Akihiko Shibamoto, Tadashi Namisaki, Masayoshi Takami, Hiroyuki Masuda, Takashi Inoue, Satoshi Iwai, Shohei Asada, Yuki Tsuji, Yukihisa Fujinaga, Shinya Sato, Norihisa Nishimura, Koh Kitagawa, Hiroaki Takaya, Kosuke Kaji, Akira Mitoro, Kiyoshi Asada, Hitoshi Yoshiji
AIM: The creatinine-to-cystatin C ratio (CCR) is considered a convenient surrogate marker for muscle mass, although its evidence in cirrhotic populations is limited. This study investigated the significance of CCR as a marker of sarcopenia in patients with cirrhosis. METHODS: Handgrip strength (HGS) and skeletal muscle mass index (SMI) were assessed in 195 patients with cirrhosis, divided into the sarcopenia (n = 70) and nonsarcopenia (n = 125) groups. Risk factors associated with sarcopenia were identified through multivariable logistic regression analyses. RESULTS: Sarcopenia was diagnosed in 70 out of 195 patients (35.9%). Patients with sarcopenia were significantly older, with lower body mass index (BMI), serum creatinine, and CCR, as well as higher albumin-bilirubin scores. Age ≥ 65 years, BMI < 25, and low CCR (< 0.63 in women, < 0.68 in men) were independently associated with sarcopenia on both univariable and multivariable analyses. The predictive accuracy of CCR for sarcopenia was comparable to that of a multivariable model combining age and BMI. On Kaplan-Meier analysis, overall survival was significantly lower in patients with low CCR (< 0.66) versus those with high CCR (≥ 0.66). Furthermore, HGS, SMI, and sarcopenia had comparable diagnostic value. CONCLUSIONS: CCR is a simple, noninvasive biomarker for the diagnosis and prognosis of sarcopenia in patients with LC.