629-P: Serum Creatinine–to–Cystatin C Ratio Is Related to Handgrip Strength as Well as Muscle and Fat Mass in People with Type 2 Diabetes Independently of Glycemic Control and Daily Protein Intake

Sarcopenia is one of the serious diabetic complications and it is related to poorer glycemic control and other diabetic chronic complications. Therefore, it is necessary to diagnose sarcopenia as early as possible in people living with diabetes. Serum creatinine to cystatin C ratio (Scr/Scys) and difference between eGFRcr and eGFRcys (diff. eGFR) were proposed as markers for sarcopenia in person with diabetes. We aimed to examine whether or not Scr/Scys or diff. eGFR predicted muscle and body fat mass in 50 persons with type 2 diabetes (32 male, 63±11 years old, BMI 26.5±5.0 kg/m², HbA1c 7.7±1.4 %, eGFRcr 57±21 ml/min/1.73 m², eGFRcys 61±26 ml/min/1.73 m²). 1) HbA1c was correlated with muscle mass (R=0.31, p=0.033), but not handgrip strength.2) Muscle mass was correlated with handgrip strength (r=0.58, p<0.001), but not with body fat mass.3) Both eGFRcr and eGFRcys themselves were not related to muscle and body fat mass, and handgrip strength.4) Scr/Scys was associated with handgrip strength (r=0.62, p<0.001) and muscle and fat mass (r=0.43, p=0.002; r=-0.38, p=0.007, respectively).5) The diff.eGFR was associated with handgrip strength (r=-0.39, p=0.007), but not with muscle and fat mass.6) Daily protein intake evaluated in 24 hr urine collection was related to muscle mass (r=0.47, p=0.019), whereas protein intake at breakfast was not.7) Multivariate analysis showed that Scr/Scys related to muscle mass (p=0.012) independently of both HbA1c (p=0.954) and daily protein intake (p=0.129).

Conclusions: The Scr/Scys could be a reliable marker to reflect handgrip strength as well as muscle and body fat mass. The muscle mass might be maintained in person with enough daily protein intake. These results suggested beneficial findings to diagnose sarcopenia as early as possible in people with type 2 diabetes.