Prediction of sarcopenia using a battery of circulating biomarkers

Rizwan Qaisar,Tahir Muhammad,Javaidullah Khan,Asima Karim,Islam Shah

doi:10.1038/s41598-021-87974-6

Abstract

Loss of muscle mass and strength with aging, termed sarcopenia is accelerated in several comorbidities including chronic heart failure (CHF) and chronic obstructive pulmonary diseases (COPD). However, the effective circulating biomarkers to accurately diagnose and assess sarcopenia are not known. We recruited male healthy controls and patients with CHF and COPD (n = 81–87/group), aged 55–74 years. Sarcopenia was clinically identified based on hand-grip strength, appendicular skeletal muscle index and physical capacity as recommended by the European working group for sarcopenia. The serum levels of amino-terminal pro-peptide of type-III procollagen, c-terminal agrin fragment-22, osteonectin, irisin, fatty acid-binding protein-3 and macrophage migration inhibitory factor were significantly different between healthy controls and patients with CHF and COPD. Risk scores for individual biomarkers were calculated by logistic regressions and combined into a cumulative risk score. The median cutoff value of 3.86 was used to divide subjects into high- and low-risk groups for sarcopenia with the area under the curve of 0.793 (95% CI = 0.738–0.845, p < 0.001). A significantly higher incidence of clinical sarcopenia was found in high-risk group. Taken together, the battery of biomarkers can be an effective tool in the early diagnosis and assessment of sarcopenia.

Highlights

Loss of muscle mass and strength with aging, termed sarcopenia is accelerated in several comorbidities including chronic heart failure (CHF) and chronic obstructive pulmonary diseases (COPD)
The COPD and CHF patients had lower appendicular skeletal muscle mass index (ASMI), hand-grip strength (HGS), gait speed and steps count than healthy controls
The circulating levels of 8-isoprostanes, CRP and CK were higher in the patients with COPD and CHF than healthy controls

Summary

Introduction

Loss of muscle mass and strength with aging, termed sarcopenia is accelerated in several comorbidities including chronic heart failure (CHF) and chronic obstructive pulmonary diseases (COPD). The European Working Group for Sarcopenia (EWGSOP) defines sarcopenia as muscle atrophy (normalized for height) combined with muscle weakness (measured in hand-grip muscles) and/or reduced physical capacity (measured via gait speed)[3]. Among these parameters, muscle weakness has emerged as the primary determinant of sarcopenia and functional dependency in a ging[2]. With low muscle mass (normalized for height) in the absence of muscle weakness and functional compromise are categorized in “pre-sarcopenia” phase, while “probable sarcopenia” is defined as reduced hand-grip strength (HGS) and/or compromised physical capacity (low chair stand test ability)[2], which warrants further assessments. Sarcopenia is frequently underdiagnosed in clinical practice despite the considerable overlap in the severities of sarcopenia phenotype and Cardiology, Post Graduate Medical Institute, Hayatabad Medical Complex, Peshawar, Pakistan. *email: rqaisar@

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