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World J Diabetes. Jun 15, 2026; 17(6): 119913
Published online Jun 15, 2026. doi: 10.4239/wjd.119913
Published online Jun 15, 2026. doi: 10.4239/wjd.119913
Visit-to-visit variability of creatinine levels associated with proteinuria progression in Chinese patients with type 2 diabetes mellitus
Yu-Hang Ma, Xiao-Hui Wei, Yue Liu, Li-Ping Gu, Ting-Ting Shen, Ting-Ting Fan, Qin Qin, Ai-Fang Zhang, Yu-Fan Wang, Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
Rui-Ping Wang, Clinical Research Center, Shanghai Skin Disease Hospital, Skin Disease Hospital of Tongji University, Shanghai 200072, China
Co-first authors: Yu-Hang Ma and Xiao-Hui Wei.
Co-corresponding authors: Rui-Ping Wang and Yu-Fan Wang.
Author contributions: Wang YF, Wang RP, Ma YH, and Wei XH designed the study; Wang RP, Ma YH, and Wei XH analyzed the data; Zhang AF, Fan TT, Qin Q, and Shen TT collected blood samples and collected anthropometric measurements; Liu Y and Gu LP contributed to clinical data collection and information verification; Ma YH, Wei XH and Liu Y drafted the manuscript; Wang YF and Wang RP have primary responsibility for final content and are the guarantors of this work; Ma YH and Wei XH contributed equally to this manuscript and are co-first authors; Wang YF and Wang RP contributed equally to this manuscript and are co-corresponding authors; all authors contributed to data acquisition, revised the manuscript for important intellectual content and approved the manuscript, read and approved the final version to be published.
Supported by the Noncommunicable Chronic Diseases-National Science and Technology Major Project, No. 2023ZD0508104; Shanghai Science and Technology Commission Foundation, No. 23ZR1451500; National Health Commission Medical Health Science and Technology Development Research Center “Innovative Medicine Post-Marketing Clinical Research Project”, No. WKZX2023CX150002; and the Fourth Round of “Committee and Hospital Cooperation” (Shanghai Songjiang District Health Commission and Shanghai General People’s Hospital); Joint Research Project and the Chronic Disease Management Research Project of National Health Commission Capacity Building and Continuing Education Center, No. GWJJMB202510024038.
Institutional review board statement: This study was approved by the Ethics Committee of the Shanghai General Hospital affiliated with Shanghai Jiao Tong University School of Medicine (No. 2017KY209).
Clinical trial registration statement: The study cohort was acquired from the database of the Shanghai General Hospital; a branch of the National Standardized Management Center for Metabolic Diseases in China (ClinicalTrials.gov ID: NCT03811470).
Informed consent statement: Written informed consent was obtained from all participants prior to their involvement in the study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Corresponding author: Yu-Fan Wang, MD, Doctor, Department of Endocrinology and Me
Received: February 10, 2026
Revised: March 12, 2026
Accepted: April 10, 2026
Published online: June 15, 2026
Processing time: 121 Days and 21.3 Hours
Revised: March 12, 2026
Accepted: April 10, 2026
Published online: June 15, 2026
Processing time: 121 Days and 21.3 Hours
Core Tip
Core Tip: This was a prospective cohort study to comprehensively analyze the relationship between variability of metabolic parameters and proteinuria in type 2 diabetes mellitus (T2DM). Variability in creatinine levels during follow-up was an independent risk factor for proteinuria progression, and this finding was consistent across patients stratified by different baseline urinary albumin-to-creatinine ratio. These results offer a reference for incorporating dynamic creatinine variability into proteinuria risk monitoring strategies in T2DM patients.