Plasma creatine may foretell diabetes in men

Plasma creatine concentrations are lower in men than in women, and men with higher plasma creatine are at greatly increased risk of developing type 2 diabetes (T2D), according to data from the PREVEND study.

A total of 4,735 participants (49 percent male) with a mean age of 52 years participated in the study. Mean fasting plasma creatine concentrations at baseline, measured using nuclear magnetic resonance spectroscopy, were 36.7 µmol/L; 30.4 µmol/L in males and 42.7 µmol/L in females (p<0.001).

Over 7.3 years of follow‐up, T2D occurred in 235 individuals (5.4 percent). T2D was defined as a fasting plasma glucose ≥7.0 mmol/L (126 mg/dl), a random sample plasma glucose ≥11.1 mmol/L (200 mg/dl), self‐report of a physician diagnosis, or the use of glucose‐lowering medications based on a central pharmacy registration.

Multivariable Cox proportional hazards analysis revealed higher plasma creatine concentrations to be associated with an increased T2D incidence. Each SD-change in creatine levels conferred a 27-percent risk increase (hazard ratio [HR], 1.27, 95 percent confidence interval [CI], 1.11–1.44; p<0.001).

The association was strongly modified by sex (p<0.001), such that higher plasma creatine contributed to an increased risk of incident T2D in males (HR, 1.40, 95 percent CI, 1.17–1.67; p<0.001) but not in females (HR, 1.10, 95 percent CI, 0.90–1.34; p=0.37).

Additional studies are needed to establish the underlying mechanisms for the sex‐based differences seen in the association between plasma creatine and T2D.