A new index based on serum creatinine and cystatin C is useful for assessing sarcopenia in patients with advanced cancer

Sarcopenia is a well-known risk factor for inferior cancer outcomes, but the identification of patients at risk remains challenging. A new sarcopenia index (SI), defined as serum creatinine (Cr) × cystatin C (CysC)-based glomerular filtration rate (eGFRCysC), has been reported to be an objective sur...

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Published in:Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2021-02, Vol.82, p.111032-111032, Article 111032
Main Authors: Fu, Xiaofen, Tian, Zhen, Wen, Su, Sun, Huihui, Thapa, Sudip, Xiong, Huihua, Liu, Huiquan, Li, Lu, Yu, Shiying
Format: Article
Language:English
Subjects:
Body mass index
Cancer
Clinical medicine
Computed tomography
Confidence intervals
Creatinine
Cystatin C
Fatigue
Glomerular filtration rate
Inflammation
Kidney diseases
Medical records
Muscle strength
Musculoskeletal system
Risk analysis
Risk factors
Sarcopenia
Skeletal muscle
Skeletal muscle mass
Spine
Spine (lumbar)
Statistical analysis
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container_title Nutrition (Burbank, Los Angeles County, Calif.)
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description Sarcopenia is a well-known risk factor for inferior cancer outcomes, but the identification of patients at risk remains challenging. A new sarcopenia index (SI), defined as serum creatinine (Cr) × cystatin C (CysC)-based glomerular filtration rate (eGFRCysC), has been reported to be an objective surrogate marker for sarcopenia. The aim of this study was to assess whether the SI is associated with sarcopenia and cancer-related fatigue (CRF) in patients with advanced cancer. This cross-sectional study included 182 patients with different types of cancer (cancer stages III/IV; mean age 55.1 ± 11.1 y). Sarcopenia was defined as the presence of both low muscle mass and low muscle strength. The cross-sectional area of skeletal muscle mass (SMA) at the third lumbar spine was estimated by computed tomography (CT). Low muscle mass was defined as a skeletal muscle index (SMA/height2)
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A new sarcopenia index (SI), defined as serum creatinine (Cr) × cystatin C (CysC)-based glomerular filtration rate (eGFRCysC), has been reported to be an objective surrogate marker for sarcopenia. The aim of this study was to assess whether the SI is associated with sarcopenia and cancer-related fatigue (CRF) in patients with advanced cancer. This cross-sectional study included 182 patients with different types of cancer (cancer stages III/IV; mean age 55.1 ± 11.1 y). Sarcopenia was defined as the presence of both low muscle mass and low muscle strength. The cross-sectional area of skeletal muscle mass (SMA) at the third lumbar spine was estimated by computed tomography (CT). Low muscle mass was defined as a skeletal muscle index (SMA/height2) <34.9 cm2/m2 for women and 40.8 cm2/m2 for men. Low muscle strength was determined by handgrip strength (HGS) according to the cutoffs of the Asian Working Group for Sarcopenia (<18 kg for women and <26 kg for men). CRF was measured by the Brief Fatigue Inventory (BFI). The associations between SI with both sarcopenia and CRF were investigated. The prevalence of sarcopenia was 27.5%. The SI was significantly lower in both the sarcopenia and severe fatigue groups. The associations between SI and SMA (r = 0.365; P < 0.001), skeletal muscle index (SMI) (r = 0.340; P < 0.001), and HGS (r = 0.414; P <0 .001) were stronger than the associations between the serum creatinine/cystatin C (Cr/CysC) ratio and SMA (r = 0.299; P < 0.001), SMI (r = 0.269; P <0 .001), and HGS (r = 0.364; P <0 .001). Additionally, a decrease in the SI was associated with a higher likelihood of sarcopenia (odds ratio per 10-unit, 1.09; 95% confidence interval, 1.02–1.16) after adjusting for potential confounding factors. However, there was only a weak correlation between the SI and BFI score (r = –0.161, P = 0.045). The SI might be a useful objective tool for assessing sarcopenia in patients with advanced cancer. Further studies are warranted to extend the present findings.]]></description><identifier>ISSN: 0899-9007</identifier><identifier>EISSN: 1873-1244</identifier><identifier>DOI: 10.1016/j.nut.2020.111032</identifier><identifier>PMID: 33172686</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Body mass index ; Cancer ; Clinical medicine ; Computed tomography ; Confidence intervals ; Creatinine ; Cystatin C ; Fatigue ; Glomerular filtration rate ; Inflammation ; Kidney diseases ; Medical records ; Muscle strength ; Musculoskeletal system ; Risk analysis ; Risk factors ; Sarcopenia ; Skeletal muscle ; Skeletal muscle mass ; Spine ; Spine (lumbar) ; Statistical analysis</subject><ispartof>Nutrition (Burbank, Los Angeles County, Calif.), 2021-02, Vol.82, p.111032-111032, Article 111032</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><rights>2020. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c381t-bd61d8a7033230ccf9b72edc498d09a1e8d2100104b1de8a6ca6ba55d12ffbc13</citedby><cites>FETCH-LOGICAL-c381t-bd61d8a7033230ccf9b72edc498d09a1e8d2100104b1de8a6ca6ba55d12ffbc13</cites><orcidid>0000-0003-3507-3464</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33172686$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fu, Xiaofen</creatorcontrib><creatorcontrib>Tian, Zhen</creatorcontrib><creatorcontrib>Wen, Su</creatorcontrib><creatorcontrib>Sun, Huihui</creatorcontrib><creatorcontrib>Thapa, Sudip</creatorcontrib><creatorcontrib>Xiong, Huihua</creatorcontrib><creatorcontrib>Liu, Huiquan</creatorcontrib><creatorcontrib>Li, Lu</creatorcontrib><creatorcontrib>Yu, Shiying</creatorcontrib><title>A new index based on serum creatinine and cystatin C is useful for assessing sarcopenia in patients with advanced cancer</title><title>Nutrition (Burbank, Los Angeles County, Calif.)</title><addtitle>Nutrition</addtitle><description><![CDATA[Sarcopenia is a well-known risk factor for inferior cancer outcomes, but the identification of patients at risk remains challenging. A new sarcopenia index (SI), defined as serum creatinine (Cr) × cystatin C (CysC)-based glomerular filtration rate (eGFRCysC), has been reported to be an objective surrogate marker for sarcopenia. The aim of this study was to assess whether the SI is associated with sarcopenia and cancer-related fatigue (CRF) in patients with advanced cancer. This cross-sectional study included 182 patients with different types of cancer (cancer stages III/IV; mean age 55.1 ± 11.1 y). Sarcopenia was defined as the presence of both low muscle mass and low muscle strength. The cross-sectional area of skeletal muscle mass (SMA) at the third lumbar spine was estimated by computed tomography (CT). Low muscle mass was defined as a skeletal muscle index (SMA/height2) <34.9 cm2/m2 for women and 40.8 cm2/m2 for men. Low muscle strength was determined by handgrip strength (HGS) according to the cutoffs of the Asian Working Group for Sarcopenia (<18 kg for women and <26 kg for men). CRF was measured by the Brief Fatigue Inventory (BFI). The associations between SI with both sarcopenia and CRF were investigated. The prevalence of sarcopenia was 27.5%. The SI was significantly lower in both the sarcopenia and severe fatigue groups. The associations between SI and SMA (r = 0.365; P < 0.001), skeletal muscle index (SMI) (r = 0.340; P < 0.001), and HGS (r = 0.414; P <0 .001) were stronger than the associations between the serum creatinine/cystatin C (Cr/CysC) ratio and SMA (r = 0.299; P < 0.001), SMI (r = 0.269; P <0 .001), and HGS (r = 0.364; P <0 .001). Additionally, a decrease in the SI was associated with a higher likelihood of sarcopenia (odds ratio per 10-unit, 1.09; 95% confidence interval, 1.02–1.16) after adjusting for potential confounding factors. However, there was only a weak correlation between the SI and BFI score (r = –0.161, P = 0.045). The SI might be a useful objective tool for assessing sarcopenia in patients with advanced cancer. Further studies are warranted to extend the present findings.]]></description><subject>Body mass index</subject><subject>Cancer</subject><subject>Clinical medicine</subject><subject>Computed tomography</subject><subject>Confidence intervals</subject><subject>Creatinine</subject><subject>Cystatin C</subject><subject>Fatigue</subject><subject>Glomerular filtration rate</subject><subject>Inflammation</subject><subject>Kidney diseases</subject><subject>Medical records</subject><subject>Muscle strength</subject><subject>Musculoskeletal system</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Sarcopenia</subject><subject>Skeletal muscle</subject><subject>Skeletal muscle mass</subject><subject>Spine</subject><subject>Spine (lumbar)</subject><subject>Statistical analysis</subject><issn>0899-9007</issn><issn>1873-1244</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kU2LFDEQhoMo7rj6A7xIgRcvPaaSnu4ET8uwfsCCFz2HdFKtGWbSY6p7P_69GWb14MFTUfDUQ_K-QrxGuUaJ3fvdOi_zWklVd0Sp1ROxQtPrBlXbPhUraaxtrJT9hXjBvJNSou3sc3GhNfaqM91K3F9BpjtIOdI9DJ4pwpSBqSwHCIX8nHLKBD5HCA88n3bYQmJYmMZlD-NUwDMTc8o_gH0J05Fy8tUIx0pTnhnu0vwTfLz1OVR_OI3yUjwb_Z7p1eO8FN8_Xn_bfm5uvn76sr26aYI2ODdD7DAa30utlZYhjHboFcXQWhOl9UgmKqz_ku2AkYzvgu8Gv9lEVOM4BNSX4t3ZeyzTr4V4dofEgfZ7n2la2Kl2YzvVa9tX9O0_6G5aSq6vq1Rv27Y1ylQKz1QoE3Oh0R1LOvjy4FC6Uy1u52ot7lSLO9dSb948mpfhQPHvxZ8eKvDhDFCN4jZRcRxqdjWuVCjMLk7pP_rfpmeePQ</recordid><startdate>202102</startdate><enddate>202102</enddate><creator>Fu, Xiaofen</creator><creator>Tian, Zhen</creator><creator>Wen, Su</creator><creator>Sun, Huihui</creator><creator>Thapa, Sudip</creator><creator>Xiong, Huihua</creator><creator>Liu, Huiquan</creator><creator>Li, Lu</creator><creator>Yu, Shiying</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RQ</scope><scope>7RV</scope><scope>7TS</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3507-3464</orcidid></search><sort><creationdate>202102</creationdate><title>A new index based on serum creatinine and cystatin C is useful for assessing sarcopenia in patients with advanced cancer</title><author>Fu, Xiaofen ; 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A new sarcopenia index (SI), defined as serum creatinine (Cr) × cystatin C (CysC)-based glomerular filtration rate (eGFRCysC), has been reported to be an objective surrogate marker for sarcopenia. The aim of this study was to assess whether the SI is associated with sarcopenia and cancer-related fatigue (CRF) in patients with advanced cancer. This cross-sectional study included 182 patients with different types of cancer (cancer stages III/IV; mean age 55.1 ± 11.1 y). Sarcopenia was defined as the presence of both low muscle mass and low muscle strength. The cross-sectional area of skeletal muscle mass (SMA) at the third lumbar spine was estimated by computed tomography (CT). Low muscle mass was defined as a skeletal muscle index (SMA/height2) <34.9 cm2/m2 for women and 40.8 cm2/m2 for men. Low muscle strength was determined by handgrip strength (HGS) according to the cutoffs of the Asian Working Group for Sarcopenia (<18 kg for women and <26 kg for men). CRF was measured by the Brief Fatigue Inventory (BFI). The associations between SI with both sarcopenia and CRF were investigated. The prevalence of sarcopenia was 27.5%. The SI was significantly lower in both the sarcopenia and severe fatigue groups. The associations between SI and SMA (r = 0.365; P < 0.001), skeletal muscle index (SMI) (r = 0.340; P < 0.001), and HGS (r = 0.414; P <0 .001) were stronger than the associations between the serum creatinine/cystatin C (Cr/CysC) ratio and SMA (r = 0.299; P < 0.001), SMI (r = 0.269; P <0 .001), and HGS (r = 0.364; P <0 .001). Additionally, a decrease in the SI was associated with a higher likelihood of sarcopenia (odds ratio per 10-unit, 1.09; 95% confidence interval, 1.02–1.16) after adjusting for potential confounding factors. However, there was only a weak correlation between the SI and BFI score (r = –0.161, P = 0.045). The SI might be a useful objective tool for assessing sarcopenia in patients with advanced cancer. Further studies are warranted to extend the present findings.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33172686</pmid><doi>10.1016/j.nut.2020.111032</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-3507-3464</orcidid></addata></record>
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identifier ISSN: 0899-9007
ispartof Nutrition (Burbank, Los Angeles County, Calif.), 2021-02, Vol.82, p.111032-111032, Article 111032
issn 0899-9007
1873-1244
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source ScienceDirect Journals
subjects Body mass index
Cancer
Clinical medicine
Computed tomography
Confidence intervals
Creatinine
Cystatin C
Fatigue
Glomerular filtration rate
Inflammation
Kidney diseases
Medical records
Muscle strength
Musculoskeletal system
Risk analysis
Risk factors
Sarcopenia
Skeletal muscle
Skeletal muscle mass
Spine
Spine (lumbar)
Statistical analysis
title A new index based on serum creatinine and cystatin C is useful for assessing sarcopenia in patients with advanced cancer
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