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

Yuji Komorita, Masanori Iwase, Hiroki Fujii, Hitoshi Ide, Toshiaki Ohkuma, Tamaki Jodai-Kitamura, Akiko Sumi, Masahito Yoshinari, Udai Nakamura, Takanari Kitazono

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Abstract

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 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. Conclusions: A lower Cr/CysC ratio is a significant risk factor for fractures in patients with type 2 diabetes.

Original languageEnglish
Pages (from-to)202-210
Number of pages9
JournalDiabetes Research and Clinical Practice
Volume146
DOIs
Publication statusPublished - Dec 1 2018

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Cystatin C
Bone Fractures
Type 2 Diabetes Mellitus
Registries
Creatinine
Serum
Sarcopenia
Sex Ratio
Biomarkers
Odds Ratio
Muscles

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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The serum creatinine to cystatin C ratio predicts bone fracture in patients with type 2 diabetes : The Fukuoka Diabetes Registry. / Komorita, Yuji; Iwase, Masanori; Fujii, Hiroki; Ide, Hitoshi; Ohkuma, Toshiaki; Jodai-Kitamura, Tamaki; Sumi, Akiko; Yoshinari, Masahito; Nakamura, Udai; Kitazono, Takanari.

In: Diabetes Research and Clinical Practice, Vol. 146, 01.12.2018, p. 202-210.

Research output: Contribution to journalArticle

Komorita, Yuji ; Iwase, Masanori ; Fujii, Hiroki ; Ide, Hitoshi ; Ohkuma, Toshiaki ; Jodai-Kitamura, Tamaki ; Sumi, Akiko ; Yoshinari, Masahito ; Nakamura, Udai ; Kitazono, Takanari. / The serum creatinine to cystatin C ratio predicts bone fracture in patients with type 2 diabetes : The Fukuoka Diabetes Registry. In: Diabetes Research and Clinical Practice. 2018 ; Vol. 146. pp. 202-210.
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title = "The serum creatinine to cystatin C ratio predicts bone fracture in patients with type 2 diabetes: The Fukuoka Diabetes Registry",
abstract = "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 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. Conclusions: A lower Cr/CysC ratio is a significant risk factor for fractures in patients with type 2 diabetes.",
author = "Yuji Komorita and Masanori Iwase and Hiroki Fujii and Hitoshi Ide and Toshiaki Ohkuma and Tamaki Jodai-Kitamura and Akiko Sumi and Masahito Yoshinari and Udai Nakamura and Takanari Kitazono",
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T1 - The serum creatinine to cystatin C ratio predicts bone fracture in patients with type 2 diabetes

T2 - The Fukuoka Diabetes Registry

AU - Komorita, Yuji

AU - Iwase, Masanori

AU - Fujii, Hiroki

AU - Ide, Hitoshi

AU - Ohkuma, Toshiaki

AU - Jodai-Kitamura, Tamaki

AU - Sumi, Akiko

AU - Yoshinari, Masahito

AU - Nakamura, Udai

AU - Kitazono, Takanari

PY - 2018/12/1

Y1 - 2018/12/1

N2 - 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 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. Conclusions: A lower Cr/CysC ratio is a significant risk factor for fractures in patients with type 2 diabetes.

AB - 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 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. Conclusions: A lower Cr/CysC ratio is a significant risk factor for fractures in patients with type 2 diabetes.

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