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Comparative Study
. 2013 Sep;61(9):1530-6.
doi: 10.1111/jgs.12413. Epub 2013 Sep 3.

Cystatin C and frailty in older men

Allyson Hart  1 , Misti L Paudel, Brent C Taylor, Areef Ishani, Eric S Orwoll, Peggy M Cawthon, Kristine E Ensrud; Osteoporotic Fractures in Men Study Group
Affiliations
Comparative Study

Cystatin C and frailty in older men

Allyson Hart et al. J Am Geriatr Soc. 2013 Sep.

Abstract

Objectives: To determine whether higher cystatin C would be associated with greater frailty in men aged 65 and older.

Design: Cross-sectional cohort study.

Setting: Six U.S. sites.

Participants: A random sample of community-dwelling men aged 65 and older enrolled in the Osteoporotic Fractures in Men (MrOS) Study (mean age 73.8; 9.8% frail and 47.2% intermediate frailty; N = 1,602).

Measurements: Serum cystatin C, creatinine, and frailty were measured. Frailty was analyzed as an ordinal outcome of robust, intermediate frailty, and frail using a multinomial logistic regression model, and the base model was adjusted for age, race, and clinical site.

Results: Higher cystatin C was associated with seven times greater odds of being frail than being robust (odds ratio (OR) quartile 4 vs 1 = 7.12, 95% confidence interval (CI) = 3.76-13.46) and 2.4 times greater odds of intermediate frailty than robust (OR quartile 4 vs 1 = 2.38, 95% CI = 1.70-3.32). The association was attenuated but persisted after adjusting for multiple possible confounders. In contrast, neither higher serum creatinine (OR quartile 4 vs 1 = 1.36, 95% CI = 0.78-2.40) nor lower creatinine-based estimated glomerular filtration rate (OR quartile 4 vs 1 = 1.01, 95% CI = 0.54-1.87) was associated in a graded manner with greater odds of frailty.

Conclusion: Higher cystatin C, but not creatinine-based measures, was associated with greater odds of frailty in this cohort of older men.

Keywords: creatinine; cystatin C; elderly; frailty; kidney function.

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Conflict of interest statement

Conflict of Interest:

Drs. Orwoll and Ensrud have received grant support from the NIH (and supporting agencies) grant as listed under Funding Sources on the title page. Dr. Ensrud also serves as a consultant for Merck Sharpe & Dohme on a Data Monitoring Committee.

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