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CLINICAL TRIAL article

Front. Nutr.

Sec. Nutrition and Metabolism

Volume 12 - 2025 | doi: 10.3389/fnut.2025.1619618

This article is part of the Research TopicNatural Products: A Microecological Perspective for Treating Diabetes and its ComplicationsView all 3 articles

Association of Serum Creatinine/Cystatin C Ratio with Insulin Resistance and All-Cause Mortality: A National Cohort Analysis

Provisionally accepted
  • Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China

The final, formatted version of the article will be published soon.

Background: Serum creatinine/cystatin C (Cr/CysC), a biomarker for skeletal muscle mass, has not been well studied concerning insulin resistance (IR). This paper inspected the links of Cr/CysC to IR and all-cause mortality.Methods: Data were sourced from the NHANES database and analyzed via logistic and linear regression to ascertain the link between Cr/CysC and IR, quantified by triglyceride-to-high-density lipoprotein cholesterol (TG/HDL). Restricted cubic splines (RCS) were employed to identify nonlinear associations, and Cox regression was leveraged to determine links with all-cause mortality.Results: Higher Cr/CysC ratios were strongly associated with lower IR risk (OR=0.48, 95% CI: 0.32-0.73, P=0.001) and lower TG/HDL (β=-0.60, P=0.001). RCS analysis indicated a nonlinear relationship, with increased IR risk below a threshold (P<0.05).Cox regression revealed a negative association between Cr/CysC and all-cause mortality in the overall population (HR=0.47, 95% CI: 0.31-0.69, P<0.001) and non-IR individuals, but not in those with IR.Associations were stronger in middle-aged individuals, women, and non-hypertensive participants.Cr/CysC is inversely linked with IR and all-cause mortality, suggesting its potential as a low-cost index for stratifying IR risk.

Keywords: Cystatin C, Insulin Resistance, Mortality, Creatinine, biomarker

Received: 28 Apr 2025; Accepted: 11 Aug 2025.

Copyright: © 2025 Han, Zhang, Li, Wan and Xie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Chunguang Xie, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China

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