Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
BMC Geriatr. 2024 Sep 11;24(1):753. doi: 10.1186/s12877-024-05326-1.
Creatinine-to-cystatin C ratio (CCR) has been associated with multiple adverse outcomes. However, little is known about its relationship with frailty. We aimed to explore the association between CCR and frailty among older adults.
A total of 2599 participants aged ≥ 60 years (mean age 67.9 ± 6.0 years, 50.4% males) were included from the China Health and Retirement Longitudinal Study (2011-2015). Baseline CCR was calculated as plasma creatinine (mg/dL) / cystatin C (mg/L) × 10 and was grouped by quartiles. Frailty was evaluated by the validated physical frailty phenotype (PFP) scale and was defined as PFP score ≥ 3. The generalized estimating equations model was used to explore the relationship between CCR and frailty.
The frailty risk decreased gradually with increasing CCR in the quartiles (P for trend = 0.002), and the fourth CCR quartile was associated with a significantly lower risk of frailty compared with the lowest quartile (odds ratio [OR] 0.37, 95% confidence interval [CI] 0.19-0.70). When modeling as a continuous variable, per 1-unit increase in CCR was related to 17% decreased odds of frailty (OR 0.83, 95% CI 0.74-0.93). The association was consistent in male and female participants (P for interaction = 0.41). Poisson models revealed that frailty score was negatively associated with CCR (β= -0.11, 95% CI= -0.19 to -0.04), and sex did not significantly moderate the associations (P for interaction = 0.22). The results were not affected by further adjusting for high-sensitivity C-reactive protein. Similar results were observed by analyses with multiple imputation technique and analyses excluding participants with baseline frailty.
Higher CCR was associated with a lower frailty risk. CCR may be a simple marker for predicting frailty in older adults.
肌酸酐-胱抑素 C 比值（CCR）与多种不良结局相关。然而，关于其与虚弱的关系知之甚少。我们旨在探讨老年人中 CCR 与虚弱的关系。
共纳入来自中国健康与退休纵向研究（2011-2015 年）的 2599 名年龄≥60 岁的参与者（平均年龄 67.9±6.0 岁，50.4%为男性）。根据四分位数计算基线 CCR，即血浆肌酸酐（mg/dL）/胱抑素 C（mg/L）×10。采用经过验证的身体虚弱表型（PFP）量表评估虚弱，定义为 PFP 评分≥3。采用广义估计方程模型探讨 CCR 与虚弱的关系。
随着四分位组 CCR 的升高，虚弱风险逐渐降低（趋势 P=0.002），第四分位 CCR 与最低分位相比，虚弱风险显著降低（比值比[OR]0.37，95%置信区间[CI]0.19-0.70）。当作为连续变量建模时，CCR 每增加 1 单位，虚弱的可能性降低 17%（OR 0.83，95%CI0.74-0.93）。该关联在男性和女性参与者中一致（交互作用 P=0.41）。泊松模型显示，虚弱评分与 CCR 呈负相关（β=-0.11，95%CI=-0.19 至-0.04），性别并未显著调节这些关联（交互作用 P=0.22）。进一步调整高敏 C 反应蛋白后，结果仍无变化。采用多重插补技术和排除基线虚弱参与者的分析，也得到了类似的结果。
较高的 CCR 与较低的虚弱风险相关。CCR 可能是预测老年人虚弱的简单标志物。
