Association Between Relative Fat Mass and the Serum Creatinine/Cystatin C Ratio and Cardiometabolic Multimorbidity - Evidence From Two Large Population-Based Surveys

Q: What is the study’s main objective regarding SCR/CysC, RFM, and CMM?

To explore how SCR/CysC and relative fat mass relate to cardiometabolic multimorbidity and assess their usefulness for early identification and intervention of CMM.

Q: Which databases and participant groups were used in the analysis?

The study used CHARLS (9292 Chinese participants) and NHANES (3822 American individuals) to evaluate associations across two large population-based surveys.

Q: How were SCR/CysC and RFM associated with CMM risk?

SCR/CysC showed a significantly negative correlation with CMM risk, whereas higher RFM levels were positively correlated with increased CMM risk across both datasets.

Sep 29, 2026

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Serum creatinine–cystatin C ratio (SCR/CysC) and relative fat mass (RFM) reflect muscle and fat content, yet their links to cardiometabolic multimorbidity (CMM) were unclear. This study analyzed 9292 Chinese participants from CHARLS and 3822 American participants from NHANES using multivariate logistic regression, restricted cubic spline models, and subgroup analyses. Results showed SCR/CysC was inversely associated with CMM risk, while higher RFM predicted increased CMM risk.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Introduction

CMM and its significance

Obesity indicators and limitations

RFM and SCR/CysC as potential markers

Methods

Results

Conclusions

Wiley Journal of Diabetes Research Volume 2025, Article ID 4075738, 13 pages [https://doi.org/10.1155/jdr/4075738](https://doi.org/10.1155/jdr/4075738) Research Article Association Between Relative Fat Mass and the Serum Creatinine/ Cystatin C Ratio and Cardiometabolic Multimorbidity: Evidence From Two Large Population-Based Surveys Yanfen Hu , 1 Lingxia Li , 1 Ling Yan, 1 Xiaoting Zhao, 1 Qinfan Wang, 1 and Zhenjie Xu2 1Department of Geriatric Endocrinology, Metabolism and Respiratory (the Cadre Ward), The Second Aﬃliated Hospital of Xi ’an Jiaotong University, Xi ’an, Shaanxi, China 2Institute of Jianjiyue Biomedical Research Center, Xi ’an, Shaanxi, China Correspondence should be addressed to Yanfen Hu; [huyanfen713@xjtu.edu.cn and Lingxia Li](huyanfen713@xjtu.edu.cn and Lingxia Li); [1633529972@qq.com](1633529972@qq.com) Received 19 April 2025; Revised 25 October 2025; Accepted 30 October 2025 Academic Editor: Yi Wang Copyright © 2025 Yanfen Hu et al. Journal of Diabetes Research published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Background: The serum creatinine–cystatin C ratio (SCR/CysC) and relative fat mass (RFM) are both important indicators reﬂecting muscle and fat content, respectively, and are closely related to metabolic diseases and cardiovascular diseases. However, the roles of SCR/CysC and RFM in cardiometabolic multimorbidity (CMM) remain unclear. This study is aimed at exploring the relationships between SCR/CysC, RFM, and CMM, providing a new perspective for the early identiﬁcation and intervention of CMM. Methods: This study included 9292 Chinese participants from the CHARLS database and 3822 American individuals from the NHANES database. Multivariate logistic regression analysis, restricted cubic spline (RCS) plots, and subgroup analyses were employed to explore the associations of SCR/CysC and RFM with CMM. Results: Analyses based on two databases revealed that the level of SCR/CysC levels was signiﬁcantly negatively correlated with the risk of CMM. Conversely, higher RFM levels were positively correlated with an increased risk of CMM. Speciﬁcally, compared to the lower quartile (Q1) of SCR/CysC, the highest quartile (Q4) was associated with a decreased risk of CMM (CHARLS: odds ratio OR =0 89, 95% conﬁdence interval (CI): 0.87–0.91, p <0 001; NHANES: OR = 0 90, 95% CI: 0.86– 0.94, p <0 001) . Compared to the lower quartile (Q1) of RFM, the highest quartile (Q4) was associated with an increased risk of CMM (CHARLS: OR = 1 18, 95% CI: 1.16–1.21, p <0 001; NHANES: OR = 1 20, 95% CI: 1.15–1.25, p <0 001) . The RCS plot results further supported this relationship, demonstrating that after adjusting for multiple confounding factors, a decrease in SCR/CysC and an increase in RFM were both associated with a higher risk of CMM. Conclusions: This study found that SCR/CysC levels were negatively correlated with CMM risk, whereas RFM levels showed a positive correlation. Thus, SCR/CysC and RFM may both serve as potential biomarkers for CMM screening. Keywords: cardiometabolic multimorbidity; CHARLS; NHANES; relative fat mass; serum creatinine–cystatin C ratio 1. Introduction Cardiovascular and metabolic comorbidities, also known as cardiometabolic multimorbidity (CMM), refer to the cooccurrence of two or more cardiovascular or metabolic disorders in an individual, typically including hypertension, diabetes, coronary heart disease, or stroke [1, 2]. A large-scale study of 500,000 Chinese adults found that CMM is the most prev- alent multimorbidity pattern, aﬀecting 6% of participants, which is higher than other patterns [3]. Importantly, individuals with CMM exhibit a shorter lifespan compared to those with only a single cardiometabolic disease [4]. Therefore, the early identiﬁcation of C

FAQs

What is the study’s main objective regarding SCR/CysC, RFM, and CMM?

To explore how SCR/CysC and relative fat mass relate to cardiometabolic multimorbidity and assess their usefulness for early identification and intervention of CMM.

Which databases and participant groups were used in the analysis?

The study used CHARLS (9292 Chinese participants) and NHANES (3822 American individuals) to evaluate associations across two large population-based surveys.

How were SCR/CysC and RFM associated with CMM risk?

SCR/CysC showed a significantly negative correlation with CMM risk, whereas higher RFM levels were positively correlated with increased CMM risk across both datasets.

Sep 29, 2026

Upload by Blue Pony