| Title: | Creatinine muscle index in UK Biobank: comparison with MRI and associations with frailty and mortality |
| Journal: | Clinical Kidney Journal |
| Published: | 1 May 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42164350/ |
| DOI: | https://doi.org/10.1093/ckj/sfag139 |
Publication 20201
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
Background: Skeletal muscle wasting due to aging, acute illness, and chronic disease is associated with adverse outcomes including mortality, frailty, and multi-morbidity. We investigated the relationship of creatinine muscle index (CMI), a serum biological signature of muscle mass, in UK Biobank participants with gold standard muscle measurement and adverse outcomes.</p>
Method: We compared CMI with Magnetic Resonance Imaging (MRI) measured muscle mass in 33 799 participants using linear regression. We then assessed CMI's ability to discriminate low muscle mass (≤2.5 SD below the mean). In the full UK Biobank cohort (n = 450 812), we utilized Cox-proportional hazards models to investigate associations between CMI with mortality, frailty and comorbidity.</p>
Results: CMI demonstrated moderate to good linear correlation with gold-standard MRI muscle mass measurements [R males: 0.68 (0.60-0.76); females: 0.65 (0.56-0.73)], after accounting for data imbalance. CMI discriminated muscle mass ≤2.5 standard deviations from the mean, with an area under the curve of 0.80 (95% CI:0.75-0.86) in males and 0.84 (95% CI:0.78-0.89) in females. CMI consistently decreased with increasing age, frailty and comorbidity. Over an 8-year follow-up, lower CMI was associated with higher morality: adjusted hazard ratio for the 25th vs 75th CMI centiles were 0.61 (95% CI: 0.58-0.66) in males and 0.72 (95% CI: 0.66-0.78) in females.</p>
Conclusions: In over 450 000 UK Biobank participants, low CMI was significantly associated with baseline comorbidity, frailty and survival on follow-up (independent of age, sex, and comorbidity). This study supports CMI as a potential biological signature for skeletal muscle wasting in clinical and research settings.</p>
5 Authors
- Giada Azzopardi
- Thomas Davies
- Myles J Lewis
- Zudin Puthucheary
- John R Prowle
1 Application
| Application ID | Title |
|---|---|
| 102574 | Biochemical estimation of muscle mass and unbiased assessment of kidney function using serum creatinine and cystatin-C. A prognostic validation study within UK Biobank. |
Enabling scientific discoveries that improve human health