Open Access血肌酐和2型糖尿病风险之间的剂量反应关联:一项中国队列研究和基于队列研究的 meta 分析
Author(s) -
Qin Pei,
Lou Yanmei,
Cao Liming,
Shi Jing,
Tian Gang,
Liu Dechen,
Zhou Qionggui,
Guo Chunmei,
Li Quanman,
Zhao Yang,
Liu Feiyan,
Wu Xiaoyan,
Qie Ranran,
Han Minghui,
Huang Shengbing,
Zhao Ping,
Wang Changyi,
Ma Jianping,
Peng Xiaolin,
Xu Shan,
Chen Hongen,
Zhao Dan,
Zhang Ming,
Hu Dongsheng,
Hu Fulan
Publication year - 2020
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.13038
Subject(s) - medicine , creatinine , cohort , hazard ratio , relative risk , quartile , type 2 diabetes mellitus , cohort study , proportional hazards model , renal function , diabetes mellitus , prospective cohort study , endocrinology , confidence interval
Background This study aims to investigate the association between serum creatinine and risk of type 2 diabetes mellitus (T2DM) based on a cohort analysis and meta‐analysis of cohort studies. Methods We enrolled 41 439 participants aged ≥18 years without T2DM at baseline, who had ≥2 health examinations based on an ongoing prospective cohort in Beijing. Cox proportional hazards regression model was used to estimate hazard ratios (HRs) and 95% CIs. For the meta‐analysis, cohort studies reporting risk estimates for the serum creatinine‐T2DM association were included. A random‐effects model was used to calculate summary relative risks (RRs) and restricted cubic splines to model the dose‐response association. Results During a mean follow‐up of 3.54 years, 1867 developed T2DM. Low serum creatinine was associated with increased risk of T2DM; adjusted HRs (95% CIs) across sex‐specific quartiles were 1.45 (1.24, 1.71), 1.19 (1.02, 1.39), 1.07 (0.92, 1.24), and 1.00 (reference). The association was significant for both sexes and individuals with overweight or obesity. In the meta‐analysis of six cohort studies (including the current study) involving 115 767 participants and 5370 T2DM events, the pooled RR was 1.61 (95% CI 1.35, 1.92), comparing the lowest with the highest category of serum creatinine. We found a linear association between serum creatinine and T2DM risk ( P nonlinearity = .082) and an increased risk of T2DM with each 0.1‐mg/dL decrease in serum creatinine (RR = 1.07; 95% CI 1.04, 1.09). Conclusions The cohort study and meta‐analysis provide further evidence supporting the negative association between serum creatinine and T2DM risk in a linear dose‐response pattern.