Association of Serum Creatinine Levels and Risk of Type 2 Diabetes Mellitus in Korea

Reduced skeletal muscle has been suggested as a risk factor for type 2 diabetes mellitus (T2DM). Serum creatinine is used as a surrogate for muscle mass. Therefore, low serum creatinine levels may be associated with an increased risk of T2DM. We aimed to evaluate the association between serum creatinine levels and the risk of T2DM. We analyzed a total of 264,832 nondiabetic adults in Korea. In men, serum creatinine levels and the risk for T2DM showed an inverse J-shaped association even after adjustment for age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting plasma glucose. In women, there was a trend that serum creatinine levels were inversely associated with the risk of T2DM among those with serum creatinine below 1.1 mg/dl. However, serum creatinine levels were not significantly associated with the risk of T2DM after adjustment for age, BMI, SBP, DBP, and fasting plasma glucose. Reduced levels of serum creatinine were significantly associated with an increased risk of T2DM in men with creatinine below 1.20 mg/dl. There was a trend that decreased levels of serum creatinine were associated with an increased risk of T2DM among women, although this result was not statistically significant.