Evaluating Muscle Mass by Using Markers of Kidney Function: Development of the Sarcopenia Index

Kashani, Kianoush; Frazee, Erin; Kukrálová, Lucie; Sarvottam, Kumar; Herasevich, Vitaly; Young, Phillip M.; Kashyap, R.; Lieske, John C.

doi:10.1097/ccm.0000000000002013

Cited by 207 publications

(271 citation statements)

References 31 publications

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“…In order to verify the relationship with muscle mass proven in previous studies [17, 18] and to study its relationship with muscle function (exercise capacity), the correlation between the SI and FFMI and the 6-min walking test was studied in a subgroup of 30 patients. SI correlated with FFMI ( r = 0.431, p = 0.017) (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…The ratio serum creatinine/serum cystatin C (SI) has previously been used as a surrogate marker of muscle mass in amyotrophic lateral sclerosis [23], in patients undergoing physical checkups [24], in ICU patients [17], in lung transplant candidates [18], and in type 2 diabetic patients [25]. All these studies have shown a good correlation of this index with muscle mass, as measured by DEXA, CT scan or electric bioimpedance.…”

Section: Discussionmentioning

confidence: 99%

“…Serum creatinine (mg/dL) was measured by the Siemens traceable enzymatic method assay (Advia 2400 Analyzer, Siemens Healthcare Diagnostics, Germany), and serum cystatin C (mg/L) was measured using an immunonephelometric assay (N-latex-Cystatin-C, BNII nephelometer, Siemens Healthcare Diagnostics, Germany). The SI was determined using the equation of Kashani et al [17], i.e., (serum creatinine/serum cystatin C) ×100.…”

Section: Methodsmentioning

confidence: 99%

“…They showed that a low SI could predict hospital stay and 90-day mortality in a variety of ICU patients who did not have acute kidney injury at the time of measurement. These authors also evaluated this ratio in lung transplant candidates [18] and, in both studies, they demonstrated that it is an objective measure for estimating muscle mass which is noninvasive, not time consuming, and much less expensive than other techniques [17, 18]. Up to now, this novel marker has not been evaluated in COPD outpatients.…”

Section: Introductionmentioning

confidence: 99%

“…In stable patients, the production of both molecules is also constant. Taking advantage of the properties of these molecules, Kashani et al [17] used the ratio serum creatinine/serum cystatin C (called by them Sarcopenia Index or SI) as a surrogate of muscle mass and validated its utility in ICU patients. They showed that a low SI could predict hospital stay and 90-day mortality in a variety of ICU patients who did not have acute kidney injury at the time of measurement.…”

Section: Introductionmentioning

confidence: 99%

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The Ratio Serum Creatinine/Serum Cystatin C (a Surrogate Marker of Muscle Mass) as a Predictor of Hospitalization in Chronic Obstructive Pulmonary Disease Outpatients

et al. 2018

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Background: In chronic obstructive pulmonary disease (COPD), low muscle mass has been associated with several clinical outcomes such as low exercise capacity, hospital admission, and mortality. The Sarcopenia Index (SI) is a novel way to estimate muscle mass based on the ratio of serum creatinine (produced exclusively by muscle)/cystatin C (produced by all nucleated body cells). Objectives: This study aims to assess the SI in stable COPD outpatients, as compared with a healthy control group, to quantify its relationship with several important clinical features in COPD, and to study its potential usefulness to predict COPD exacerbations and hospital admissions. Methods: The SI was calculated in 18 healthy control subjects and 65 stable COPD outpatients were included in the study. Patients were prospectively followed for 1 year after being enrolled in the study. Results: COPD patients had a lower SI than controls, that is lower muscle mass. Furthermore, patients with a modified Medical Research Council dyspnea score ≥2, patients with a COPD Assessment Test score ≥10, and patients with a high risk of exacerbation had lower levels of SI compared with patients without these characteristics. SI correlated with FEV1 (r = 0.491, p < 0.001), the 6-min walking test (r = 0.560, p = 0.001), and the Fat-Free Mass Index (r = 0.431, p = 0.017). Univariate and multivariate Cox proportional risk analysis showed that a low SI is an independent predictor of hospital admission in COPD outpatients followed for 1 year (HR 5.16, p = 0.025). Conclusions: The ratio serum creatinine/serum cystatin C correlates with several COPD characteristics, and it can be used to predict COPD hospitalization.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Ratio Serum Creatinine/Serum Cystatin C (a Surrogate Marker of Muscle Mass) as a Predictor of Hospitalization in Chronic Obstructive Pulmonary Disease Outpatients

et al. 2018

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Usefulness of serum creatinine and cystatin C ratio as a screening tool for predicting prognosis in patients with pancreatic cancer

Tsukagoshi

Watanabe

Araki

et al. 2023

Annals of Gastroent Surgery

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AimThis study aimed to evaluate the usefulness of the serum creatinine/cystatin C (Cr/CysC) ratio as a prognostic factor after pancreatic surgery in patients with pancreatic cancer.MethodsWe retrospectively analyzed the data of 88 patients with pancreatic ductal carcinoma who underwent pancreatic surgery from January 2017 to December 2020. CysC measured from frozen serum samples and circulating Cr levels were used to calculate the Cr/CysC ratio. The cutoff value of the Cr/CysC ratio was determined using receiver operating characteristic curves. Cox proportional hazards model analysis and survival curves were applied to identify the prognostic factors.ResultsThe optimal cutoff value of the Cr/CysC ratio for predicting mortality after surgery was 1.05. This study included 20 (22.7%) and 68 (77.3%) patients with high and low Cr/CysC ratios, respectively. The low Cr/CysC ratio was significantly associated with female sex (p = 0.020) and higher levels of C‐reactive protein (p = 0.020). The postoperative length of stay was significantly longer in patients with low Cr/CysC rates (p = 0.044). Patients with low Cr/CysC ratio showed poorer prognosis in relapse‐free survival (hazard ratio [HR] = 3.33; 95% confidence interval [CI]: 1.54–4.20; p = 0.002) and overall survival (HR = 2.52, 95% CI: 1.04–6.10, p = 0.041), respectively, which were significantly worse than in those with high Cr/CysC ratios (p = 0.003 and 0.049, respectively).ConclusionThe Cr/CysC ratio could be a useful screening tool for predicting the prognosis of patients with pancreatic ductal carcinoma undergoing pancreatic surgery.

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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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Evaluating Muscle Mass by Using Markers of Kidney Function: Development of the Sarcopenia Index

Abstract: The sarcopenia index is a fair measure for muscle mass estimation among ICU patients and can modestly predict hospital and 90-day mortality among patients who do not have acute kidney injury at the time of measurement.

Cited by 207 publications

References 31 publications

The Ratio Serum Creatinine/Serum Cystatin C (a Surrogate Marker of Muscle Mass) as a Predictor of Hospitalization in Chronic Obstructive Pulmonary Disease Outpatients

The Ratio Serum Creatinine/Serum Cystatin C (a Surrogate Marker of Muscle Mass) as a Predictor of Hospitalization in Chronic Obstructive Pulmonary Disease Outpatients

Usefulness of serum creatinine and cystatin C ratio as a screening tool for predicting prognosis in patients with pancreatic cancer

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

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