Clinical analysis of serum creatinine cystatin c ratio and diabetes complicated with fractures / 中华内分泌外科杂志

ABSTRACT

Objective:To explore the relationship between the ratio of serum creatinine and cystatin C (Creatinine/Cystatin C, Cr/CysC) and the risk of fracture in diabetic patients, and to provide a basis for evaluating the risk of fracture in diabetic patients.Methods:Prospectively selected 216 patients with type 2 diabetes (T2DM) who were treated in our hospital from Apr. 2019 to Apr. 2021. Among them, they were divided into fracture group (56 cases) and non-fracture group (160 cases) according to whether they were combined with fractures.Collected two groups of baseline data, general clinical data, laboratory, imaging data, use sarcosine oxidase method to detect serum creatinine (Cr) content, use immunoturbidimetric method to determine serum cystatin C (CysC) level, and calculate The ratio of the two, After matching the propensity scores for age, gender, body mass index, diabetes course, etc., multi-factor Logistic regression analysis was used to evaluate the influencing factors of fracture risk in diabetic patients, and the restrictive cubic spline was used to evaluate the relationship between Cr/CysC and diabetic fracture risk. Relationship.Results:After the two groups were matched by propensity scores, 42 groups were successfully matched, and there was no statistically significant difference in baseline data after matching ( P>0.05) ; Compared with the fracture group, the AGEs (129.13±37.51) ng/mL andALP (97.50±23.80) U/L in the fracture group were higher than those in the non-fracture group (108.41±29.33) ng/mL, (84.35±25.66) U/L higher; Cr/CysC (0.87±0.15) , limb skeletal muscle mass (19.58±3.99) kg were higher than those in the non-fracture group (0.99±0.21) , (21.81±4.38) kg low ( P<0.05) ;Multivariate logistic regression analysis showed that the skeletal muscle mass of extremities ( OR=0.865, 95% CI0.761~0.985) and Cr/CysC ( OR=0.048, 95% CI0.002~0.933) were protective factors for diabetes complicated with fractures; ALP ( OR=1.023, 95% CI1.002~1.044) , AGEs ( OR=1.022, 95% CI1.006~1.039) risk factors for diabetes and fracture (all P<0.05) ,Restricted cubic spline showed a significant non-linear relationship between Cr/CysC and diabetic fractures ( P<0.05) . Conclusion:Cr/CysC is related to the occurrence of fractures in diabetic patients and can be used as a potential predictor of the occurrence of diabetic fractures.