Creatinine to cystatin C ratio, a biomarker of sarcopenia measures and falls risk in community-dwelling older women
The journals of gerontology. Series A, Biological sciences and medical sciences
School of Medical and Health Sciences / Institute for Nutrition Research
National Health and Medical Research Council - grants: 254627, 303169, 572604 / NHMRC of Australia Emerging Leader (Level 2) Fellowship (ID: GNT1174886) / NHMRC of Australia Senior Research Fellowship (ID: 1116973) / National Heart Foundation of Australia Future Leader Fellowship (ID: 102817) / Healthway, Western Australian Health Promotion Foundation / Royal Perth Hospital Career Advancement Fellowship (ID: CAF 130/2020)
NHMRC Numbers : 254627, 303169, 572604, GNT1174886, 1116973
http://purl.org/au-research/grants/nhmrc/1116973 http://purl.org/au-research/grants/nhmrc/25462 http://purl.org/au-research/grants/nhmrc/303169 http://purl.org/au-research/grants/nhmrc/572604
BACKGROUND: The ratio of creatinine to cystatin C (Cr:Cyc) has been proposed as a biomarker of sarcopenia, as greater Cr:Cyc is typically associated with greater muscle mass. We examined the relationship between Cr:Cyc with individual sarcopenia measures, 5-year self-reported falls, and 12-year fall-related hospitalizations in a prospective cohort study of 1 118 community-dwelling older women (mean age 75.2 ± 2.7 years). METHODS: Serum Cr:Cyc, hand grip strength, and timed-up-and-go performance were assessed at baseline (1998), while dual-energy x-ray absorptiometry-derived appendicular lean mass (ALM)/height2 (m) was obtained in a subset of women at baseline and 1 year (n = 334). Incident 5-year self-reported falls and 12-year falls-related hospitalizations were considered. RESULTS: In a multivariable-adjusted model, women with the lowest Cr:Cyc (Quartile [Q] 1) had 5% (1.0 kg) weaker grip strength, as well as 3.7% (0.22 kg/m2) and 5.5% (0.031) lower ALM adjusted for height2 or body mass index, respectively, compared to women in Q4 (all p < .05). 329 women reported an incident fall over 5 years, and 326 fall-related hospitalizations were recorded over 12 years. Women in Q1 of Cr:Cyc had a greater relative hazard for a fall over 5 years (hazard ratio [HR] 1.50; 95% confidence interval [CI] 1.11-2.01) and fall-related hospitalization over 12 years (HR 1.53; 95% CI 1.13-2.07) compared to Q4 in the multivariable-adjusted model. CONCLUSION: These findings support further investigation into the use of Cr:Cyc as a muscle biomarker to help clinicians identify individuals at risk of falls for early inclusion into evidence-based primary prevention programs targeting improvements to diet and exercise.