02736nas a2200265 4500008004100000022001400041245010700055210006900162260001600231520191100247100002402158700002102182700002402203700001902227700001802246700002502264700001902289700002002308700002402328700001802352700001902370700002102389700002402410856003602434 2021 eng d a1532-541500aUrine creatinine concentration and clinical outcomes in older adults: The Cardiovascular Health Study.0 aUrine creatinine concentration and clinical outcomes in older ad c2021 Aug 073 a

PURPOSE: 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.

METHODS: 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.

RESULTS: 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).

CONCLUSION: 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.

1 aBarzilay, Joshua, I1 aBůzková, Petra1 aShlipak, Michael, G1 aLyles, Mary, F1 aBansal, Nisha1 aGarimella, Pranav, S1 aIx, Joachim, H1 aKizer, Jorge, R1 aStrotmeyer, Elsa, S1 aDjoussé, Luc1 aBiggs, Mary, L1 aSiscovick, David1 aMukamal, Kenneth, J uhttps://chs-nhlbi.org/node/8825