Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
Department of Endocrinology and Metabolism, Kameoka Municipal Hospital, 1-1 Shinoda Shino-cho, Kaweoka, Kyoto 621-8585, Japan.
Diabetes Res Clin Pract. 2018 May;139:52-58. doi: 10.1016/j.diabres.2018.02.025. Epub 2018 Feb 27.
Sarcopenia has recently been shown to affect quality of life and mortality in patients with diabetes. However, early detection requires an expensive equipment. We hypothesized that the ratio of the creatinine/cystatin (Cre/CysC) could be used as a marker for sarcopenia.
We investigated the association between the Cre/CysC ratio and sarcopenia in a cross-sectional study of patients with type 2 diabetes. Skeletal muscle mass (SMM) was estimated by bioelectrical impedance. The skeletal muscle index (SMI) was defined as the appendicular SMM divided by the square of the height. Sarcopenia was defined with SMI and a grip strength.
We identified 285 patients with type 2 diabetes, of whom 25 (8.8%) had sarcopenia. The Cre/CysC ratio was associated with an increased risk of sarcopenia [odds ratio per 0.01 increment, 1.05; 95% confidence interval (CI), 1.01-1.09] after adjusting for covariates. Receiver operating characteristic curve analysis indicated that the optimal the Cre/CysC ratio cut-off point for identifying sarcopenia was 0.9, with an area under the curve, sensitivity, and specificity of 0.683 (95% CI, 0.573-0.793), 0.80, and 0.48, respectively.
We recommend the Cre/CysC ratio as a practical screening marker for sarcopenia in patients with type 2 diabetes.
肌少症最近被证明会影响糖尿病患者的生活质量和死亡率。然而，早期检测需要昂贵的设备。我们假设肌酐/半胱氨酸（Cre/CysC）比值可作为肌少症的标志物。
我们对 2 型糖尿病患者进行了一项横断面研究，调查 Cre/CysC 比值与肌少症之间的关系。通过生物电阻抗法估计骨骼肌质量（SMM）。四肢骨骼肌指数（SMI）定义为四肢骨骼肌质量除以身高的平方。通过 SMI 和握力来定义肌少症。
我们共纳入 285 例 2 型糖尿病患者，其中 25 例（8.8%）患有肌少症。校正混杂因素后，Cre/CysC 比值与肌少症的发生风险增加相关[每增加 0.01 的比值比，1.05；95%置信区间（CI），1.01-1.09]。受试者工作特征曲线分析表明，用于识别肌少症的最佳 Cre/CysC 比值截断点为 0.9，曲线下面积、敏感度和特异度分别为 0.683（95%CI，0.573-0.793）、0.80 和 0.48。
我们建议 Cre/CysC 比值可作为 2 型糖尿病患者肌少症的实用筛查标志物。
