Lower Serum Creatinine Is a New Risk Factor of Type 2 Diabetes

The Kansai Healthcare Study

  1. Nobuko Harita, MD1,
  2. Tomoshige Hayashi, MD, PHD1,
  3. Kyoko Kogawa Sato, MD, PHD1,
  4. Yoshiko Nakamura, MD, PHD2,
  5. Takeshi Yoneda, MD1,
  6. Ginji Endo, MD, PHD1 and
  7. Hiroshi Kambe, MD12
  1. 1Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
  2. 2Kansai Health Administration Center, Nippon Telegraph and Telephone West Corporation, Osaka, Japan
  1. Corresponding author: Tomoshige Hayashi, thayashi{at}med.osaka-cu.ac.jp


OBJECTIVE—Because skeletal muscle is one of the target tissues for insulin, skeletal muscle mass might be associated with type 2 diabetes. Serum creatinine is a possible surrogate marker of skeletal muscle mass. The purpose of this study was to determine whether serum creatinine level is associated with type 2 diabetes.

RESEARCH DESIGN AND METHODS—The study participants were nondiabetic Japanese men (n = 8,570) aged 40–55 years at entry. Type 2 diabetes was diagnosed if fasting plasma glucose was ≥126 mg/dl or if participants were taking oral hypoglycemic medication or insulin.

RESULTS—During the 4-year follow-up period, 877 men developed type 2 diabetes. Lower serum creatinine was associated with an increased risk of type 2 diabetes. The multiple-adjusted odds ratio for those who had serum creatinine levels between 0.40 and 0.60 mg/dl was 1.91 (95% CI 1.44–2.54) compared with those who had levels between 0.71 and 0.80 mg/dl.

CONCLUSIONS—Lower serum creatinine increased the risk of type 2 diabetes.


  • Published ahead of print at http://care.diabetesjournals.org on 15 December 2008.

    The funding sources had no role in the collection of the data or in the decision to submit the manuscript for publication.

    Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted November 24, 2008.
    • Received July 9, 2008.
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  1. Diabetes Care vol. 32 no. 3 424-426
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