Prognostic value of creatinine-to-cystatin c ratio in patients with type 2 diabetes mellitus: a cohort study

Wei, Wen; Li, Shanggang; Liu, Jin; Liu, Yong; Chen, Kaihong; Chen, Shiqun; Tu, Mei; Chen, Hong

doi:10.1186/s13098-022-00958-y

Cited by 3 publications

(1 citation statement)

References 50 publications

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“…as a simplified method for diagnosing sarcopenia in patients ( 6 ). Since then, CCR has been extensively studied and established as a biomarker for the prognosis in patients with critically illness ( 7 , 8 ), hypertension ( 9 ), type 2 diabetes ( 10 , 11 ) and cancer ( 12 – 17 ). Recently, a retrospective study reported that low CCR was an independent biomarker of poor prognosis in non-small cell lung cancer (NSCLC) patients treated with PD-1 monotherapy ( 18 ).…”

Section: Introductionmentioning

confidence: 99%

Creatinine-to-cystatin C ratio and body composition predict response to PD-1 inhibitors-based combination treatment in metastatic gastric cancer

Ji,

Liu,

Jin

et al. 2024

Front. Immunol.

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BackgroundCreatinine-to-cystatin C ratio (CCR) and body composition (BC) parameters have emerged as significant prognostic factors in cancer patients. However, the potential effects of CCR in gastric cancer (GC) remains to be elucidated. This multi-center retrospective study explored the predictive and prognostic value of CCR and BC-parameters in patients with metastatic GC receiving PD-1 inhibitors-based combination therapy.MethodsOne hundred and thirteen GC patients undergoing PD-1 inhibitors-based combination therapy were enrolled at three academic medical centers from January 2021 to July 2023. A deep-learning platform based on U-Net was developed to automatically segment skeletal muscle index (SMI), subcutaneous adipose tissue index (SATI) and visceral adipose tissue index (VATI). Patients were divided into two groups based on the median of CCR or the upper tertile of BC-parameters. Logistic and Cox regression analysis were used to determine the effect of CCR and BC-parameters in predicting response rates and survival rates.ResultsThe CCR was positively correlated with SMI (r=0.43; P<0.001), but not with SATI or VATI (P>0.05). Multivariable logistic analysis identified that both low CCR (OR=0.423, P=0.066 for ORR; OR=0.026, P=0.005 for DCR) and low SATI (OR=0.270, P=0.020 for ORR; OR=0.149, P=0.056 for DCR) were independently associated with worse objective response rate (ORR) and disease control rate (DCR). Patients with low CCR or low SATI had significantly lower 8-month progression-free survival (PFS) rate and 16-month overall survival (OS) rate than those with high CCR (PFS rate, 37.6% vs. 55.1%, P=0.011; OS rate, 19.4% vs. 44.9%, P=0.002) or those with high SATI (PFS rate, 37.2% vs. 53.8%, P=0.035; OS rate, 8.0% vs. 36.0%, P<0.001). Multivariate Cox analysis showed that low CCR (HR=2.395, 95% CI: 1.234-4.648, P=0.010 for PFS rate; HR=2.528, 95% CI: 1.317-4.854, P=0.005 for OS rate) and low SATI (HR=2.188, 95% CI: 1.050-4.560, P=0.037 for PFS rate; HR=2.818, 95% CI: 1.381-5.752, P=0.004 for OS rate) were both independent prognostic factors of poor 8-month PFS rate and 16-month OS rate. A nomogram based on CCR and BC-parameters showed a good performance in predicting the 12- and 16-month OS, with a concordance index of 0.756 (95% CI, 0.722-0.789).ConclusionsLow pre-treatment CCR and SATI were independently associated with lower response rates and worse survival in patients with metastatic GC receiving PD-1 inhibitors-based combination therapy.

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Section: Introductionmentioning

confidence: 99%

Creatinine-to-cystatin C ratio and body composition predict response to PD-1 inhibitors-based combination treatment in metastatic gastric cancer

Ji,

Liu,

Jin

et al. 2024

Front. Immunol.

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Diabetes Mellitus Should Be Considered While Analysing Sarcopenia-Related Biomarkers

Rentflejsz,

Wojszel

2024

JCM

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Sarcopenia is a chronic, progressive skeletal muscle disease characterised by low muscle strength and quantity or quality, leading to low physical performance. Patients with type 2 diabetes mellitus (T2DM) are more at risk of sarcopenia than euglycemic individuals. Because of several shared pathways between the two diseases, sarcopenia is also a risk factor for developing T2DM in older patients. Various biomarkers are under investigation as potentially valuable for sarcopenia diagnosis and treatment monitoring. Biomarkers related to sarcopenia can be divided into markers evaluating musculoskeletal status (biomarkers specific to muscle mass, markers of the neuromuscular junction, or myokines) and markers assuming causal factors (adipokines, hormones, and inflammatory markers). This paper reviews the current knowledge about how diabetes and T2DM complications affect potential sarcopenia biomarker concentrations. This review includes markers recently proposed by the expert group of the European Society for the Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) as those that may currently be useful in phase II and III clinical trials of sarcopenia: myostatin (MSTN); follistatin (FST); irisin; brain-derived neurotrophic factor (BDNF); procollagen type III N-terminal peptide (PIIINP; P3NP); sarcopenia index (serum creatinine to serum cystatin C ratio); adiponectin; leptin; insulin-like growth factor-1 (IGF-1); dehydroepiandrosterone sulphate (DHEAS); C-reactive protein (CRP); interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α). A better understanding of factors influencing these biomarkers’ levels, including diabetes and diabetic complications, may lead to designing future studies and implementing results in clinical practice.

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Cistatina C como marcador precoz de riesgo cardiovascular en pacientes con diabetes

Tisalema-Panimboza,

Galárraga-Pérez

2023

Salud, Ciencia y Tecnología

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Introducción: La cistatina C, una proteína con concentración plasmática estable y eliminación renal exclusiva, se ha destacado como un prometedor marcador precoz de riesgo cardiovascular en pacientes diabéticos debido a su relación con la función renal y la inflamación.Objetivo: Identificar en la literatura existente la asociación entre la cistatina C y el riesgo cardiovascular en pacientes con diabetes, evaluando su potencial como marcador mediante una revisión sistemática. Métodos: Se realizaron búsquedas exhaustivas en bases de datos científicos y se seleccionaron diez estudios que cumplieron con los criterios de inclusión. Estos estudios se centraron en la evaluación de los perfiles de expresión de cistatina C y su efectividad como marcador en el diagnóstico y pronóstico de enfermedades cardiovasculares. Se utilizo el Método PRISMA.Resultados: Los estudios revelan que la cistatina C se asocia estrechamente con la diabetes tipo 2, predicción de enfermedades cardiovasculares y proporciona una evaluación precisa de la función renal en pacientes diabéticos, destacando su utilidad como marcador temprano de complicaciones. Además, niveles elevados de cistatina C se correlacionan con mayor mortalidad y riesgo cardiovascular, superando en precisión a otros marcadores tradicionales, lo que la posiciona como un indicador clave en la evaluación integral de riesgo y pronóstico en pacientes diabéticos.Conclusiones: La cistatina C muestra prometedores vínculos con la diabetes y riesgo cardiovascular en pacientes diabéticos, sugiriendo su utilidad como marcador temprano. Aunque ofrece potencial para detectar complicaciones renales y cardíacas, se requieren más investigaciones antes de su implementación clínica generalizada.

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Prognostic value of creatinine-to-cystatin c ratio in patients with type 2 diabetes mellitus: a cohort study

Cited by 3 publications

References 50 publications

Creatinine-to-cystatin C ratio and body composition predict response to PD-1 inhibitors-based combination treatment in metastatic gastric cancer

Creatinine-to-cystatin C ratio and body composition predict response to PD-1 inhibitors-based combination treatment in metastatic gastric cancer

Diabetes Mellitus Should Be Considered While Analysing Sarcopenia-Related Biomarkers

Cistatina C como marcador precoz de riesgo cardiovascular en pacientes con diabetes

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