Zhang Li, Jin Jun, Tu You-Yi, Zhao Zhe, Tao Jun, Zhang Xiao-Yan
Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yi Shan Road, Shanghai, 200233, China.
Heliyon. 2023 Mar 8;9(3):e14214. doi: 10.1016/j.heliyon.2023.e14214. eCollection 2023 Mar.
Sarcopenia is a prevalent condition in the senior population and has been related to adverse outcomes. This study aimed to investigate the performance of the serum creatinine/cystatin C ratio (Cr/CysC) in predicting all-cause mortality in elders over 80 years.
A total of 486 older patients over 80 were enrolled in this study. Calf circumference (CC) and handgrip strength (HGS) were carried out for each patient. All the participants accepted serum creatinine and cystatin C test. The primary clinical outcome was all-cause mortality during an over-4-year follow-up.
During an over 4-year follow-up, 200 participants died. The non-survivors had a significantly lower baseline Cr/CysC level than the survivors (62.6 ± 13.1 vs. 71.4 ± 14.5 < 0.001). The lowest Cr/CysC quartile group (Q1) had a significantly higher mortality rate than their counterparts (Q1 vs. Q2-4, 62.8% vs. 33.2%, < 0.001). The Cr/CysC level was positively correlated with CC (R = 0.17, < 0.001) and HGS (R = 0.19, < 0.001). Moreover, survival curve was significantly worse in the lowest Cr/CysC quartile (Log-rank test χ = 21.09, < 0.001). After adjustment for potential confounders, age (HR, 1.10; 95% CI, 1.06-1.14, < 0.001), coronary heart disease (HR, 1.49; 95% CI, 1.01-2.21, = 0.045), and lowest Cr/CysC (HR, 1.59; 95% CI, 1.12-2.24, = 0.009) were independent factors of all-cause mortality during the over-4-year follow-up.
Cr/CysC, also known as Sarcopenia Index, could be used as a predictor of all-cause mortality in older adults over 80 years.
肌肉减少症在老年人群中普遍存在，且与不良后果相关。本研究旨在调查血清肌酐/胱抑素C比值（Cr/CysC）在预测80岁以上老年人全因死亡率方面的表现。
本研究共纳入486名80岁以上的老年患者。对每位患者进行小腿围（CC）和握力（HGS）测量。所有参与者均接受血清肌酐和胱抑素C检测。主要临床结局为4年以上随访期间的全因死亡率。
在4年以上的随访期间，200名参与者死亡。非幸存者的基线Cr/CysC水平显著低于幸存者（62.6±13.1 vs. 71.4±14.5，<0.001）。最低Cr/CysC四分位数组（Q1）的死亡率显著高于其他组（Q1 vs. Q2 - 4，62.8% vs. 33.2%，<0.001）。Cr/CysC水平与CC呈正相关（R = 0.17，<0.001），与HGS呈正相关（R = 0.19，<0.001）。此外，最低Cr/CysC四分位数组的生存曲线明显更差（对数秩检验χ = 21.09，<0.001）。在对潜在混杂因素进行调整后，年龄（HR，1.10；95%CI，1.06 - 1.14，<0.001）、冠心病（HR，1.49；95%CI，1.01 - 2.21，= 0.045）和最低Cr/CysC（HR，1.59；95%CI，1.12 - 2.24，= 0.009）是4年以上随访期间全因死亡率的独立因素。
Cr/CysC，也称为肌肉减少症指数，可作为80岁以上老年人全因死亡率的预测指标。
