Yoshida Naohiko, Miyake Teruki, Yamamoto Shin, Furukawa Shinya, Senba Hidenori, Kanzaki Sayaka, Koizumi Mitsuhito, Ishihara Toru, Yoshida Osamu, Hirooka Masashi, Kumagi Teru, Abe Masanori, Kitai Kohichiro, Matsuura Bunzo, Hiasa Yoichi
Department of Internal Medicine, Ozora Hospital, Japan.
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan.
Intern Med. 2019 Feb 15;58(4):505-510. doi: 10.2169/internalmedicine.0760-18. Epub 2018 Oct 17.
Objective Skeletal muscle is the main target organ for glycemic control, and the serum creatinine level is a convenient indicator of the skeletal muscle mass. This study aimed to assess the potential relationship between the serum creatinine level and the onset of impaired fasting glucose (IFG). Methods In this large, community-based, retrospective longitudinal cohort study, we examined the records of 7,905 Japanese participants (3,863 men, 4,042 women) of 18-80 years of age who underwent annual health checkups at a single center between April 2003 and August 2013. After applying the exclusion criteria, 6,490 participants were reviewed to identify those with the onset of IFG, defined as a fasting plasma glucose ≥6.11 mM. Among the participants, 278 met the criterion for the onset of IFG during the observation period. Results Creatinine levels were higher in male subjects who exercised periodically and were exercise conscious in comparison to those who did not exercise, and were higher in female subjects who exercised periodically in comparison to female subjects who did not exercise and who were not exercise conscious. Additionally, the serum creatinine level was negatively associated with the onset of IFG in both men [adjusted hazard ratio, 0.98; 95% confidence interval (CI), 0.96-0.99; p=0.008] and women (adjusted hazard ratio, 0.94; 95% CI, 0.91-0.97; p<0.001) after adjustment for variables previously reported to be risk factors for the onset of glucose intolerance and factors associated with chronic kidney disease. Conclusion A low creatinine level might be associated with the onset of IFG. Moreover, the fact that serum creatinine levels increase with exercise might demonstrate the importance of exercise therapy.
目的 骨骼肌是血糖控制的主要靶器官，血清肌酐水平是骨骼肌质量的便捷指标。本研究旨在评估血清肌酐水平与空腹血糖受损（IFG）发病之间的潜在关系。方法 在这项基于社区的大型回顾性纵向队列研究中，我们检查了2003年4月至2013年8月期间在单一中心接受年度健康检查的7905名18 - 80岁日本参与者（3863名男性，4042名女性）的记录。应用排除标准后，对6490名参与者进行了评估，以确定那些发生IFG的患者，IFG定义为空腹血糖≥6.11 mM。在这些参与者中，278人在观察期内符合IFG发病标准。结果 与不运动的男性相比，定期运动且有运动意识的男性肌酐水平更高；与不运动且没有运动意识的女性相比，定期运动的女性肌酐水平更高。此外，在对先前报道的葡萄糖不耐受发病风险因素和与慢性肾病相关的因素进行调整后，男性[调整后风险比，0.98；95%置信区间（CI），0.96 - 0.99；p = 0.008]和女性（调整后风险比，0.94；95%CI，0.91 - 0.97；p < 0.001）的血清肌酐水平与IFG发病均呈负相关。结论 低肌酐水平可能与IFG发病有关。此外，血清肌酐水平随运动增加这一事实可能表明运动疗法的重要性。
