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Serum Creatinine–Cystatin C Based Screening of Sarcopenia in Community Dwelling Older Adults: A Cross-Sectional Analysis

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Abstract

Objectives

To compare the discriminative capabilities for the manifestation of sarcopenia or physical frailty between serum creatinine- and cystatin C-derived indices among community-dwelling older adults.

Design

Cross-sectional study.

Setting

Primary Care and Community.

Participants

We utilized a subset of data from the Frail Elderly in the Sasayama-Tamba Area (FESTA) study, which was initiated in 2015 to gather comprehensive information on various health-related parameters among community-dwelling older individuals (age ≥65 years).

Measurements

Five serum creatinine–cystatin C based indices including the Sarcopenia Index, the serum creatinine/cystatin C ratio, the disparity between serum cystatin-C-based and creatinine-based estimated GFR, the total body muscle mass index (TBMM), and the prediction equation for skeletal muscle mass index (pSMI) were employed. Sarcopenia and physical frailty were identified based on the Asian Working Group for Sarcopenia criteria and the revised Japanese version of the Cardiovascular Health Study criteria, respectively. The receiver operating characteristic (ROC) and logistic regression analyses were performed to assess the discriminative abilities of these tools.

Results

In the analysis of 954 participants, 52 (5.5%) were identified with sarcopenia and 35 (3.7%) with physical frailty. Regarding sarcopenia discrimination, TBMM and pSMI both exhibited area under the curve (AUC) values exceeding 0.8 for both men and women. Concerning the identification of physical frailty, AUC values ranged from 0.61 to 0.77 for males and 0.50 to 0.69 for females. In the multivariate logistic regression analyses, only TBMM and pSMI consistently displayed associations with sarcopenia, irrespective of sex (P<0.001, respectively). On the other hand, no consistent associations were observed between the indices and physical frailty.

Conclusions

This study provides a robust association of a serum creatinine- and cystatin C-derived indices, especially TBMM and pSMI, with sarcopenia among community-dwelling older adults. Conversely, the application of these indices for the screening of physical frailty has its constraints, necessitating further investigation.

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Acknowledgments

The authors wish to express their appreciation of the staff for all the time and attention that they have devoted to the study.

Author information

Authors and Affiliations

  1. Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo, 650-8530, Japan

    Ryota Matsuzawa & K. Nagai

  2. Department of Biostatistics, Hyogo Medical University, Nishinomiya, Japan

    K. Takahashi

  3. Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan

    T. Mori, K. Tamaki, Y. Wada, H. Kusunoki, Y. Nagasawa & K. Shinmura

  4. Amagasaki Medical COOP Honden Clinic, Amagasaki, Hyogo, Japan

    T. Mori

  5. Department of Orthopedic Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan

    M. Onishi & S. Tsuji

  6. Department of Orthopedic Surgery, Tatsuno City Hospital, Tatsuno, Japan

    S. Tsuji

  7. School of Pharmacy, Hyogo Medical University, Kobe, Japan

    K. Hashimoto

  8. Roppou Clinic, Toyooka, Hyogo, Japan

    Y. Wada

  9. Department of Internal Medicine, Osaka Dental University, Hirakata, Japan

    H. Kusunoki

Authors
  1. Ryota Matsuzawa
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  2. K. Nagai
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  8. K. Tamaki
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  10. H. Kusunoki
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  12. K. Shinmura
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Corresponding author

Correspondence to Ryota Matsuzawa.

Ethics declarations

Conflicts of interest: The authors declare that they have no conflicts of interest.

Ethical approval: All participants of the Frail Elderly in the Sasayama-Tamba Area (FESTA) study provided written informed consent before study enrollment. This study was approved by the Ethic Review Board (approval number: Rinhi 0342) and conducted in accordance with the principles of the Declaration of Helsinki.

Additional information

Financial support: This work was supported in part by the JSPS KAKENHI (grant number: 22K19496 to K.S. in 2022), Uehara Memorial Foundation (grant number: 202120105 to K.S.), National Center for Geriatrics and Gerontology (grant number: Choujyu 20-1 to K.S. in 2022), Hyogo Medical University Grant for Research Promotion, 2023 (to R.M.), and the JSPS KAKENH (grant number: 20K19332 to R.M. in 2020).

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Matsuzawa, R., Nagai, K., Takahashi, K. et al. Serum Creatinine–Cystatin C Based Screening of Sarcopenia in Community Dwelling Older Adults: A Cross-Sectional Analysis. J Frailty Aging 13, 116–124 (2024). https://doi.org/10.14283/jfa.2024.13

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  • DOI: https://doi.org/10.14283/jfa.2024.13

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