Title | Urine creatinine concentration and clinical outcomes in older adults: The Cardiovascular Health Study. |
Publication Type | Journal Article |
Year of Publication | 2021 |
Authors | Barzilay, JI, Bůzková, P, Shlipak, MG, Lyles, MF, Bansal, N, Garimella, PS, Ix, JH, Kizer, JR, Strotmeyer, ES, Djoussé, L, Biggs, ML, Siscovick, D, Mukamal, KJ |
Journal | J Am Geriatr Soc |
Date Published | 2021 Aug 07 |
ISSN | 1532-5415 |
Abstract | <p><b>PURPOSE: </b>Loss of muscle mass and strength are associated with long-term adverse health outcomes in older adults. Urine creatinine concentrations (Ucr; mg/dl) are a measure of muscle tissue mass and turnover. This study assessed the associations of a spot Ucr level with muscle mass and with risk of hospitalization, mortality, and diabetes mellitus in older adults.</p><p><b>METHODS: </b>We examined 3424 participants from the Cardiovascular Health Study who provided spot urine samples in 1996-1997 and who were followed through June 2015. All participants underwent baseline measurement of grip strength. In a sub-cohort, 1331 participants underwent dual energy X-ray absorptiometry (DEXA) scans, from which lean muscle mass was derived. Participants were followed for a median of 10 years for hospitalizations and mortality, and 9 years for diabetes mellitus.</p><p><b>RESULTS: </b>In linear regression analysis, a one standard deviation higher Ucr concentration (64.6 mg/dl) was associated with greater grip strength (kg force) β = 0.44 [0.16, 0.72]; p = 0.002) and higher lean muscle mass (kg) (β = 0.43 [0.08, 0.78]; p = 0.02). In Cox regression analyses, each standard deviation greater Ucr concentration was associated with lower rates of hospitalizations (0.94 [95% confidence interval, 0.90, 0.98]; p < 0.001) and lower mortality risk (0.92 [0.88, 0.97]; p < 0.001), while a one standard deviation increase in muscle mass derived from DEXA had no such significant association. Ucr levels were not associated with incident diabetes mellitus risk (0.97 [0.85, 1.11]; p = 0.65).</p><p><b>CONCLUSION: </b>A higher spot Ucr concentration was favorably associated with muscle mass and strength and with health outcomes in older community-living adults. The ease of obtaining a spot Ucr makes it an attractive analyte to use for gauging the health of older adults.</p> |
DOI | 10.1111/jgs.17388 |
Alternate Journal | J Am Geriatr Soc |
PubMed ID | 34363689 |
Grant List | U01HL080295 / HL / NHLBI NIH HHS / United States This research was supported by contracts HHSN26820 / / National Institues of Health / U01 HL130114 / HL / NHLBI NIH HHS / United States / NS / NINDS NIH HHS / United States R01AG023629 / AG / NIA NIH HHS / United States U01HL130114 / HL / NHLBI NIH HHS / United States |