Comparison of the serum creatinine- and cystatin-C-based indices as screening biomarkers for sarcopenia in community-dwelling older adults

Jae Young Jang; Hyung Eun Shin; Chang Won Won; Miji Kim

doi:10.1016/j.archger.2023.105207

Comparison of the serum creatinine- and cystatin-C-based indices as screening biomarkers for sarcopenia in community-dwelling older adults

Arch Gerontol Geriatr. 2023 Dec:115:105207. doi: 10.1016/j.archger.2023.105207. Epub 2023 Sep 20.

Authors

Jae Young Jang¹, Hyung Eun Shin², Chang Won Won³, Miji Kim⁴

Affiliations

¹ Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, 02447, Korea.
² Department of Biomedical Science and Technology, College of Medicine, Kyung Hee University, Seoul, 02447, Korea.
³ Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, 02447, Korea. Electronic address: chunwon62@naver.com.
⁴ Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, 02447, Korea. Electronic address: mijiak@khu.ac.kr.

PMID: 37776755
DOI: 10.1016/j.archger.2023.105207

Abstract

Background: Several creatinine- and cystatin-C-based indices have been proposed as sarcopenia predictors. This study aimed to compare serum creatinine- and cystatin-C-based indices as screening biomarkers for sarcopenia in community-dwelling older adults.

Methods: A cross-sectional study was conducted on 945 participants aged between 70 and 84 years (men=47.5%; mean age=76.0 ± 3.9 years) from the Korean Frailty and Aging Cohort Study. The serum creatinine-to-cystatin-C ratio estimated glomerular filtration rate (eGFR) ratio (eGFR_cystatin-C/eGFR_creatinine), sarcopenia index (serum creatinine × eGFR_creatinine), predicted skeletal muscle mass index (pSMI), and total body muscle mass index (TBMM) were compared.

Results: The prevalence of sarcopenia was 19.9% in men and 14.0% in women. The pSMI and TBMM showed higher correlations with appendicular lean mass and grip strength in men (pSMI: r_s=0.356-0.701, p < 0.001; TBMM: r_s=0.320-0.730, p < 0.001) and women (pSMI: r_s=0.299-0.669, p < 0.001; TBMM: r_s=0.256-0.658, p < 0.001) than the other indices. The area under the receiver operating characteristic curves (AUC) of the serum indices for predicting sarcopenia showed the highest accuracy for pSMI (men: AUC=0.77, p < 0.001; women: AUC=0.71, p < 0.001). After adjusting for potential confounders, pSMI was associated with the likelihood of sarcopenia in both men (odds ratio [OR]=0.170; 95% confidence interval [CI]=0.103-0.279) and women (OR=0.167; 95% CI=0.087-0.321).

Conclusion: pSMI and TBMM accurately determined sarcopenia than the other indices. Furthermore, a higher pSMI was strongly associated with a decreased risk of sarcopenia compared to TBMM. These findings suggest pSMI as a potential biomarker for sarcopenia screening in community-dwelling older adults.

Keywords: Community-dwelling older adults; Creatinine; Cystatin C; Muscle mass; Sarcopenia; Screening.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Biomarkers
Cohort Studies
Creatinine
Cross-Sectional Studies
Female
Humans
Independent Living
Male
Sarcopenia* / diagnosis
Sarcopenia* / epidemiology

Substances

Biomarkers
Creatinine