; Fracture ; Fractures, Bone - diagnosis ; Fractures, Bone - etiology ; Humans ; Male ; Prospective Studies ; Registries ; Risk Factors ; Sarcopenia ; Sarcopenia - diagnosis ; Sarcopenia - etiology ; Serum creatinine ; Type 2 diabetes</subject><ispartof>Diabetes research and clinical practice, 2018-12, Vol.146, p.202-210</ispartof><rights>2018 Elsevier B.V.</rights><rights>Copyright © 2018 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-d5091111daf570d8f12d7215595e2878d3b0c0f62a868b013a801f0f115d1b53</citedby><cites>FETCH-LOGICAL-c365t-d5091111daf570d8f12d7215595e2878d3b0c0f62a868b013a801f0f115d1b53</cites><orcidid>0000-0001-5446-3295 ; 0000-0002-9592-4251</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.diabres.2018.10.021$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30391334$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Komorita, Yuji</creatorcontrib><creatorcontrib>Iwase, Masanori</creatorcontrib><creatorcontrib>Fujii, Hiroki</creatorcontrib><creatorcontrib>Ide, Hitoshi</creatorcontrib><creatorcontrib>Ohkuma, Toshiaki</creatorcontrib><creatorcontrib>Jodai-Kitamura, Tamaki</creatorcontrib><creatorcontrib>Sumi, Akiko</creatorcontrib><creatorcontrib>Yoshinari, Masahito</creatorcontrib><creatorcontrib>Nakamura, Udai</creatorcontrib><creatorcontrib>Kitazono, Takanari</creatorcontrib><title>The serum creatinine to cystatin C ratio predicts bone fracture in patients with type 2 diabetes: The Fukuoka Diabetes Registry</title><title>Diabetes research and clinical practice</title><addtitle>Diabetes Res Clin Pract</addtitle><description>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.
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.
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 postmenopausal 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.
A lower Cr/CysC ratio is a significant risk factor for fractures in patients with type 2 diabetes.</description><subject>Aged</subject><subject>Cohort study</subject><subject>Creatinine - blood</subject><subject>Cystatin C</subject><subject>Cystatin C - blood</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Female</subject><subject>Fracture</subject><subject>Fractures, Bone - diagnosis</subject><subject>Fractures, Bone - etiology</subject><subject>Humans</subject><subject>Male</subject><subject>Prospective Studies</subject><subject>Registries</subject><subject>Risk Factors</subject><subject>Sarcopenia</subject><subject>Sarcopenia - diagnosis</subject><subject>Sarcopenia - etiology</subject><subject>Serum creatinine</subject><subject>Type 2 diabetes</subject><issn>0168-8227</issn><issn>1872-8227</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEFvGyEQhVGUqHGd_oRGHHOxOwNhF-dSVW7TVooUKfIdsTDb4NjeLbCpfOpfLxu7uYbLwJs3PPgY-4gwR8Dq03rug20ipbkA1EWbg8ATNkFdi5kWoj5lk-LTL_tz9j6lNQBU8lq9Y-cS5AKlvJ6wv6tH4onisOUuks1hF3bEc8fdPuXxyJc8ltrxPpIPLifedMXRRuvyEIkXR1_6tCudPyE_8rzviQs-vo4ypRs-JtwOT0P3ZPnXo8of6FdIOe4v2FlrN4k-HOuUrW6_rZY_Znf3338uv9zNnKxUnnkFCyzL21bV4HWLwtcClVooErrWXjbgoK2E1ZVuAKXVgC20iMpjo-SUXR2u7WP3e6CUzTYkR5uN3VE3JCNQAqi6KoCmTB2sLnYpRWpNH8PWxr1BMCN6szZH9GZEP8oFfZm7PEYMzZb869R_1sXw-WCg8s_nQNEkV7i5gjWSy8Z34Y2If2iMl9c</recordid><startdate>201812</startdate><enddate>201812</enddate><creator>Komorita, Yuji</creator><creator>Iwase, Masanori</creator><creator>Fujii, Hiroki</creator><creator>Ide, Hitoshi</creator><creator>Ohkuma, Toshiaki</creator><creator>Jodai-Kitamura, Tamaki</creator><creator>Sumi, Akiko</creator><creator>Yoshinari, Masahito</creator><creator>Nakamura, Udai</creator><creator>Kitazono, Takanari</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5446-3295</orcidid><orcidid>https://orcid.org/0000-0002-9592-4251</orcidid></search><sort><creationdate>201812</creationdate><title>The serum creatinine to cystatin C ratio predicts bone fracture in patients with type 2 diabetes: The Fukuoka Diabetes Registry</title><author>Komorita, Yuji ; Iwase, Masanori ; Fujii, Hiroki ; Ide, Hitoshi ; Ohkuma, Toshiaki ; Jodai-Kitamura, Tamaki ; Sumi, Akiko ; Yoshinari, Masahito ; Nakamura, Udai ; Kitazono, Takanari</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-d5091111daf570d8f12d7215595e2878d3b0c0f62a868b013a801f0f115d1b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Cohort study</topic><topic>Creatinine - blood</topic><topic>Cystatin C</topic><topic>Cystatin C - blood</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Female</topic><topic>Fracture</topic><topic>Fractures, Bone - diagnosis</topic><topic>Fractures, Bone - etiology</topic><topic>Humans</topic><topic>Male</topic><topic>Prospective Studies</topic><topic>Registries</topic><topic>Risk Factors</topic><topic>Sarcopenia</topic><topic>Sarcopenia - diagnosis</topic><topic>Sarcopenia - etiology</topic><topic>Serum creatinine</topic><topic>Type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Komorita, Yuji</creatorcontrib><creatorcontrib>Iwase, Masanori</creatorcontrib><creatorcontrib>Fujii, Hiroki</creatorcontrib><creatorcontrib>Ide, Hitoshi</creatorcontrib><creatorcontrib>Ohkuma, Toshiaki</creatorcontrib><creatorcontrib>Jodai-Kitamura, Tamaki</creatorcontrib><creatorcontrib>Sumi, Akiko</creatorcontrib><creatorcontrib>Yoshinari, Masahito</creatorcontrib><creatorcontrib>Nakamura, Udai</creatorcontrib><creatorcontrib>Kitazono, Takanari</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes research and clinical practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Komorita, Yuji</au><au>Iwase, Masanori</au><au>Fujii, Hiroki</au><au>Ide, Hitoshi</au><au>Ohkuma, Toshiaki</au><au>Jodai-Kitamura, Tamaki</au><au>Sumi, Akiko</au><au>Yoshinari, Masahito</au><au>Nakamura, Udai</au><au>Kitazono, Takanari</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The serum creatinine to cystatin C ratio predicts bone fracture in patients with type 2 diabetes: The Fukuoka Diabetes Registry</atitle><jtitle>Diabetes research and clinical practice</jtitle><addtitle>Diabetes Res Clin Pract</addtitle><date>2018-12</date><risdate>2018</risdate><volume>146</volume><spage>202</spage><epage>210</epage><pages>202-210</pages><issn>0168-8227</issn><eissn>1872-8227</eissn><abstract>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.
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.
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 postmenopausal 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.
A lower Cr/CysC ratio is a significant risk factor for fractures in patients with type 2 diabetes.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>30391334</pmid><doi>10.1016/j.diabres.2018.10.021</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5446-3295</orcidid><orcidid>https://orcid.org/0000-0002-9592-4251</orcidid></addata></record> |
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| ispartof | Diabetes research and clinical practice, 2018-12, Vol.146, p.202-210 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Aged Cohort study Creatinine - blood Cystatin C Cystatin C - blood Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - complications Female Fracture Fractures, Bone - diagnosis Fractures, Bone - etiology Humans Male Prospective Studies Registries Risk Factors Sarcopenia Sarcopenia - diagnosis Sarcopenia - etiology Serum creatinine Type 2 diabetes |
| title | The serum creatinine to cystatin C ratio predicts bone fracture in patients with type 2 diabetes: The Fukuoka Diabetes Registry |
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