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Cross-Sectional and Longitudinal Associations of Creatinine-to-Cystatin C Ratio with Sarcopenia Parameters in Older Adults

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Accumulating evidence from cross-sectional studies suggests that the serum creatinine-to-cystatin C ratio (CCR) may be a useful biomarker for sarcopenia. This study aimed to assess the cross-sectional and longitudinal associations of CCR with sarcopenia and its parameters in community-dwelling older adults.

Design

Cross-sectional and longitudinal study.

Setting and Participants

This 6-year prospective cohort study included the repeated measurement data from 1,253 Japanese residents (662 males and 591 females) aged ≥65 years who underwent medical checkups in Kusatsu and Hatoyama, Japan. A total of 4,421 observations were collected.

Measurements

The CCR was grouped into quartiles by sex (Q1–Q4) using Q4 as the reference category. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 algorithm. Skeletal muscle mass index (SMI) measured using segmental multifrequency bioelectrical impedance analysis, handgrip strength (HGS), usual gait speed (UGS), and maximal gait speed (MGS) were measured repeatedly as sarcopenia parameters. The association of the CCR with changes in sarcopenia, SMI, HGS, UGS, and MGS during the 6-year period were analyzed using a generalized linear mixed-effects model.

Results

The prevalence of sarcopenia at baseline was 13.1% (11.9% in males and 14.5% in females). In a cross-sectional analysis, the CCR quartile was inversely associated with sarcopenia and was positively associated with SMI, HGS, and MGS (P for trend < 0.001). In a longitudinal analysis during the 6 years, a significant increase in sarcopenia in Q2 (B = 1.1% point/year; P = 0.026 for group-by-time interaction) and significant declines in SMI (B = −0.01 kg/m2/year; P = 0.044 for group-by-time interaction) and MGS (B = −0.008 m/sec/year; P = 0.041 for group-by-time interaction) in Q1 were observed compared with Q4. However, the dose-response relationship was significant only for MGS (P = 0.033 for trend). No significant group-by-time interaction was observed for HGS. CCR was not significantly associated with UGS either cross-sectionally or longitudinally.

Conclusions

CCR is a useful biomarker regarding the status of sarcopenia. It may be used for sarcopenia screening even in older adults whose physical function is difficult to assess. However, further longitudinal studies are needed to determine whether CCR can be a predictor of future sarcopenia.

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Acknowledgments

We would like to thank the residents and staff of the towns of Kusatsu and Hatoyama and our collaborators.

Funding

Funding: This study was supported by grants from the Tokyo Metropolitan Institute of Gerontology; Research Institute of Science and Technology for Society, Japan Science and Technology Agency; Japan Society for the Promotion of Science KAKENHI JP24390173 and JP26310111; the Japan Arteriosclerosis Prevention Fund for the Japan Arteriosclerosis Longitudinal Study (2001–2012); and the towns of Kusatsu and Hatoyama.

Author information

Authors and Affiliations

  1. Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan

    M. Kitago, S. Seino, S. Shinkai, Y. Nofuji, Y. Yokoyama, H. Toshiki, T. Abe, Y. Taniguchi, H. Amano, H. Murayama & A. Kitamura

  2. Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    M. Kitago & M. Akishita

  3. Department of Nutrition Sciences, Kagawa Nutrition University, Saitama, Japan

    S. Shinkai

  4. Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Ibaraki, Japan

    Y. Taniguchi

  5. Health Town Development Science Center, Yao City Health Center, Osaka, Japan

    A. Kitamura

  6. Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae, Itabashi, Tokyo, 173-0015, Japan

    Yoshinori Fujiwara

Authors
  1. M. Kitago
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  2. S. Seino
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  6. H. Toshiki
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  7. T. Abe
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  9. H. Amano
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  10. H. Murayama
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  11. A. Kitamura
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  13. Yoshinori Fujiwara
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Corresponding author

Correspondence to Yoshinori Fujiwara.

Ethics declarations

Ethical statements: The study protocol was developed in accordance with the guidelines proposed in the Declaration of Helsinki and approved by the Ethics Committee of the Tokyo Metropolitan Institute of Gerontology. All participants provided written informed consent prior to inclusion in the study.

Conflict of interest: The authors declare that they have no competing interests.

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Kitago, M., Seino, S., Shinkai, S. et al. Cross-Sectional and Longitudinal Associations of Creatinine-to-Cystatin C Ratio with Sarcopenia Parameters in Older Adults. J Nutr Health Aging 27, 946–952 (2023). https://doi.org/10.1007/s12603-023-2029-3

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  • DOI: https://doi.org/10.1007/s12603-023-2029-3

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