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The diagnostic performance of Cr/CysC for sarcopenia and its predictive value on clinical outcomes in hospitalized older patients: a prospective cohort study

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Key summary points

AbstractSection Aim

To compare the diagnostic accuracy of Cr/CysC, SARC-F, SARC-CalF, the combination of Cr/CysC and SARC-CalF, and the Ishii score for sarcopenia and investigate the predictive value of Cr/CysC concerning clinical outcomes in hospitalized older adults.

AbstractSection Findings

Cr/CysC could effectively detect sarcopenia and predict poor outcomes in hospitalized older adults. A more precise sarcopenia screening may be offered by combining Cr/CysC with SARC-CalF. In our study, the Ishii score may be the most accurate clinical method for detecting sarcopenia.

AbstractSection Message

Cr/CysC could be used to screen for sarcopenia and predict poor outcomes in clinical settings.

Abstract

Purpose

The utilization of the creatinine-to-cystatin C ratio (Cr/CysC) represents an innovative method for predicting sarcopenia. Our objectives encompassed the evaluation of sarcopenia diagnostic accuracy for Cr/CysC, SARC-F, SARC-CalF, the combination of Cr/CysC and SARC-CalF, and the Ishii score, as well as an exploration of the predictive value of Cr/CysC concerning clinical outcomes within hospitalized older individuals.

Methods

We employed receiver operating characteristic (ROC) curves and calculated areas under the curves (AUCs) to assess the diagnostic accuracy. Furthermore, we applied univariate and multivariate Cox proportional-hazard models to calculate the hazard ratio (HR) and 95% confidence interval (CI) of risk factors affecting prognosis.

Results

Our study included 312 participants, comprising 167 men and 145 women, with an average age of 71 years. Among males, the AUCs for Cr/CysC, SARC-F, SARC-CalF, the combination of Cr/CysC and SARC-CalF, and the Ishii score were 0.717 [95% CI 0.642–0.784], 0.669 (95% CI 0.592–0.739), 0.845 (95% CI 0.781–0.896), 0.882 (95% CI 0.823–0.926), and 0.938 (95% CI 0.890–0.969), respectively. In females, the AUCs for Cr/CysC, SARC-F, SARC-CalF, the combination of Cr/CysC and SARC-CalF, and the Ishii score were 0.706 (95% CI 0.625–0.779), 0.631 (95% CI 0.547–0.710), 0.763 (95% CI 0.686–0.830), 0.789 (95% CI 0.714–0.853), and 0.898 (95% CI 0.837–0.942), respectively. After adjusting for age, sex, physical exercise, smoking, drinking, hypertension, coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), and cancer, sarcopenia identified by Cr/CysC (adjusted HR = 2.176, 95% CI 1.062–4.460, P = 0.034) was independently associated with poor overall survival in hospitalized older patients.

Conclusions

Cr/CysC has satisfactory diagnostic accuracy for sarcopenia diagnosis and predictive value for poor outcomes in hospitalized older patients. The combination of Cr/CysC and SARC-CalF may provide a more accurate screening for sarcopenia and the Ishii score may be the most accurate clinical method for detecting sarcopenia.

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Data availability

The data are accessible upon reasonable request from the corresponding author.

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Funding

This study was supported by grants from Chinese National Science & Technology Pillar Program (2020YFC2009004); Sichuan Science and Technology Program (2022YFS0295, 2022YFG0205); 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZYJC21005); National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University (Z20191012); Health Research of Cadres in Sichuan province (SCR2022-101).

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Author notes

  1. Xiangping Tu, Taiping Lin and Li Huang have contributed equally to this work.

Authors and Affiliations

  1. Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu City, Sichuan Province, China

    Xiangping Tu, Taiping Lin, Li Huang, Tianjiao Tang, Dongmei Xie, Langli Gao, Tingting Jiang & Jirong Yue

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  1. Xiangping Tu
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Contributions

XT and TL contributed to conceiving this study and wrote the main manuscript text. LH contributed to the data analysis and prepared the tables and figures. TT, DX, LG, and TJ contributed to the data collection. JY assisted with the research design and reviewed the text. All authors read and approved the final manuscript.

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Correspondence to Jirong Yue.

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The authors have no conflict of interest to declare.

Ethical approval

Approval was obtained from the ethics committee of the West China Hospital of Sichuan University (2019(1041)). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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All participants provided their informed consent to participate in the study.

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Tu, X., Lin, T., Huang, L. et al. The diagnostic performance of Cr/CysC for sarcopenia and its predictive value on clinical outcomes in hospitalized older patients: a prospective cohort study. Eur Geriatr Med 15, 579–588 (2024). https://doi.org/10.1007/s41999-024-00948-5

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  • DOI: https://doi.org/10.1007/s41999-024-00948-5

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