Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea.
Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea.
J Cachexia Sarcopenia Muscle. 2022 Aug;13(4):2064-2072. doi: 10.1002/jcsm.13006. Epub 2022 Apr 27.
Muscle wasting is prevalent in cancer patients, and early recognition of this phenomenon is important for risk stratification. Recent studies have suggested that the creatinine-cystatin C ratio may correlate with muscle mass in several patient populations. The association between creatinine-cystatin C ratio and survival was assessed in cancer patients.
A total of 3060 patients who were evaluated for serum creatinine and cystatin C levels at the time of cancer diagnosis were included. The primary outcome was 6-month mortality. The 1-year mortality, and length of intensive care unit (ICU) and hospital stay were also evaluated.
The mean age was 61.6 ± 13.5 years, and 1409 patients (46.0%) were female. The median creatinine and cystatin C levels were 0.9 (interquartile range [IQR], 0.6-1.3) mg/dL and 1.0 (IQR, 0.8-1.5) mg/L, respectively, with a creatinine-cystatin C ratio range of 0.12-12.54. In the Cox proportional hazards analysis, an increase in the creatinine-cystatin C ratio was associated with a significant decrease in the 6-month mortality (per 1 creatinine-cystatin C ratio, hazard ratio [HR] 0.35; 95% confidence interval [CI], 0.28-0.44). When stratified into quartiles, the risk of 6-month mortality was significantly lower in the highest quartile (HR 0.30; 95% CI, 0.24-0.37) than in the lowest quartile. Analysis of 1-year mortality outcomes revealed similar findings. These associations were independent of confounding factors. The highest quartile was also associated with shorter lengths of ICU and hospital stay (both P < 0.001).
The creatinine-cystatin C ratio at the time of cancer diagnosis significantly associates with survival and hospitalization in cancer patients.
肌肉减少症在癌症患者中很常见，早期识别这种现象对于风险分层很重要。最近的研究表明，在几种患者群体中，肌酐-胱抑素 C 比值可能与肌肉量相关。本研究评估了癌症患者的肌酐-胱抑素 C 比值与生存的相关性。
共纳入 3060 例在癌症诊断时评估血清肌酐和胱抑素 C 水平的患者。主要结局为 6 个月死亡率。还评估了 1 年死亡率、重症监护病房（ICU）和住院时间。
患者的平均年龄为 61.6±13.5 岁，1409 例（46.0%）为女性。肌酐和胱抑素 C 的中位数分别为 0.9（四分位距 [IQR]，0.6-1.3）mg/dL 和 1.0（IQR，0.8-1.5）mg/L，肌酐-胱抑素 C 比值范围为 0.12-12.54。Cox 比例风险分析显示，肌酐-胱抑素 C 比值的增加与 6 个月死亡率的显著降低相关（每增加 1 个肌酐-胱抑素 C 比值，风险比 [HR] 0.35；95%置信区间 [CI]，0.28-0.44）。按 quartiles 分层，最高 quartile 的 6 个月死亡率风险显著低于最低 quartile（HR 0.30；95% CI，0.24-0.37）。对 1 年死亡率结果的分析也发现了类似的结果。这些关联独立于混杂因素。最高 quartile 还与 ICU 和住院时间更短相关（均 P<0.001）。
癌症诊断时的肌酐-胱抑素 C 比值与癌症患者的生存和住院时间显著相关。
