Abstract
Objective
Sarcopenia is a risk factor for poor outcomes in older adults. Identification of plasma
markers may facilitate screening of sarcopenia. We previously reported that creatinine-to-cystatin
C ratio is a simple marker of muscle mass. To further assess the clinical relevance
of the creatinine-to-cystatin C ratio, we investigated its association with myosteatosis
and physical performance.
Design
Observational study.
Setting and Participants
Cross-sectional analysis of the dataset obtained from a Japanese population consisting
of 1468 older (≥60 years of age) community residents.
Methods
The mean attenuation values of the skeletal muscle calculated from computed tomography
images of the midthigh were used as an index of myosteatosis, while the cross-sectional
area of the muscle was used as a proxy for muscle mass. Physical performance was assessed
by 1-leg standing time.
Results
Creatinine-to-cystatin C ratio was positively associated with the cross-sectional
area of muscle fiber-rich muscles, while it showed an inverse association with fat-rich
muscle areas, resulting in the positive association between creatinine-to-cystatin
C ratio and the mean attenuation value of the skeletal muscle [creatinine-to-cystatin
C ratio quartiles (Q), Q1: 47.4 ± 4.8, Q2: 48.9 ± 4.4, Q3: 49.8 ± 4.1, Q4: 50.9 ± 3.7,
P < .001]. The results of the linear regression analysis adjusted for major covariates
(including muscle cross-sectional area) identified creatinine-to-cystatin C ratio
as an independent determinant of the mean attenuation value (Q1: reference, Q2: β = 0.07,
P = .019, Q3: β = 0.11, P < .001, Q4: β = 0.16, P < .001). Low creatinine-to-cystatin C ratio was independently associated with 1-leg
standing time, although the association was attenuated substantially by adjusting
for skeletal muscle cross-sectional area and mean attenuation value.
Conclusion and Implications
Creatinine-to-cystatin C ratio was associated with myosteatosis in older adults, independent
of the muscle mass. Creatinine-to-cystatin C ratio may serve as a convenient marker
of sarcopenia.
Keywords
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Article info
Publication history
Published online: April 26, 2021
Footnotes
The Department of Antiaging Medicine at Ehime University is funded by endowments from Nitta Gelatin Incorporated to Ehime University.
This work was supported by the Grant-in-Aid for Scientific Research (20390185, 23659382, 24390084, 23659352, 25293141, 26670313, 17H04123) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan; Research and Development Grants for Longevity Science (dk0110040) from the Japan Agency for Medical Research and Development (AMED); research grant from the Japan Atherosclerosis Prevention Found; National Cardiovascular Research Grants; and Research Promotion Award from Ehime University.
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© 2021 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
