Abstract: PO2293
Cystatin C and Creatinine as Biomarkers of Pediatric Sarcopenia
Session Information
- CKD: Drugs, Diet, and Other Determinants
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Shah, Lokesh N., Stanford University School of Medicine, Stanford, California, United States
- Long, Jin, Stanford University School of Medicine, Stanford, California, United States
- Whalen, Jessica R., Stanford University School of Medicine, Stanford, California, United States
- Grimm, Paul C., Stanford University School of Medicine, Stanford, California, United States
- Leonard, Mary B., Stanford University School of Medicine, Stanford, California, United States
Background
Pediatric sarcopenia defines a state of reduced muscle mass and strength in chronically ill children. Since Creatinine is a byproduct of all skeletal muscle cells and Cystatin C is made by all nucleated cells, we hypothesized that a relationship between the two could estimate muscle mass and muscle strength.
Methods
In 217 recruited healthy children and adolescents, data collected included anthropometric measures, whole body DXA composition, handgrip strength, leg extension and leg flexion. Stored sera were sent for Creatinine and Cystatin C measurements. We developed 4 models to estimate muscle mass and strength. Low lean mass based on an NHANES Z-score of appendicular lean mass index < -1 defined sarcopenia.
Results
Univariate analyses demonstrated the following to be associated with muscle mass and strength: age, sex, weight, height, sexual maturity, serum creatinine, differences in eGFR, and ratio of serum Cystatin C to serum Creatinine (p < 0.01). When compared against a model of only physical exam biomarkers, adding creatinine and cystatin C did not lead to clinically significant improved estimates. Using a definition of sarcopenia defined by low lean mass, there was minimal added predictive ability in identifying sarcopenia in healthy children.
Conclusion
The addition of Cystatin C and Creatinine did not meaningfully improve the estimation of muscle mass or muscle strength in healthy children. Future work remains to evaluate these models in children with chronic kidney disease.
ROC Curves of Estimating Equations for Identifying Sarcopenia (ALMI NHANES Z-score < -1).
Funding
- NIDDK Support