Serum creatinine and cystatin C-based index can be a screening biomarker for sarcopenia in older population

Singhal, Sunny; Singh, Sundararajan Baskar; Upadhyay, Ashish Datt; Dwivedi, Sada Nand; Das, Chandan Jyoti; Mohta, Srikant; Chatterjee, Prasun; Dey, Aparajit Ballav; Chakrawarty, Avinash

doi:10.1007/s41999-019-00197-x

Cited by 16 publications

(9 citation statements)

References 27 publications

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“…In addition, Osaka et al 27 argued that the Cr/CysC ratio was a useful biomarker for sarcopenia screening based on data from 285 Japanese patients with type 2 diabetes. However, Singhal et al 28 reported that the Cr/CysC ratio was not associated with sarcopenia among 100 older outpatients, from a tertiary hospital in India. Our team has also previously found that the "sarcopenia index" (i.e., the Cr/ CysC ratio × 10) could not accurately identify sarcopenia among community-dwelling older Chinese adults 12 .…”

Section: Discussionmentioning

confidence: 98%

Serum creatinine/cystatin C ratio as a case-finding tool for low handgrip strength in Chinese middle-aged and older adults

et al. 2020

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Measuring handgrip strength is the initial step to diagnose sarcopenia. To investigate whether the serum creatinine (Cr)/cystatin C (CysC) ratio could serve as a case-finding tool for low handgrip strength, we conducted a diagnostic accuracy study. Adults (aged ≥ 40 years) with normal renal function were recruited. Trained nurses collected blood samples and conducted the anthropometric measurements and handgrip strength test. The serum concentrations of Cr, CysC, and other biomarkers were measured. We recruited 1098 men and 1241 women. The Cr/CysC ratio was significantly associated with AWGS-defined low handgrip strength among men and women. The areas under the receiver operating characteristic curves were 0.79 among men and 0.78 among women for using the Cr/CysC ratio to identify AWGS-defined low handgrip strength. We set the Cr/CysC ratio cutoff values at < 8.9 among men and < 8.0 among women. The corresponding sensitivity values were 64.9% among men and 63.1% among women, while the specificity values were 83.7% among men and 77.5% among women. In conclusion, the Cr/CysC ratio is positively and linearly associated with handgrip strength and may be helpful for screening low handgrip strength in Chinese middle-aged and older adults dwelling in communities.

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Section: Discussionmentioning

confidence: 98%

Serum creatinine/cystatin C ratio as a case-finding tool for low handgrip strength in Chinese middle-aged and older adults

et al. 2020

Sci Rep

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“…In fact, several studies have shown the close association of the creatinine/cystatin C ratio with the diagnosis of sarcopenia according to contemporary guidelines [39][40][41][42]. Since some other studies failed to confirm this finding [43,44] more work is clearly needed in different populations to understand the potential pathophysiological background.…”

Section: Discussionmentioning

confidence: 99%

Nutritional and Non-Nutritional Predictors of Low Spot Urinary Creatinine Concentration in Patients with Heart Failure

et al. 2021

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Low spot urinary creatinine concentration (SUCR) is a marker of muscle wasting and clinical outcome. The risk factors for low SUCR in heart failure (HF) remain poorly understood. We explored the risk factors for low SUCR related to poor outcomes. In 721 HF patients (age: 52.3 ± 11 years, female: 14%, NYHA: 2.7 ± 0.7) SUCR and Dexa body composition scans were performed. BMI prior HF-onset, weight loss, and appendicular muscle mass were obtained. Each patient was classified as malnutrition or normal by GLIM criteria and three other biochemical indices (CONUT, PNI, and GRNI). Sarcopenia index (SI) as creatinine to cystatin C ratio was also calculated. Within 1 year, 80 (11.1%) patients died. In ROC curve we identified a SUCR value of 0.628 g/L as optimally discriminating surviving from dead. In low SUCR group more advanced HF, higher weight loss and catabolic components of weight trajectory (CCWT), more frequent under-nutrition by GLIM, and lower SI were observed. In multivariate analysis the independent predictors of low SUCR were SI, CCWT, and GNRI score. In conclusion: the risk of low SUCR was associated with a worse outcome. Low SUCR was associated with greater catabolism and sarcopenia but not with biochemical indices of malnutrition.

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“…The two markers contributing to the SI are readily available from standard blood tests, so the SI would be an inexpensive alternative approach to identify sarcopenia in patients to the more demanding methods of CT, MRI, and DXA. However, the contradicting conclusion of the correlation of SI with skeletal muscle mass was also reported from several cohorts of community‐dwelling older adults 51,54,55 . For the present concern, the application of SI in pediatric cancer patients should be questioned in at least two aspects: (1) the age‐ and sex‐dependent correlation of SI with skeletal muscle mass; (2) the impact of the cancer stage and treatments on the correlation of SI with skeletal muscle mass.…”

Section: Introductionmentioning

confidence: 81%

“…[42][43][44][45][46][47][48][49][50][51][52][53] Our result, however, adds to the fewer reports that the SI fails as a mark of sarcopenia. 51,54,55 The success of SI in being closely related to the muscle mass relies on the validity of the hypothesis that the serum Cr correlates with muscle mass positively, meanwhile serum CysC does not depend much, if at all, on lean muscle mass. 69,70 Indeed, many of the supportive reports confirmed this hypothesis with data.…”

Section: On the Weak Correlation Of Si With Tpmamentioning

confidence: 99%

“…However, the contradicting conclusion of the correlation of SI with skeletal muscle mass was also reported from several cohorts of community-dwelling older adults. 51,54,55 For the present concern, the application of SI in pediatric cancer patients should be questioned in at least two aspects: (1) the age-and sex-dependent correlation of SI with skeletal muscle mass; (2) the impact of the cancer stage and treatments on the correlation of SI with skeletal muscle mass.…”

Section: Introductionmentioning

confidence: 99%

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Weak correlation between total psoas muscle area and sarcopenia index for children with brain tumor

et al. 2023

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Objective The aim of this study is to determine whether the sarcopenia index (SI) is a viable measure of muscle mass in pediatric patients with brain tumors. Methods Retrospectively enrolled patients (1–16 years) who had serum creatinine (Cr) and cystatin C (CysC) levels evaluated within 28 days of an abdomen magnetic resonance imaging scan for the lumbar vertebrae 3‐4 total psoas muscle area (tPMA) were studied. Variables were compared using their z scores calculated from age‐ and sex‐dependent reference. We hypothesized that a low SI indicated less skeletal muscle, and therefore potentially indicated sarcopenia. Results The SI z score had no correlation with tPMA z score (r = 0.004). Both Cr and CysC levels were positively correlated with tPMA in z scores (r = 0.249 and 0.320). tPMA strongly correlated with body mass index in z scores (r = 0.582). The z scores of tPMA, Cr and CysC decreased with elevated World Health Organization grades of tumor, but the z scores of SI showed no significant dependence on WHO grades. Conclusion The correlation of SI to muscle mass is very weak in our sample of pediatric patients with brain tumor. Its viability as biomarker for sarcopenia needs more study.

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Serum creatinine and cystatin C-based index can be a screening biomarker for sarcopenia in older population

Cited by 16 publications

References 27 publications

Serum creatinine/cystatin C ratio as a case-finding tool for low handgrip strength in Chinese middle-aged and older adults

Serum creatinine/cystatin C ratio as a case-finding tool for low handgrip strength in Chinese middle-aged and older adults

Nutritional and Non-Nutritional Predictors of Low Spot Urinary Creatinine Concentration in Patients with Heart Failure

Weak correlation between total psoas muscle area and sarcopenia index for children with brain tumor

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