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Serum creatinine: a surrogate measurement of lean body mass in children with acute lymphoblastic leukemia
Alessandra Sala1, Mark Tarnopolsky, Colin Webber
1McMaster University, Hamilton, Ontario L8S 4J9, Canada.
Insights
Serum creatinine (SC) strongly correlates with lean body mass (LBM) in children, suggesting SC can indicate LBM and nutritional status. This relationship was observed in patients with acute lymphoblastic leukemia and primary muscular disorders.
Area of Science:
- Biochemistry
- Pediatrics
- Clinical Nutrition
Background:
- Serum creatinine (SC) is primarily produced in skeletal muscle.
- Lean body mass (LBM) is a key indicator of nutritional status.
- Dual-energy X-ray absorptiometry (DXA) is a standard method for LBM assessment.
Purpose of the Study:
- To investigate the relationship between serum creatinine (SC) and lean body mass (LBM).
- To determine if SC can serve as a surrogate marker for LBM.
Main Methods:
- Analysis of two patient cohorts: 37 children with acute lymphoblastic leukemia (ALL) and 20 children with primary muscular disorders (PMD).
- Utilized linear regression statistical analyses.
- LBM was determined using dual-energy X-ray absorptiometry (DXA).
Main Results:
- A strong positive correlation was found between SC and LBM in both PMD (r = 0.77) and ALL cohorts (r = 0.83 at diagnosis, r = 0.77 on therapy, r = 0.56 off therapy).
- Correlations between SC and body mass index (a measure of body size) were significantly weaker across all observations.
- Results support the hypothesis that SC is related to LBM.
Conclusions:
- Serum creatinine demonstrates a strong association with lean body mass in pediatric patients.
- SC shows potential as a non-invasive surrogate marker for LBM and nutritional status.
- Further research across diverse disease populations is recommended to validate SC as a general indicator of LBM.
Background:
Since creatinine is formed almost exclusively in skeletal muscle, the hypothesis of a relationship between serum creatinine (SC) and lean body mass (LBM), determined by dual-energy X-ray absorptiometry (DXA), was tested.
Methods:
Two cohorts of patients were analyzed: 37 children with acute lymphoblastic leukemia (ALL) and 20 children with primary muscular disorders (PMD). The latter cohort was used as a comparative group. Statistical analyses were performed using linear regressions.
Results:
A strong correlation was demonstrated between SC and LBM in the patients with PMD (r = 0.77) and in patients with ALL (r = 0.83 at diagnosis; r = 0.77 on therapy; and r = 0.56 off therapy). The correlation between SC and body size (body mass index) was much weaker (r = 0.38; r = -0.09; r = 0.29 at the successive observations in the ALL cohort and r = 0.05 in the PMD cohort). These data provide support for the initial hypothesis.
Conclusions:
Further investigations with a wider variety of diseases are needed for this will allow the consideration of SC as a general surrogate measure of LBM and consequently of nutritional status.
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