Author Identifier (ORCID)
Abstract
Background: Biomarkers for sarcopenia are lacking. We examined the diagnostic power of serum creatinine to cystatin C ratio for identifying low magnetic resonance imaging-muscle volume and low grip strength in a large observational study of UK Biobank older adults.
Methods: Serum creatinine and cystatin C were measured via immunoassays (Beckman Coulter AU5800 and Siemens Advia 1800, respectively) and grip strength by hydraulic hand dynamometer at baseline visit (2008-2010). magnetic resonance imaging-thigh fat-free muscle volume and DXA-derived appendicular lean mass were measured at imaging visit (2014-2018). Extreme outliers were removed, and covariates (demographic, lifestyle, and clinical factors, as well as time elapsed between baseline-imaging visit) were adjusted for in statistical models.
Results: 12 873 older adults (mean age: 63.5 ± 2.7 years, 44.2% women) were included for fat-free muscle volume and appendicular lean mass/body mass index; 149 707 older adults (mean age: 64.0 ± 2.9 years, 50.5% women) for grip strength. Despite significant associations (p < .05), in fully adjusted models, creatinine to cystatin C showed poor to acceptable diagnostic power for identifying low fat-free muscle volume when using cutpoints of 20th percentile (area under the curve: 0.577 men; 0.622 women) and T scores of -2 (area under the curve: 0.596 men; 0.659 women) and -2.5 (area under the curve: 0.609 men; 0.722 women). In fully adjusted model, creatinine to cystatin C showed poor diagnostic power (area under the curves: < 0.70) for identifying low appendicular lean mass/body mass index or low grip strength, irrespective of the cutpoint used.
Conclusions: Creatinine to cystatin C may not be a suitable biomarker for identifying low muscle volume or low strength in older adults. This finding, drawn from a large sample size and the use of advanced medical imaging, marks an important contribution to the sarcopenia field.
Keywords
Biomarkers, Medical Imaging, Sarcopenia, Skeletal Muscle
Document Type
Journal Article
Date of Publication
12-11-2024
Volume
80
Issue
1
PubMed ID
39538979
Publication Title
The journals of gerontology. Series A, Biological sciences and medical sciences
Publisher
Oxford Academic
School
Nutrition and Health Innovation Research Institute / School of Medical and Health Sciences
RAS ID
72718
Funding Information
Access to UK Biobank data was granted under application no. 92647 “Research to Inform the Field of Precision Gerontology” (PI: Richard H. Fortinsky), funded by the Claude D. Pepper Older American Independence Centers (OAIC) program: P30AG067988 (MPIs: George A. Kuchel and Richard H. Fortinsky). C.L.K. and G.A.K. are partially supported by P30AG067988. M.S. is supported by a Career Advancement Fellowship from the Royal Perth Hospital Research Foundation and an Emerging Leader Fellowship from the Future Health Research and Innovation Fund (Department of Health, Western Australia).
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Content Type
Full object
Recommended Citation
Kirk, B., Kuo, C. L., Liu, P., Xiang, M., Zanker, J., Prokopidis, K., ... & Duque, G. (2025). Diagnostic power of serum creatinine/cystatin C ratio for identifying low MRI-muscle volume and low grip strength: Data From 9 731 to 149 707 UK Biobank Older Adults. The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 80(1). https://doi.org/10.1093/gerona/glae274
Comments
Kirk, B., Kuo, C. L., Liu, P., Xiang, M., Zanker, J., Prokopidis, K., ... & Duque, G. (2025). Diagnostic power of serum creatinine/cystatin C ratio for identifying low MRI-muscle volume and low grip strength: Data From 9 731 to 149 707 UK Biobank Older Adults. The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 80(1). https://doi.org/10.1093/gerona/glae274