Background: Research on the relationship between creatinine to body weight ratios (Cre/BW ratios) and the prevalence of diabetes is still lacking. The intention of this research was to explore the potential relationship between Cre/BW ratio and diabetes prevalence in Chinese adults.
Methods: This retrospective study was conducted on 199 526 patients in the Chinese Rich Healthcare Group from 2010 to 2016. The participants were divided into four groups on the basis of the quartiles of the Cre/BW ratios. Multivariate multiple imputation and dummy variables were used to handle missing values. Multivariate regression analysis was applied to detect the relationship between Cre/BW and diabetes. A smoothing plot was also used to identify whether there were nonlinear relationships.
Results: After handling missing values and adjusting for potential confounders, the multivariate Cox regression analysis results showed that Cre/BW was inversely correlated with diabetes risk (hazard ratio [HR]: 0.268; 95% confidence interval [CI]: 0.229-0.314, p < 0.00001). For men, the HR of incident diabetes was 0.255 (95% CI: 0.212-0.307) and for women it was 0.297 (95% CI: 0.218-0.406). Moreover, sensitivity analysis confirmed the stability of the results. Furthermore, the smoothing plot revealed that there was a saturation effect between Cre/BW and the incidence of diabetes.
Conclusions: This study demonstrated that increased Cre/BW is negatively correlated with diabetes in Chinese adults. It also found that Cre/BW has a nonlinear relationship with the incidence of diabetes.
背景: 肌酐/体重比值(Cre/BW)与糖尿病患病率的关系尚缺乏研究。本研究旨在探讨CRE/BW比值与中国成年人糖尿病患病率之间的潜在关系。 方法: 本回顾性队列研究纳入中国华富医疗项目(Chinese Rich Healthcare Group)从2010 -2016年的199,526例患者。根据Cre/BW比率的四分位数，参与者被分成四组。应用多重插补及哑变量处理缺失值。采用多元回归分析探讨Cre/BW与糖尿病发病风险之间的关系，并运用平滑拟合曲线分析两者是否存在非线性关系。 结果: 在所有受试者中，在处理缺失值和校正潜在混杂因素后，多元回归分析结果显示，Cre/BW与糖尿病风险呈负相关(HR:0.268；95%CI:0.229~0.314，P<0.00001)；男性发生糖尿病的危险比(HR)为0.255(95%CI:0.212~0.307)；女性为0.297(95%CI:0.218~0.406)，敏感性分析证实了结果的稳定性。此外，平滑拟合曲线分析显示CRE/BW与糖尿病发病率之间存在饱和效应。 结论: 本研究表明中国人Cre/BW增加与糖尿病呈负相关。研究还发现，Cre/BW与糖尿病发病率之间存在非线性关系。.
Keywords: body weight; creatinine; diabetes incident; dummy variables; multiple imputations; nonlinearity; 体重; 哑变量; 多重插补; 糖尿病发病率; 肌酐; 非线性。.
© 2022 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd.