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Войти в исследования Journal of diabetes and its complications · 2026
Cystatin or creatinine in the estimation of GFR in diabetic patients: Relevance of taking muscle mass into account.
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Richard Salome, Dubois-Laforgue Danièle, Larger Etienne
Аннотация
AIM: Estimation of glomerular filtration rate (eGFR) based on serum creatinine is influenced by muscle mass. Cystatin C-based equations have been proposed as an alternative, particularly in situations of abnormal body composition. Patients with type 2 diabetes often present reduced muscle/weight ratio, which may contribute to discrepancies in eGFR.
OBJECTIVE: To investigate the impact of muscle/weight ratio on the difference between creatinine- and cystatin C-based eGFR in patients with diabetes.
METHODS: 182 patients who underwent body composition assessment by bioimpedance analysis. eGFR was calculated using CKD-EPI equations based on creatinine, cystatin C, and both. Muscle/weight ratio was assessed using bioimpedance-derived muscle mass-to-body weight ratio and the serum creatinine-to-cystatin C ratio.
RESULTS: Creatinine-based eGFR overestimated GFR compared with cystatin C, particularly in patients with type 2 diabetes (T2D). eGFR difference between equations was significantly associated with muscle/weight ratio indices. The association between muscle/weight ratio and eGFR discrepancy was observed in patients with T2D but not in those with T1D.
CONCLUSION: In patients with T2D, muscle/weight ratio rather than absolute muscle mass contributes to discrepancies between creatinine- and cystatin C-based eGFR. Incorporating a simple marker of muscle/weight ratio, may improve the accuracy of creatinine-based GFR estimation in patients with atypical body composition.
OBJECTIVE: To investigate the impact of muscle/weight ratio on the difference between creatinine- and cystatin C-based eGFR in patients with diabetes.
METHODS: 182 patients who underwent body composition assessment by bioimpedance analysis. eGFR was calculated using CKD-EPI equations based on creatinine, cystatin C, and both. Muscle/weight ratio was assessed using bioimpedance-derived muscle mass-to-body weight ratio and the serum creatinine-to-cystatin C ratio.
RESULTS: Creatinine-based eGFR overestimated GFR compared with cystatin C, particularly in patients with type 2 diabetes (T2D). eGFR difference between equations was significantly associated with muscle/weight ratio indices. The association between muscle/weight ratio and eGFR discrepancy was observed in patients with T2D but not in those with T1D.
CONCLUSION: In patients with T2D, muscle/weight ratio rather than absolute muscle mass contributes to discrepancies between creatinine- and cystatin C-based eGFR. Incorporating a simple marker of muscle/weight ratio, may improve the accuracy of creatinine-based GFR estimation in patients with atypical body composition.