Dataset Information

Low serum creatinine and risk of diabetes: The Japan Epidemiology Collaboration on Occupational Health Study.

ABSTRACT: AIMS/INTRODUCTION:We examined a prospective association between serum creatinine levels and diabetes. MATERIALS AND METHODS:The present study included 31,343 male workers without diabetes, and aged between 20 and 64 years at baseline. We calculated the cumulative average of their serum creatinine over the study period. We defined diabetes as either glycated hemoglobin levels ?6.5%, random glucose levels ?200 mg/dL, fasting glucose levels ?126 mg/dL or receiving antidiabetic treatment. Cox proportional hazards regression analysis was carried out to estimate the hazard ratio (HR) and 95% confidence interval (CI). RESULTS:With a median observation of 7.7 years, 2,509 participants developed diabetes. After adjusting for age, smoking, body mass index, hypertension and dyslipidemia, lower cumulative average serum creatinine levels were related to a greater diabetes risk: HRs were 1.56 (95% CI 1.35-1.82), 1.22 (1.09-1.35) and 1.06 (0.96-1.17) for the participants with serum creatinine <0.70, 0.70-0.79 and 0.80-0.89 mg/dL, respectively, compared with those with 0.90-1.20 mg/dL (P for trend <0.001). The serum creatinine-diabetes association was more pronounced among older adults (serum creatinine <0.70 vs 0.90-1.20 mg/dL, HR 1.66, 95% CI 1.37-2.00) than younger adults (HR 1.32, 95% CI 1.02-1.71; P for interaction by age group = 0.001). CONCLUSIONS:Low serum creatinine is associated with an increased risk of diabetes. Screening serum creatinine levels can be used to identify those who are at high risk of diabetes.

SUBMITTER: Hu H

PROVIDER: S-EPMC6717816 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Low serum creatinine and risk of diabetes: The Japan Epidemiology Collaboration on Occupational Health Study.

Hu Huanhuan H Nakagawa Tohru T Honda Toru T Yamamoto Shuichiro S Okazaki Hiroko H Yamamoto Makoto M Miyamoto Toshiaki T Eguchi Masafumi M Kochi Takeshi T Shimizu Makiko M Murakami Taizo T Tomita Kentaro K Ogasawara Takayuki T Sasaki Naoko N Uehara Akihiko A Kuwahara Keisuke K Kabe Isamu I Mizoue Tetsuya T Sone Tomofumi T Dohi Seitaro S

Journal of diabetes investigation 20190402 5

<h4>Aims/introduction</h4>We examined a prospective association between serum creatinine levels and diabetes.<h4>Materials and methods</h4>The present study included 31,343 male workers without diabetes, and aged between 20 and 64 years at baseline. We calculated the cumulative average of their serum creatinine over the study period. We defined diabetes as either glycated hemoglobin levels ≥6.5%, random glucose levels ≥200 mg/dL, fasting glucose levels ≥126 mg/dL or receiving antidiabetic treatm ...[more]

PMID: 30756513

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Project description:AimsThe control of blood glucose levels, blood pressure (BP), and low-density lipoprotein cholesterol (LDL-C) levels reduces the risk of diabetes complications; however, data are scarce on control status of these factors among workers with diabetes. The present study aimed to estimate the prevalence of participants with diabetes who meet glycated hemoglobin (HbA1c), BP, and LDL-C recommendations, and to investigate correlates of poor glycemic control in a large working population in Japan.MethodsThe Japan Epidemiology Collaboration on Occupational Health (J-ECOH) Study is an ongoing cohort investigation, consisting mainly of employees in large manufacturing companies. We conducted a cross-sectional analysis of 3,070 employees with diabetes (2,854 men and 216 women) aged 20-69 years who attended periodic health examinations. BP was measured and recorded using different company protocols. Risk factor targets were defined using both American Diabetes Association (ADA) guidelines (HbA1c < 7.0%, BP < 140/90 mmHg, and LDL-C < 100 mg/dL) and Japan Diabetes Society (JDS) guidelines (HbA1c < 7.0%, BP < 130/80 mmHg, and LDL-C < 120 mg/dL). Logistic regression models were used to explore correlates of poor glycemic control (defined as HbA1c ? 8.0%).ResultsThe percentages of participants who met ADA (and JDS) targets were 44.9% (44.9%) for HbA1c, 76.6% (36.3%) for BP, 27.1% (56.2%) for LDL-C, and 11.2% (10.8%) for simultaneous control of all three risk factors. Younger age, obesity, smoking, and uncontrolled dyslipidemia were associated with poor glycemic control. The adjusted odds ratio of poor glycemic control was 0.58 (95% confidence interval, 0.46-0.73) for participants with treated but uncontrolled hypertension, and 0.47 (0.33-0.66) for participants with treated and controlled hypertension, as compared with participants without hypertension. There was no significant difference in HbA1c levels between participants with treated but uncontrolled hypertension and those with treated and controlled hypertension.ConclusionData from a large working population, predominantly composed of men, suggest that achievement of HbA1c, BP, and LDL-C targets was less than optimal, especially in younger participants. Uncontrolled dyslipidemia was associated with poor glycemic control. Participants not receiving antihypertensive treatment had higher HbA1c levels.

Project description:BACKGROUND: 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. METHODS: Cross-sectional study of 1,017 consecutive morbidly obese patients with an estimated glomerular filtration rate >60 ml/min/1.73 m2. 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. RESULTS: The unadjusted GAM analysis suggested a piecewise linear relationship between serum creatinine and diabetes. Each 1 mumol/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 mumol/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. CONCLUSIONS: 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.

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Low serum creatinine and risk of diabetes: The Japan Epidemiology Collaboration on Occupational Health Study.

Publications

Low serum creatinine and risk of diabetes: The Japan Epidemiology Collaboration on Occupational Health Study.

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