Relationship between sarcopenia and the serum creatinine/cystatin C ratio in Japanese rural community-dwelling older adults

Hiroshi Kusunoki, Shotaro Tsuji, Yosuke Wada, Mayuka Fukai, Koutatsu Nagai, Masako Itoh, Kyoko Sano, Kayoko Tamaki, Yoshinori Ohta, Manabu Amano, Hatsuo Maeda, Yoko Hasegawa, Hiromitsu Kishimoto, Soji Shimomura, Hiroo Yoshikawa, Ken Shinmura
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引用次数: 27

Abstract

Aims

Sarcopenia, the age-related decline in skeletal muscle volume and function, is associated with negative clinical and socioeconomic outcomes in elderly people. Clinical biomarkers to diagnose sarcopenia that can be quantified in a reliable, and cost- effective manner, are needed. We investigated whether the creatinine (Cr) /cystatin C (CysC) ratio is correlated with muscle volume and physical function in Japanese community-dwelling elderly subjects.

Methods and results

The present study included 213 men aged 73.2±6.2 years and 464 women aged 72.4±5.5 years from a rural area in the Hyogo prefecture of Japan. To evaluate whether the Cr/CysC ratio is correlated with sarcopenia criteria in elderly individuals without severe renal impairment, we excluded subjects with estimate glomerular filtration rate (eGFR) <45.

The prevalence of sarcopenia diagnosed according to the AWGS criteria was 2.8% in men and 3.4% in women. The Cr/CysC ratio correlated with skeletal mass index (r = 0.49, p <0.0001), skeletal muscle mass (r = 0.53, p <0.0001), grip power (r = 0.59, p <0.0001), knee extension muscle strength (r = 0.49, p <0.0001), normal gait speed (r = 0.18, p <0.0001), and maximal gait speed (r = 0.32, p <0.0001). A negative correlation between the Cr/CysC ratio and, body fat mass (r = −0.20, p <0.0001) and percentage of body fat mass (r = −0.39, p <0.0001) was observed. In a multiple regression analysis, Cr/CysC was also found to be significantly positively correlated with each component of the sarcopenia criteria.

Conclusions

Even in elderly individuals without severe renal impairment, the Cr/CysC ratio was positively correlated with muscle volume and physical function and negatively correlated with body fat mass. Therefore, the Cr/CysC ratio might be a useful biomarker to predict sarcopenia.

Abstract Image

日本农村社区老年人肌肉减少症与血清肌酐/胱抑素C比值的关系
目的骨骼肌减少症,骨骼肌体积和功能与年龄相关的下降,与老年人的负面临床和社会经济结果有关。临床生物标志物诊断肌肉减少症,可以量化可靠,成本效益的方式,是需要的。我们调查了日本社区老年人肌酐(Cr) /胱抑素C (CysC)比值是否与肌肉体积和身体功能相关。方法与结果本研究纳入了来自日本兵库县农村的213名男性(73.2±6.2岁)和464名女性(72.4±5.5岁)。为了评估Cr/CysC比值是否与无严重肾功能损害的老年人肌肉减少症标准相关,我们排除了估算肾小球滤过率(eGFR) [lt;45]的受试者。根据AWGS标准诊断的肌肉减少症患病率在男性中为2.8%,在女性中为3.4%。Cr/CysC比值与骨量指数(r = 0.49, p <0.0001)、骨骼肌质量(r = 0.53, p <0.0001)、握力(r = 0.59, p <0.0001)、膝关节伸肌力量(r = 0.49, p <0.0001)、正常步速(r = 0.18, p <0.0001)、最大步速(r = 0.32, p <0.0001)相关。Cr/CysC比值与体脂质量(r = - 0.20, p <0.0001)和体脂质量百分比(r = - 0.39, p <0.0001)呈负相关。在多元回归分析中,还发现Cr/CysC与肌少症标准的各个组成部分显著正相关。结论即使在没有严重肾功能损害的老年人中,Cr/CysC比值也与肌肉体积和身体功能呈正相关,与体脂量呈负相关。因此,Cr/CysC比值可能是预测肌少症的一个有用的生物标志物。
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