Assessment of the relationship between prediabetes and low skeletal mass based on blood creatinine level

BACKGROUND: Low muscle mass increases the risk of developing type 2 diabetes mellitus (DM 2) and prediabetes. Nutrition is an important factor in the study of the relationship between low muscle mass and the development of glucose metabolic disorders.

AIM: The present study was conducted to assess the relationship between prediabetes and low muscle mass on the basis of serum creatinine levels, taking into account patient nutrition.

MATERIALS AND METHODS: The study included 551 patients aged 18–69 years without DM 2. The glucose level was determined based on fasting glucose and after an oral glucose tolerance test (OGTT). Hyperglycemia is assessed according to the classification of the World Health Organization. The MedDietScore questionnaire was used to assess the nutritional factor, which determines the adherence of patients to the Mediterranean diet. In order to assess odds ratios (OR) and 95% confidence interval (CI), a binary logistic regression was performed.

RESULTS: The prevalence of prediabetes in the group with the lowest and highest blood creatinine level was 31.9% and 17.5% respectively (p=0.016). As a result of the conducted regression analysis, a statistically significant relationship was found between low creatinine levels and the chances of having prediabetes (crude OR 2,07, 95% CI 1,21; 3,56), which persisted after adjusting for socio-demographic, anthropometric factors, stress level and physical activity as well as muscle strength. After adding the data on MedDietScore to the statistical model, the revealed relationship was lost (p = 0.187).

CONCLUSION: Low serum creatinine increases the chances of the presence of prediabet regardless of gender, age, body weight index, the volume of the hips, the ratio of the volume of the waist to growth, as well as physical activity, the level of stress and muscular power. However, the chances of the presence of prediabet do not differ in persons with low creatinine blood depending on the commitment to the Mediterranean diet among the population of those living in the Turkestan region.

1. Jing C, Wang Z, Fu X. Effect of diabetes mellitus on survival in patients with gallbladder Cancer: A systematic review and meta-analysis. BMC Cancer. 2020;20(1):1-8. doi: https://doi.org/10.1186/s12885-020-07139-y

2. Bullard KMK, Saydah SH, Imperatore G, et al. Secular changes in U.S. prediabetes prevalence defined by hemoglobin A 1c and fasting plasma glucose: National Health and Nutrition Examination Surveys, 1999-2010. Diabetes Care. 2013;36(8):2286-2293. doi: https://doi.org/10.2337/dc12-2563

3. Al-Goblan AS, Al-Alfi MA, Khan MZ. Mechanism linking diabetes mellitus and obesity. Diabetes, MetabSyndrObes Targets Ther. 2014;7:587-591. doi: https://doi.org/10.2147/DMSO.S67400

4. Rhee E-J. Diabetes in Asians. Endocrinol Metab. 2015;30(3):263. doi: https://doi.org/10.3803/EnM.2015.30.3.263

5. Harita N, Hayashi T, Sata KK, et al. Lower serum creatinine is a new risk factor of type 2 diabetes: The kansai healthcare study. Diabetes Care. 2009;32(3):424-426. doi: https://doi.org/10.2337/dc08-1265

6. Takeuchi M, Imano H, Muraki I, et al. Serum creatinine levels and risk of incident type 2 diabetes mellitus or dysglycemia in middle-aged Japanese men: a retrospective cohort study. BMJ Open Diabetes Res Care. 2018;6(1):e000492. doi: https://doi.org/10.1136/bmjdrc-2017-000492

7. Kim JA, Hwang SY, Chung HS, et al. Proportion and characteristics of the subjects with low muscle mass and abdominal obesity among the newly diagnosed and drug-naïve type 2 diabetes mellitus patients. Diabetes Metab J. 2019;43(1):105-113. doi: https://doi.org/10.4093/dmj.2018.0036

8. Patel SS, Molnar MZ, Tayek JA, et al. Serum creatinine as a marker of muscle mass in chronic kidney disease: Results of a cross-sectional study and review of literature. J Cachexia Sarcopenia Muscle. 2013;4(1):19-29. doi: https://doi.org/10.1007/s13539-012-0079-1

9. Clark RV, Walker AC, O’Connor-Semmes RL, et al. Total body skeletal muscle mass: Estimation by creatine (methyl-d3) dilution in humans. J Appl Physiol. 2014;116(12):1605-1613. doi: https://doi.org/10.1152/japplphysiol.00045.2014

10. Noori N,Kovesdy CP,Bross R, et al. Novel equations to estimate lean bodymassin maintenance hemodialysis patients. Am J Kidney Dis. 2011;57(1):130-139.doi: https://doi.org/10.1053/j.ajkd.2010.10.003

11. Thongprayoon C, Cheungpasitporn W, Kashani K. Serum creatinine level, a surrogate of muscle mass, predicts mortality in critically ill patients. J Thorac Dis. 2016;8(5):E305-E311. doi: https://doi.org/10.21037/jtd.2016.03.62

12. Hjelmesæth J, Røislien J, Nordstrand N, et al. Low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: A cross-sectional study. BMC Endocr Disord. 2010;10(1):1-6. doi: https://doi.org/10.1186/1472-6823-10-6

13. Kashima S, Inoue K, Matsumoto M, Akimoto K. Low serum creatinine is a type 2 diabetes risk factor in men and women: The Yuport Health Checkup Center cohort study. Diabetes Metab. 2017;43(5):460-464. doi: https://doi.org/10.1016/j.diabet.2017.04.005

14. Hu H, Nakagawa T, Honda T, et al. Low serum creatinine and risk of diabetes: The Japan Epidemiology Collaboration on Occupational Health Study. J Diabetes Investig. 2019;10(5):1209-1214. doi: https://doi.org/10.1111/jdi.13024

15. Yoshida N, Miyake T, Yamamoto S, et al. The serum creatinine level might be associated with the onset of impaired fasting glucose: A community-based longitudinal cohort health checkup study. InternMed. 2019;58(4):505-510. doi: https://doi.org/10.2169/internalmedicine.0760-18

16. Sakai S, Tanimoto K, Imbe A, et al. Decreased β-cell function is associated with reduced skeletal muscle mass in Japanese subjects without diabetes. PLoS One. 2016;11(9):1-11. doi: https://doi.org/10.1371/journal.pone.0162603

17. Aleman-Mateo H, Lopez Teros MT, Ramirez C FA, Astiazaran-Garcia H. Association Between Insulin Resistance and Low Relative Appendicular Skeletal Muscle Mass: Evidence From a Cohort Study in Community-Dwelling Older Men and Women Participants. Journals Gerontol Ser A Biol Sci Med Sci. 2014;69(7):871-877. doi: https://doi.org/10.1093/gerona/glt193

18. Moon SS. Low skeletal muscle mass is associated with insulin resistance, diabetes, and metabolic syndrome in the Korean population: The Korea National health and nutrition examination survey (KNHANES) 2009-2010. Endocr J. 2014;61(1):61-70. doi: https://doi.org/10.1507/endocrj.EJ13-0244

19. Toktarova NN, Bazarbekova RB, Dosanova AK. The prevalence of type 2 diabetes mellitus in adult population of Kazakhstan (results of NOMAD national register study). Medicine (Almaty). 2017;6(180):43-51. (In Russ.).

20. Dedov II, Shestakova MV, Galstyan GR. The prevalence of type 2 diabetes mellitus in the adult population of Russia (NATION study). Diabetes Mellitus. 2016;19(2):104-112. (In Russ.). doi: https://doi.org/10.14341/DM2004116-17

21. Mohammad A, Ziyab AH, Mohammad T. Prevalence of prediabetes and undiagnosed diabetes among kuwaiti adults: A cross-sectional study. Diabetes, MetabSyndrObes Targets Ther. 2021;14:2167-2176. doi: https://doi.org/10.2147/DMSO.S296848

22. Andes LJ, Cheng YJ, Rolka DB, et al. Prevalence of Prediabetes among Adolescents and Young Adults in the United States, 2005-2016. JAMA Pediatr. 2020;174(2). doi: https://doi.org/10.1001/jamapediatrics.2019.4498

23. Aekplakorn W, Tantayotai V, Numsangkul S, et al. Detecting Prediabetes and Diabetes: Agreement between Fasting Plasma Glucose and Oral Glucose Tolerance Test in Thai Adults. J Diabetes Res. 2015;2015:1-7. doi: https://doi.org/10.1155/2015/396505

24. Mustafa N, Kamarudin NA, Ismail AA, et al. Prevalence of abnormal glucose tolerance and risk factors in urban and rural Malaysia. Diabetes Care. 2011;34(6):1362-1364. doi: https://doi.org/10.2337/dc11-0005

25. Hostalek U. Global epidemiology of prediabetes — present and future perspectives. ClinDiabetesEndocrinol. 2019;5(1):1-5. doi: https://doi.org/10.1186/s40842-019-0080-0

26. Sharabi K, Tavares CDJ, Rines AK, Puigserver P. Molecular pathophysiology of hepatic glucose production. Mol Aspects Med. 2015;46:21-33. doi: https://doi.org/10.1016/j.mam.2015.09.003

27. Yoshida N, Miyake T, Yamamoto S, et al. The serum creatinine level might be associated with the onset of impaired fasting glucose: A community-based longitudinal cohort health checkup study. InternMed. 2019;58(4):505-510. doi: https://doi.org/10.2169/internalmedicine.0760-18

28. Larsen BA, Wassel CL, Kritchevsky SB, et al. Association of muscle mass, area, and strength with incident diabetes in older adults: The Health ABC Study. J Clin Endocrinol Metab. 2016;101(4):1847-1855. doi: https://doi.org/10.1210/jc.2015-3643

29. Kuk JL, Kilpatrick K, Davidson LE, et al. Whole-body skeletal muscle mass is not related to glucose tolerance or insulin sensitivity in overweight and obese men and women. Appl PhysiolNutrMetab. 2008;33(4):769-774. doi: https://doi.org/10.1139/H08-060

30. Granic A, Sayer AA, Robinson SM. Dietary patterns, skeletal muscle health, and sarcopenia in older adults. Nutrients. 2019;11(4):1-29. doi: https://doi.org/10.3390/nu11040745

31. Kelaiditi E, Jennings A, Steves CJ, et al. Measurements of skeletal muscle mass and power are positively related to a Mediterranean dietary pattern in women. Osteoporos Int. 2016;27(11):3251-3260. doi: https://doi.org/10.1007/s00198-016-3665-9

32. Bloom I, Shand C, Cooper C, et al. Diet quality and sarcopenia in older adults: A systematic review. Nutrients. 2018;10(3):1-28. doi: https://doi.org/10.3390/nu10030308

33. Silva R, Pizato N, da Mata F, et al. Mediterranean Diet and Musculoskeletal-Functional Outcomes in CommunityDwelling Older People: A Systematic Review and Meta-Analysis. J Nutr Heal Aging. 2018;22(6):655-663. doi: https://doi.org/10.1007/s12603-017-0993-1

34. Craig J V., Bunn DK, Hayhoe RP, et al. Relationship between the Mediterranean dietary pattern and musculoskeletal health in children, adolescents, and adults: Systematic review and evidence map. Nutr Rev. 2017;75(10):830-857. doi: https://doi.org/10.1093/nutrit/nux042

35. Falguera M, Castelblanco E, Rojo-López MI, et al. Mediterranean diet and healthy eating in subjects with prediabetes from the mollerussa prospective observational cohort study. Nutrients. 2021;13(1):1-10. doi: https://doi.org/10.3390/nu13010252

36. Buchanan A, Villani A. Association of Adherence to a Mediterranean Diet with Excess Body Mass, Muscle Strength and Physical Performance in Overweight or Obese Adults with or without Type 2 Diabetes: Two Cross-Sectional Studies. Healthcare. 2021;9(10):1255. doi: https://doi.org/10.3390/healthcare9101255

37. Alexandrov NV, Eelderink C, Singh-Povel CM, et al. Dietary protein sources and muscle mass over the life course: The lifelines cohort study. Nutrients. 2018;10(10):1-17. doi: https://doi.org/10.3390/nu10101471