Journal of Clinical Medicine
Association and Incremental Discriminative Value of Four Estimated Muscle-Related Indices for Progression from Prediabetes to Type 2 Diabetes Mellitus: A Retrospective Cohort Study with up to 10 Years of Follow-Up
By Xinrui Cao, Yan He, Zhihao Ni and 3 others.
Abstract
Objective
This study examined the associations of four estimated muscle-related indices (height-adjusted appendicular skeletal muscle mass [ASM/height2], weight-adjusted ASM [ASM/weight], predicted skeletal muscle mass index [pSMI], and creatinine-to-cystatin C ratio [CCR]) with progression from prediabetes to type 2 diabetes mellitus (T2DM) and compared their preliminary predictive performance.
Methods
This retrospective cohort included 927 Chinese adults with prediabetes. Incident T2DM was the primary endpoint. Associations were assessed using Cox regression, dose–response relationships using restricted cubic splines, and incremental discrimination using time-dependent AUC with bootstrap internal validation. Subgroup analyses were performed by sex and body mass index (BMI). Sensitivity analyses additionally adjusted for age and HbA1c and excluded early incident T2DM cases.