Decreased the creatinine to cystatin C ratio is a surrogate marker of sarcopenia in patients with type 2 diabetes

Osaka, Takafumi; Hamaguchi, Masahide; Hashimoto, Yoshitaka; Ushigome, Emi; Tanaka, Muhei; Yamazaki, Masahiro; Fukui, Michiaki

doi:10.1016/j.diabres.2018.02.025

Cited by 125 publications

(112 citation statements)

References 33 publications

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“…In another study of 62 patients with amyotrophic lateral sclerosis, the Cr/CysC ratio was shown to be associated with the severity of muscle loss (Tetsuka, ). Recently, a study in 285 patients with type 2 diabetes also indicated that the Cr/CysC ratio was consistent with the skeletal muscle mass estimated by bioelectrical impedance and could be used as a practical screening marker for sarcopenia (Osaka et al, ). In our study, we did not use the above methods except the Cr/CysC ratio to evaluate the muscle mass, due to the clinical instability of the patients at NCU admission.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of serum creatinine/cystatin C in neurocritically ill patients

Wang

Xie

et al. 2019

Brain and Behavior

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ObjectiveTo explore the predictive value of serum creatinine (Cr) to cystatin C (CysC) ratio in neurocritically ill patients.MethodsWe conducted a retrospectively observational study of adult patients admitted to a neurocritical care unit (NCU) between Jan 2013 and Jan 2017. Patients were excluded if <18 years old, required neurocritical care <72 hr, did operation during hospitalization, had premorbid disability or acute kidney injury (AKI) at admission. The Cr/CysC ratio was obtained at NCU admission. Primary end points were short‐term (30‐day) mortality and long‐term (6‐month) poor outcome, with the latter defined as modified Rankin Scale (mRS) of 4–6.ResultsOf 538 eligible patients, the etiology included acute ischemic stroke (N = 193, 35.9%), intracranial hemorrhage (N = 116, 21.6%), encephalitis and/or meningitis (N = 85, 15.8%), and others (N = 144, 26.7%). Serum Cr/CysC ratio was significantly correlated with body mass index (BMI) (r = .161, p < .001), the length of NCU stay (r = −.161, p < .001), duration of mechanical ventilation (r = −.138, p = .001), and risk of tracheotomy (r = −.095, p = .028). During follow‐up, 88 (16.4%), patients died within 30 days and 307 (57.1%) patients achieved good outcome at 6 months. In multivariate logistic regression analysis, we identified serum Cr/CysC ratio as an independent predictor of long‐term functional outcome (OR: 0.989, 95% CI: 0.980–0.998, p = .015) but not 30‐day mortality (p = .513).ConclusionsSerum Cr/CysC ratio at admission could be used as a predictor of long‐term poor prognosis in neurocritically ill patients.

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Section: Discussionmentioning

confidence: 99%

Predictive value of serum creatinine/cystatin C in neurocritically ill patients

Wang

Xie

et al. 2019

Brain and Behavior

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“…We used the multifrequency impedance body composition analyzer, InBody 720 (InBody Japan, Tokyo, Japan), for evaluation of body composition . The result of this analyzer has a good correlation with the dual‐energy X‐ray absorptiometry method .…”

Section: Methodsmentioning

confidence: 99%

Sarcopenia is associated with tongue pressure in older patients with type 2 diabetes: A cross‐sectional study of the KAMOGAWA‐DM cohort study

Kaji

Hashimoto

Kobayashi

et al. 2018

Geriatrics Gerontology Int

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Aim Death as a result of pneumonia is an important issue in patients with diabetes. Tongue pressure is associated with swallowing function, which has a close association with aspiration pneumonia. However, no previous studies have shown the association between sarcopenia and tongue pressure in older patients with type 2 diabetes. Methods In the present cross‐sectional study, we investigated body composition, handgrip strength and tongue pressure. Skeletal muscle mass index (kg/m2) was defined as appendicular muscle mass / the square of the height. Sarcopenia was defined when both handgrip strength <26 kg for men and <18 kg for women, and the skeletal muscle mass index <7.0 kg/m2 for men and <5.7 kg/m2 for women existed. Results Among 144 patients (82 men, 71.4 years [SD 6.7 years]), 11.8% had sarcopenia. Tongue pressure was associated with skeletal muscle mass index and handgrip strength (r = 0.361, P < 0.001 and r = 0.387, P < 0.001, respectively, in men; and r = 0.300, P = 0.018 and r = 0.538, P < 0.001, respectively, in women). Tongue pressure was associated with the prevalence of sarcopenia after adjusting for covariates (OR 3.83, 95% CI 1.06–13.9, P = 0.041). According to the receiver operating characteristic curve analysis, the optimal cut‐off value of handgrip strength for the presence of low tongue pressure was 27.7 kg (AUC 0.70, 95% CI 0.53–0.83, sensitivity 0.78, specificity 0.64) in men and 18.3 kg (AUC 0.71, 95% CI 0.54–0.84, sensitivity 0.82, specificity 0.54) in women. Conclusions Sarcopenia, especially handgrip strength, is associated with tongue pressure in older patients with type 2 diabetes. We should consider a decrease of swallowing function when examining patients with sarcopenia. Geriatr Gerontol Int 2019; 19: 153–158.

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“…CysC is used as a serum marker to estimate GFR irrespective of the presence of chronic kidney disease and nutritional status [8]. Therefore, several studies have hypothesized that Scr or the Scr/CysC ratio could serve as a biomarker of SMM [12,13]. In addition, Lien et al [14] proposed another sarcopenia index (SI), the Scr 9 CysC-based GFR (GFR CysC ), which may be better correlated with SMM.…”

Section: Introductionmentioning

confidence: 99%

A new diagnostic index for sarcopenia and its association with short‐term postoperative complications in patients undergoing surgery for colorectal cancer

et al. 2019

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Aim Sarcopenia is a robust prognostic indicator of outcomes after surgery for colorectal cancer (CRC). However, there are no serum markers routinely available for estimating skeletal muscle mass (SMM). The present study aimed to describe a new sarcopenia index (SI), serum creatinine (Scr) 9 cystatin C-based glomerular filtration rate, and investigate its association with shortterm complications after curative resection of CRC.Method Consecutive patients who underwent curative resection of CRC from December 2011 to January 2017 were retrospectively identified. Skeletal muscle cross-sectional area was analysed on L3 computed tomographic images. Receiver operating characteristic curve analysis showed that the cutoff points of SI for sarcopenia were below 56.1 in men and below 43.7 in women. Patients were classified into low and high SI groups in accordance with these cutoff values. The association between SI and body composition and the impact of preoperative SI on postoperative outcomes were analysed.Results Among 417 patients, SI showed a stronger correlation with skeletal muscle area (SMA) (r = 0.537, P < 0.001) than with the Scr/cystatin C ratio (r = 0.469, P < 0.001) and Scr (r = 0.447, P < 0.001). The low SI group had a lower SMA, lower preoperative haemoglobin, a higher prevalence of sarcopenia and experienced more postoperative complications compared with the high SI group (all P < 0.001). Multivariate logistic regression analysis showed that the independent risk factors for overall complications were low preoperative haemoglobin, low SI, sarcopenia and American Society of Anesthesiologists grade ≥ 3.Conclusion This new SI is a simple and useful surrogate marker for estimating SMM, and is associated with outcomes after CRC surgery.What does this paper add to the literature? We describe a novel, simple approach with which to diagnose sarcopenia. The new sarcopenia index (SI), serum creatinine 9 cystatin C-based glomerular filtration rate, is closely associated with skeletal muscle mass. A low SI is an independent risk factor for postoperative complications after curative resection of colorectal cancer.

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Decreased the creatinine to cystatin C ratio is a surrogate marker of sarcopenia in patients with type 2 diabetes

Cited by 125 publications

References 33 publications

Predictive value of serum creatinine/cystatin C in neurocritically ill patients

Predictive value of serum creatinine/cystatin C in neurocritically ill patients

Sarcopenia is associated with tongue pressure in older patients with type 2 diabetes: A cross‐sectional study of the KAMOGAWA‐DM cohort study

A new diagnostic index for sarcopenia and its association with short‐term postoperative complications in patients undergoing surgery for colorectal cancer

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