Creatinine/cystatin C ratio as a surrogate marker of residual muscle mass in amyotrophic lateral sclerosis

Tetsuka, Syuichi; Morita, Mitsuya; Ikeguchi, Kunihiko; Nakano, Imaharu

doi:10.1002/ncn3.11

Cited by 50 publications

(41 citation statements)

References 24 publications

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“…CysC is another marker of renal function, but it is less affected by the muscle mass than Cr . We, therefore, calculated the serum Cr/CysC ratio to minimize the effect of renal function on serum Cr concentrations …”

Section: Methodsmentioning

confidence: 99%

Impaired muscle uptake of creatine in spinal and bulbar muscular atrophy

Hijikata

Katsuno

Suzuki

et al. 2016

Ann Clin Transl Neurol

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ObjectiveThe aim of this study was to explore the pathomechanism underlying the reduction of serum creatinine (Cr) concentrations in spinal and bulbar muscular atrophy (SBMA).MethodsWe evaluated blood chemistries, motor function, and muscle mass measured by dual‐energy X‐ray absorptiometry in male subjects with SBMA (n = 65), amyotrophic lateral sclerosis (ALS; n = 27), and healthy controls (n = 25). We also examined the intramuscular concentrations of creatine, a precursor of Cr, as well as the protein and mRNA expression levels of the creatine transporter (SLC6A8) in autopsy specimens derived from subjects who had SBMA and ALS and disease controls. Furthermore, we measured the mRNA expression levels of SLC6A8 in cultured muscle cells (C2C12) transfected with the polyglutamine‐expanded androgen receptor (AR‐97Q).ResultsSerum Cr concentrations were significantly lower in subjects with SBMA than in those with ALS (P < 0.001), despite similar muscle mass values. Intramuscular creatine concentrations were also lower in with the autopsied specimen of SBMA subjects than in those with ALS subjects (P = 0.018). Moreover, the protein and mRNA expression levels of muscle SLC6A8 were suppressed in subjects with SBMA. The mRNA levels of SLC6A8 were also suppressed in C2C12 cells bearing AR‐97Q.InterpretationThese results suggest that low serum Cr concentration in subjects with SBMA is caused by impaired muscle uptake of creatine in addition to being caused by neurogenic atrophy. Given that creatine serves as an energy source in skeletal muscle, increasing muscle creatine uptake is a possible therapeutic approach for treating SBMA.

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Section: Methodsmentioning

confidence: 99%

Impaired muscle uptake of creatine in spinal and bulbar muscular atrophy

Hijikata

Katsuno

Suzuki

et al. 2016

Ann Clin Transl Neurol

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“…Then, ADFs in this area might reflect neurodegeneration of muscles involved in respiratory functions. ADFs are said to show neurodegeneration from before appearance of clinical signs such as muscle weakness and muscle atrophy in ALS (10,14). Therefore we analyzed the prognosis of patients without neck flexors muscle weakness nor shoulder abductors muscle weakness at registration and found that the number of patients with ADFs of the cervical-upper limb area who progressed to severe ALS within 3 years were significant large (χ 2 = 4.00, p = 0.045).…”

Section: Discussionmentioning

confidence: 99%

“…The mRS is a marker of severity of ALS (14). In this study, mild ALS was defined as not requiring daily assistance (grades 1 and 2), moderate ALS as requiring daily assistance (grades 3 and 4), and severe ALS as requiring life support such as tubal feeding, gastrostoma, positive pressure ventilation, tracheotomy, and an artificial ventilator (grade 5, Table 1).…”

Section: Definition Of Variablesmentioning

confidence: 99%

Prediction of prognosis of ALS: Importance of active denervation findings of the cervical-upper limb area and trunk area

Nakatani

Watanabe

Fukushima

et al. 2015

IRDR

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“…The ratio serum creatinine/serum cystatin C (SI) has previously been used as a surrogate marker of muscle mass in amyotrophic lateral sclerosis [23], in patients undergoing physical checkups [24], in ICU patients [17], in lung transplant candidates [18], and in type 2 diabetic patients [25]. All these studies have shown a good correlation of this index with muscle mass, as measured by DEXA, CT scan or electric bioimpedance.…”

Section: Discussionmentioning

confidence: 99%

The Ratio Serum Creatinine/Serum Cystatin C (a Surrogate Marker of Muscle Mass) as a Predictor of Hospitalization in Chronic Obstructive Pulmonary Disease Outpatients

et al. 2018

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Background: In chronic obstructive pulmonary disease (COPD), low muscle mass has been associated with several clinical outcomes such as low exercise capacity, hospital admission, and mortality. The Sarcopenia Index (SI) is a novel way to estimate muscle mass based on the ratio of serum creatinine (produced exclusively by muscle)/cystatin C (produced by all nucleated body cells). Objectives: This study aims to assess the SI in stable COPD outpatients, as compared with a healthy control group, to quantify its relationship with several important clinical features in COPD, and to study its potential usefulness to predict COPD exacerbations and hospital admissions. Methods: The SI was calculated in 18 healthy control subjects and 65 stable COPD outpatients were included in the study. Patients were prospectively followed for 1 year after being enrolled in the study. Results: COPD patients had a lower SI than controls, that is lower muscle mass. Furthermore, patients with a modified Medical Research Council dyspnea score ≥2, patients with a COPD Assessment Test score ≥10, and patients with a high risk of exacerbation had lower levels of SI compared with patients without these characteristics. SI correlated with FEV1 (r = 0.491, p < 0.001), the 6-min walking test (r = 0.560, p = 0.001), and the Fat-Free Mass Index (r = 0.431, p = 0.017). Univariate and multivariate Cox proportional risk analysis showed that a low SI is an independent predictor of hospital admission in COPD outpatients followed for 1 year (HR 5.16, p = 0.025). Conclusions: The ratio serum creatinine/serum cystatin C correlates with several COPD characteristics, and it can be used to predict COPD hospitalization.

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Creatinine/cystatin C ratio as a surrogate marker of residual muscle mass in amyotrophic lateral sclerosis

Cited by 50 publications

References 24 publications

Impaired muscle uptake of creatine in spinal and bulbar muscular atrophy

Impaired muscle uptake of creatine in spinal and bulbar muscular atrophy

Prediction of prognosis of ALS: Importance of active denervation findings of the cervical-upper limb area and trunk area

The Ratio Serum Creatinine/Serum Cystatin C (a Surrogate Marker of Muscle Mass) as a Predictor of Hospitalization in Chronic Obstructive Pulmonary Disease Outpatients

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