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Serum creatinine and cystatin C-based index can be a screening biomarker for sarcopenia in older population

  • Sunny Singhal
  • Sumitabh Singh
  • Ashish Datt Upadhyay
  • Sada Nand Dwivedi
  • Chandan Jyoti Das
  • Srikant Mohta
  • Prasun Chatterjee
  • Aparajit Ballav Dey
  • Avinash ChakrawartyEmail author
Research Paper

Key summary points

Aim

To use an index based on blood biomarkers (serum creatinine and cystatin c) to screen sarcopenia in older adults.

Findings

Lower value of Biochemical Total Body Muscle mass index (TBMM) (calculated from serum creatinine and cystatin C) was significantly associated with higher risk of sarcopenia.

Message

Biochemical Total Body Muscle Mass index based on serum creatinine and cystatin C can be used to screen sarcopenia in older people.

Abstract

Purpose

Considering the clinical impact of sarcopenia, it would be interesting to get a rapid and sensible screening tool. We conducted a cross-sectional study with the motive to use an index based on serum creatinine and cystatin C to screen sarcopenia in older people in outpatient settings.

Methods

100 participants above the age of 65 years were recruited from the outpatient department of Geriatric medicine of a tertiary care hospital in India. Muscle mass, muscle strength and physical performance were measured by DXA scan, hand-held dynamometer and 4 m gait speed, respectively. Sarcopenia was identified using Asian working group of sarcopenia (AWGS) criteria. Serum creatinine and cystatin C were measured for all participants. Serum creatinine/cystatin C ratio and biochemical total body muscle mass index (TBMM) were calculated and its association was checked with sarcopenia.

Results

The prevalence of sarcopenia was 53%. Mean serum creatinine/cystatin C ratio was 74.79 ± 24.91. It was not significantly associated with sarcopenia. Mean biochemical TBMM index of participants was 36.40 ± 7.88 (males—38.77 ± 7.72, females—31.22 ± 5.13). The lower value of biochemical TBMM index was significantly associated with an increased risk of sarcopenia (p < 0.01). Cut-off value of 40.9 in males (sensitivity—79.41%; specificity—61.76%) and 32.2 in females (sensitivity—78.95%; specificity—66.67%) was proposed for identification of sarcopenia.

Conclusion

Out of the two indices, only low biochemical total body muscle mass index is significantly associated with sarcopenia and a value of less than 40.9 in males and 32.2 in females can be used to screen sarcopenia in older people.

Keywords

Sarcopenia Biomarkers Creatinine Cystatin C 

Notes

Funding

This work was supported by National Programme for Health Care of the Elderly, Government of India.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (IECPG-111/12/2015) and with the 1964 Helsinki Declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© European Geriatric Medicine Society 2019

Authors and Affiliations

  • Sunny Singhal
    • 1
  • Sumitabh Singh
    • 1
  • Ashish Datt Upadhyay
    • 2
  • Sada Nand Dwivedi
    • 2
  • Chandan Jyoti Das
    • 3
  • Srikant Mohta
    • 4
  • Prasun Chatterjee
    • 1
  • Aparajit Ballav Dey
    • 1
  • Avinash Chakrawarty
    • 1
    Email author
  1. 1.Department of Geriatric MedicineAll India Institute of Medical Sciences, AIIMSNew DelhiIndia
  2. 2.Department of BiostatisticsAll India Institute of Medical SciencesNew DelhiIndia
  3. 3.Department of RadiodiagnosisAll India Institute of Medical SciencesNew DelhiIndia
  4. 4.Department of Internal MedicineAll India Institute of Medical SciencesNew DelhiIndia

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