Matsuzawa R, Nagai K, Takahashi K, Mori T, Onishi M, Tsuji S, Hashimoto K, Tamaki K, Wada Y, Kusunoki H, Nagasawa Y, Shinmura K
Ryota Matsuzawa, PT, PhD., Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo 650-8530, Japan. Tel: +81-78-304-3181; Fax: +81-78-304-2811; E-mail:
J Frailty Aging. 2024;13(2):116-124. doi: 10.14283/jfa.2024.13.
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.
Cross-sectional study.
Primary Care and Community.
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).
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.
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.
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.
比较社区居住老年人中基于血清肌酐和胱抑素C的指标在肌肉减少症或身体虚弱表现方面的鉴别能力。
横断面研究。
初级保健和社区。
我们使用了来自笹山-丹波地区虚弱老年人（FESTA）研究的一部分数据，该研究于2015年启动，旨在收集社区居住老年人（年龄≥65岁）各种健康相关参数的综合信息。
采用了五个基于血清肌酐-胱抑素C的指标，包括肌肉减少症指数、血清肌酐/胱抑素C比值、基于血清胱抑素C和肌酐的估计肾小球滤过率之间的差异、全身肌肉质量指数（TBMM）以及骨骼肌质量指数预测方程（pSMI）。分别根据亚洲肌肉减少症工作组标准和修订后的日本版心血管健康研究标准确定肌肉减少症和身体虚弱。进行了受试者工作特征（ROC）和逻辑回归分析，以评估这些工具的鉴别能力。
在对954名参与者的分析中，52人（5.5%）被确定为患有肌肉减少症，35人（3.7%）患有身体虚弱。关于肌肉减少症的鉴别，男性和女性的TBMM和pSMI的曲线下面积（AUC）值均超过0.8。关于身体虚弱的识别，男性的AUC值范围为0.61至0.77，女性为0.50至0.69。在多变量逻辑回归分析中，无论性别如何，只有TBMM和pSMI始终显示与肌肉减少症相关（P均<0.001）。另一方面，未观察到这些指标与身体虚弱之间存在一致的关联。
本研究提供了基于血清肌酐和胱抑素C的指标，尤其是TBMM和pSMI，与社区居住老年人肌肉减少症之间的有力关联。相反，将这些指标应用于身体虚弱的筛查存在局限性，需要进一步研究。
