The Predictive Power of the Cystatin C-Creatinine Score in Assessing Frailty

IF 9.1 1区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Cachexia Sarcopenia and Muscle Pub Date : 2025-08-15 DOI:10.1002/jcsm.70040

Li Deng, Xin Zheng, Yue Chen, Chenan Liu, Jinyu Shi, Zhaoting Bu, Xiaoyue Liu, Hong Zhao, Shuqun Li, Bing Yin, Siyu Xing, Hanping Shi

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Abstract

Background

As the global population ages, identifying reliable biomarkers to predict frailty and mortality is critical for early intervention. This study aims to construct a valuable biomarker and evaluate its predictive performance in assessing frailty and all-cause mortality.

Methods

Data from 3613 participants in the Health and Retirement Study (HRS) were used to construct the nomogram and main analysis, whereas data from the National Health and Nutrition Examination Survey were used to validate the robustness of the model. LASSO regression identified key biomarkers, and a nomogram was used to construct the score. The frailty index (FI) and all-cause mortality were used as the outcomes, and the score's predictive ability was evaluated using ROC curves, C-index and decision curve analysis. Subgroup analyses were conducted to assess the score's consistency across age, sex and clinical conditions.

Results

Sixteen haematological markers were selected through LASSO regression. The nomogram demonstrated that a scoring model based on cystatin C and creatinine can achieve optimal predictive performance. The Cystatin C-Creatinine Score demonstrated strong predictive power for frailty (AUC = 0.687) and all-cause mortality (AUC = 0.733). Logistic regression analysis showed a significant association between higher Cystatin C-Creatinine Scores and increased frailty risk, with participants in the high-risk group having an OR of 1.48 (95% CI: 1.35–1.62, p < 0.001) compared to the low-risk group. Cox proportional hazards models also indicated that higher scores were associated with increased mortality risk (HR = 3.34, 95% CI: 1.75–6.38, p < 0.001 for the high-risk group). In the validation set, the AUC values of the Cystatin C-Creatinine Score for predicting frailty and all-cause mortality reached 0.701 and 0.713, respectively.

Conclusion

Our findings support the use of the Cystatin C-Creatinine Score as a practical and effective tool for identifying individuals at higher risk of frailty and mortality.

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胱抑素c -肌酐评分在评估衰弱中的预测能力

背景随着全球人口老龄化，确定可靠的生物标志物来预测虚弱和死亡率对于早期干预至关重要。本研究旨在构建一个有价值的生物标志物，并评估其在评估虚弱和全因死亡率方面的预测性能。方法采用美国健康与退休研究（HRS） 3613名参与者的数据构建nomogram并进行主分析，同时采用美国国家健康与营养调查（National Health and Nutrition Examination Survey）的数据验证模型的稳健性。LASSO回归确定了关键的生物标志物，并使用nomogram来构建评分。以衰弱指数（FI）和全因死亡率作为结局，采用ROC曲线、c指数和决策曲线分析评价评分的预测能力。进行亚组分析以评估评分在不同年龄、性别和临床条件下的一致性。结果采用LASSO回归方法筛选出16个血液学指标。nomogram显示基于胱抑素C和肌酐的评分模型能够达到最佳的预测效果。胱抑素c -肌酐评分对虚弱（AUC = 0.687）和全因死亡率（AUC = 0.733）具有很强的预测能力。Logistic回归分析显示高胱抑素c -肌酐评分与衰弱风险增加之间存在显著关联，与低风险组相比，高风险组参与者的OR为1.48 （95% CI: 1.35-1.62, p < 0.001）。Cox比例风险模型还显示，评分越高，死亡风险越高（高危组HR = 3.34, 95% CI: 1.75-6.38, p < 0.001）。在验证集中，预测虚弱和全因死亡率的胱抑素c -肌酐评分的AUC值分别达到0.701和0.713。结论：我们的研究结果支持将胱抑素c -肌酐评分作为一种实用有效的工具，用于识别脆弱和死亡风险较高的个体。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cachexia Sarcopenia and Muscle MEDICINE, GENERAL & INTERNAL-

CiteScore

13.30

自引率

12.40%

发文量

234

审稿时长

16 weeks

期刊介绍： The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.