Association of creatinine to body weight ratio with glycemic progression and remission in Chinese adults with prediabetes: a large-scale retrospective cohort study
4 affiliations
- 1Department of Nephrology, Shenzhen Longgang district sixth people’s hospital
- 2Department of Rehabilitation, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen Second People’s Hospital Dapeng Hospital
- 3Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital
- 4Department of Nephrology, Shenzhen Longgang Central Hospital
Abstract
Objective The creatinine-to-body weight ratio (Cre/BW) has been proposed as a practical surrogate marker of skeletal muscle mass. Emerging evidence highlights a notable correlation connecting Cre/BW to diabetes alongside various metabolic dysfunctions; however, its role in glycemic worsening and the restoration of normoglycemia in individuals with prediabetes has not been well defined. This study, therefore, examined the effect of Cre/BW on glycemic remission and progression among Chinese adults with prediabetes. Methods A total of 24,506 adults with prediabetes from 11 cities in China were included in this retrospective cohort study based on health examination data. Cox proportional hazards models and subgroup analyses were used to estimate associations of Cre/BW with incident diabetes and remission to normoglycemia. Potential nonlinearity in these relationships was assessed by RCS analyses. Results During an observation period spanning 2.9 years (median), 11,170 participants (45.58%) achieved remission to normoglycemia, and 2,641 (10.78%) progressed to diabetes. In multivariable-adjusted Cox models, higher Cre/BW was linked to a greater likelihood of remission (HR = 1.41, 95% CI: 1.28–1.55, p < 0.0001) and lower hazard of progression to diabetes (HR = 0.42, 95% CI: 0.35–0.52, p < 0.0001). RCS analyses indicated a nonlinear association between Cre/BW and diabetes progression: the HR was 0.29 (95% CI: 0.20–0.40) when Cre/BW was < 1.07 μmol/L/kg and increased to 0.66 (95% CI: 0.46–0.95) when Cre/BW was ≥ 1.07 μmol/L/kg. Subgroup analyses suggested that the effect of Cre/BW on glycemic remission was more pronounced in men and in participants aged 40–50 years; a stronger effect of Cre/BW on glycemic progression was also observed among those aged < 30 years (all interaction p < 0.05). Conclusion In adults with prediabetes, Cre/BW was linked to bidirectional changes in glycemic status: higher Cre/BW was linked to a lower hazard of progression to diabetes and a greater likelihood of remission to normoglycemia. Clinical trial number Not applicable.
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BibTeX
@article{xu2026association,
title = {{Association of creatinine to body weight ratio with glycemic progression and remission in Chinese adults with prediabetes: a large-scale retrospective cohort study}},
author = {Hengchang Xu and Yueqin Gou and Wenhong Zhai and Bo Lu and Zhihui Ye and Dongni Sun and Weijia Xiao and Changchun Cao and Haohan Zhai and Haochuan Qiu},
journal = {BMC Endocrine Disorders},
year = {2026},
month = jul,
doi = {10.1186/s12902-026-02406-8},
url = {https://doi.org/10.1186/s12902-026-02406-8},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association of creatinine to body weight ratio with glycemic progression and remission in Chinese adults with prediabetes: a large-scale retrospective cohort study
AU - Hengchang Xu
AU - Yueqin Gou
AU - Wenhong Zhai
AU - Bo Lu
AU - Zhihui Ye
AU - Dongni Sun
AU - Weijia Xiao
AU - Changchun Cao
AU - Haohan Zhai
AU - Haochuan Qiu
PY - 2026
DA - 2026/07/01
JO - BMC Endocrine Disorders
DO - 10.1186/s12902-026-02406-8
UR - https://doi.org/10.1186/s12902-026-02406-8
AB - Objective The creatinine-to-body weight ratio (Cre/BW) has been proposed as a practical surrogate marker of skeletal muscle mass. Emerging evidence highlights a notable correlation connecting Cre/BW to diabetes alongside various metabolic dysfunctions; however, its role in glycemic worsening and the restoration of normoglycemia in individuals with prediabetes has not been well defined. This study, therefore, examined the effect of Cre/BW on glycemic remission and progression among Chinese adults with prediabetes. Methods A total of 24,506 adults with prediabetes from 11 cities in China were included in this retrospective cohort study based on health examination data. Cox proportional hazards models and subgroup analyses were used to estimate associations of Cre/BW with incident diabetes and remission to normoglycemia. Potential nonlinearity in these relationships was assessed by RCS analyses. Results During an observation period spanning 2.9 years (median), 11,170 participants (45.58%) achieved remission to normoglycemia, and 2,641 (10.78%) progressed to diabetes. In multivariable-adjusted Cox models, higher Cre/BW was linked to a greater likelihood of remission (HR = 1.41, 95% CI: 1.28–1.55, p < 0.0001) and lower hazard of progression to diabetes (HR = 0.42, 95% CI: 0.35–0.52, p < 0.0001). RCS analyses indicated a nonlinear association between Cre/BW and diabetes progression: the HR was 0.29 (95% CI: 0.20–0.40) when Cre/BW was < 1.07 μmol/L/kg and increased to 0.66 (95% CI: 0.46–0.95) when Cre/BW was ≥ 1.07 μmol/L/kg. Subgroup analyses suggested that the effect of Cre/BW on glycemic remission was more pronounced in men and in participants aged 40–50 years; a stronger effect of Cre/BW on glycemic progression was also observed among those aged < 30 years (all interaction p < 0.05). Conclusion In adults with prediabetes, Cre/BW was linked to bidirectional changes in glycemic status: higher Cre/BW was linked to a lower hazard of progression to diabetes and a greater likelihood of remission to normoglycemia. Clinical trial number Not applicable.
SN - 1472-6823
ER -