Low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: a cross-sectional study
<p>Abstract</p> <p>Background</p> <p>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...
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doaj-c6a35dd7a5e14c9b8ed4ac39a14487392020-11-25T03:55:12ZengBMCBMC Endocrine Disorders1472-68232010-04-01101610.1186/1472-6823-10-6Low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: a cross-sectional studyHofsø DagNordstrand NjordRøislien JoHjelmesæth JøranHager HelleHartmann Anders<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>Cross-sectional study of 1,017 consecutive morbidly obese patients with an estimated glomerular filtration rate >60 ml/min/1.73 m<sup>2</sup>. 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.</p> <p>Results</p> <p>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.</p> <p>Conclusions</p> <p>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.</p> http://www.biomedcentral.com/1472-6823/10/6 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hofsø Dag Nordstrand Njord Røislien Jo Hjelmesæth Jøran Hager Helle Hartmann Anders |
spellingShingle |
Hofsø Dag Nordstrand Njord Røislien Jo Hjelmesæth Jøran Hager Helle Hartmann Anders Low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: a cross-sectional study BMC Endocrine Disorders |
author_facet |
Hofsø Dag Nordstrand Njord Røislien Jo Hjelmesæth Jøran Hager Helle Hartmann Anders |
author_sort |
Hofsø Dag |
title |
Low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: a cross-sectional study |
title_short |
Low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: a cross-sectional study |
title_full |
Low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: a cross-sectional study |
title_fullStr |
Low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: a cross-sectional study |
title_full_unstemmed |
Low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: a cross-sectional study |
title_sort |
low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: a cross-sectional study |
publisher |
BMC |
series |
BMC Endocrine Disorders |
issn |
1472-6823 |
publishDate |
2010-04-01 |
description |
<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>Cross-sectional study of 1,017 consecutive morbidly obese patients with an estimated glomerular filtration rate >60 ml/min/1.73 m<sup>2</sup>. 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.</p> <p>Results</p> <p>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.</p> <p>Conclusions</p> <p>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.</p> |
url |
http://www.biomedcentral.com/1472-6823/10/6 |
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