The sarcopenia index: A novel measure of muscle mass in lung transplant candidates

Clin Transplant. 2018 Mar;32(3):e13182. doi: 10.1111/ctr.13182. Epub 2018 Jan 17.

Abstract

Background: Frailty, including low muscle mass, is an emerging risk factor for poor outcomes after lung transplant. The sarcopenia index (SI)-(serum creatinine value/cystatin C value) × 100-is a novel blood test to approximate muscle mass. We sought to validate SI among lung transplant patients.

Methods: We retrospectively identified adult lung transplant recipients from 2000 through 2012 at our institution who underwent computed tomography within 1 year before transplant and had preserved blood samples. Creatinine and cystatin C values were measured using the samples and used to calculate SI. Muscle mass was estimated by computed tomographic measurement of skeletal muscle cross-sectional surface area (SA) at the L1 to L3 vertebral levels. Correlation between SI and SA was evaluated.

Results: Of 28 patients meeting eligibility criteria, most were white (96%) and men (54%). Median (interquartile range) body mass index, SI, and SA were 25.9 (22-30) kg/m2 , 106 (91-119), and 157 (113-195) cm2, respectively. The Pearson correlation coefficient between SI and SA was significant at L2 (0.43; P = .02) and L3 (0.41; P = .03).

Conclusion: Sarcopenia index is a potentially objective measure for estimating muscle mass that is noninvasive and less expensive. Sarcopenia index could be considered in lung transplant candidate selection following prospective validation in larger cohorts.

Keywords: creatinine; cystatin C; lung transplant; muscle mass; nutrition; sarcopenia index.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Creatinine / blood*
  • Cross-Sectional Studies
  • Cystatin C / blood*
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Muscle, Skeletal / diagnostic imaging
  • Muscle, Skeletal / physiopathology*
  • Prognosis
  • Retrospective Studies
  • Sarcopenia / blood
  • Sarcopenia / diagnosis*
  • Sarcopenia / diagnostic imaging
  • Sarcopenia / etiology
  • Tomography, X-Ray Computed / methods

Substances

  • Cystatin C
  • Creatinine