血清肌酐/胱抑素C比值与胰岛素抵抗及全因死亡率的关联：一项全国队列分析

Association of serum creatinine/cystatin C ratio with insulin resistance and all-cause mortality: a national cohort analysis.

作者信息

Han Yutong, Zhang Jiahong, Li Qian, Wan Bin, Xie Chunguang

机构信息

Chengdu University of Traditional Chinese Medicine, Chengdu, China.

TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.

出版信息

Front Nutr. 2025 Aug 29;12:1619618. doi: 10.3389/fnut.2025.1619618. eCollection 2025.

DOI:10.3389/fnut.2025.1619618

PMID:40948869

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12426255/

Abstract

BACKGROUND

Serum creatinine/cystatin C (Cr/CysC), a biomarker for skeletal muscle mass, has not been well studied in relation to insulin resistance (IR). This study examined the associations between Cr/CysC, IR, and all-cause mortality.

METHODS

Data were sourced from the NHANES database and analyzed using logistic and linear regression to assess the association between Cr/CysC and IR, quantified by the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL) ratio. Restricted cubic splines (RCS) were employed to identify non-linear associations, and Cox regression was leveraged to determine associations with all-cause mortality.

RESULTS

Higher Cr/CysC ratios were strongly associated with lower IR risk (OR = 0.48, 95% CI: 0.32-0.73,  = 0.001) and lower TG/HDL ( = -0.60,  = 0.001). RCS analysis indicated a non-linear relationship, with increased IR risk below a certain threshold ( < 0.05). Cox regression revealed a negative association between Cr/CysC and all-cause mortality in the overall population (HR = 0.47, 95% CI: 0.31-0.69,  < 0.001) and among non-IR individuals, but not among those with IR. Associations were stronger in middle-aged individuals, women, and non-hypertensive participants.

CONCLUSION

Cr/CysC is inversely associated with IR and all-cause mortality, suggesting its potential as a low-cost marker for stratifying IR risk.

摘要

背景

血清肌酐/胱抑素C（Cr/CysC）作为骨骼肌质量的生物标志物，尚未针对胰岛素抵抗（IR）进行充分研究。本研究探讨了Cr/CysC、IR与全因死亡率之间的关联。

方法

数据来源于美国国家健康与营养检查调查（NHANES）数据库，并使用逻辑回归和线性回归进行分析，以评估Cr/CysC与通过甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL）量化的IR之间的关联。采用受限立方样条（RCS）来识别非线性关联，并利用Cox回归确定与全因死亡率的关联。

结果

较高的Cr/CysC比值与较低的IR风险（OR = 0.48，95%CI：0.32 - 0.73，P = 0.001）和较低的TG/HDL（β = -0.60，P = 0.001）密切相关。RCS分析表明存在非线性关系，在某个阈值以下IR风险增加（P < 0.05）。Cox回归显示，在总体人群中（HR = 0.47，95%CI：0.31 - 0.69，P < 0.001）以及非IR个体中，Cr/CysC与全因死亡率呈负相关，但在IR个体中并非如此。在中年个体、女性和非高血压参与者中，关联更强。