{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:41:28Z","timestamp":1787172088935,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,6,20]],"date-time":"2021-06-20T00:00:00Z","timestamp":1624147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The coexistence of low muscle mass and high fat mass, two interrelated conditions strongly associated with declining health status, has been characterized by only a few protein biomarkers. High\u2010throughput proteomics enable concurrent measurement of numerous proteins, facilitating the discovery of potentially new biomarkers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data derived from the prospective population\u2010based Cooperative Health Research in the Region of Augsburg S4\/FF4 cohort study (median follow\u2010up time: 13.5\u00a0years) included 1478 participants (756 men and 722 women) aged 55\u201374\u00a0years in the cross\u2010sectional and 608 participants (315 men and 293 women) in the longitudinal analysis. Appendicular skeletal muscle mass (ASMM) and body fat mass index (BFMI) were determined through bioelectrical impedance analysis at baseline and follow\u2010up. At baseline, 233 plasma proteins were measured using proximity extension assay. We implemented boosting with stability selection to enable false positives\u2010controlled variable selection to identify new protein biomarkers of low muscle mass, high fat mass, and their combination. We evaluated prediction models developed based on group least absolute shrinkage and selection operator (lasso) with 100\u00d7 bootstrapping by cross\u2010validated area under the curve (AUC) to investigate if proteins increase the prediction accuracy on top of classical risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the cross\u2010sectional analysis, we identified kallikrein\u20106, C\u2010C motif chemokine 28 (CCL28), and tissue factor pathway inhibitor as previously unknown biomarkers for muscle mass [association with low ASMM: odds ratio (OR) per 1\u2010SD increase in log2 normalized protein expression values (95% confidence interval (CI)): 1.63 (1.37\u20131.95), 1.31 (1.14\u20131.51), 1.24 (1.06\u20131.45), respectively] and serine protease 27 for fat mass [association with high BFMI: OR (95% CI): 0.73 (0.61\u20130.86)]. CCL28 and metalloproteinase inhibitor 4 (TIMP4) constituted new biomarkers for the combination of low muscle and high fat mass [association with low ASMM combined with high BFMI: OR (95% CI): 1.32 (1.08\u20131.61), 1.28 (1.03\u20131.59), respectively]. Including protein biomarkers selected in \u226590% of group lasso bootstrap iterations on top of classical risk factors improved the performance of models predicting low ASMM, high BFMI, and their combination [delta AUC (95% CI): 0.16 (0.13\u20130.20), 0.22 (0.18\u20130.25), 0.12 (0.08\u20130.17), respectively]. In the longitudinal analysis, N\u2010terminal prohormone brain natriuretic peptide (NT\u2010proBNP) was the only protein selected for loss in ASMM and loss in ASMM combined with gain in BFMI over 14\u00a0years [OR (95% CI): 1.40 (1.10\u20131.77), 1.60 (1.15\u20132.24), respectively].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Proteomic profiling revealed CCL28 and TIMP4 as new biomarkers of low muscle mass combined with high fat mass and NT\u2010proBNP as a key biomarker of loss in muscle mass combined with gain in fat mass. Proteomics enable us to accelerate biomarker discoveries in muscle research.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12733","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T02:50:15Z","timestamp":1624243815000},"page":"1011-1023","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Proteomic profiling of low muscle and high fat mass: a machine learning approach in the KORA S4\/FF4 study"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4329-8607","authenticated-orcid":false,"given":"Marie\u2010Theres","family":"Huemer","sequence":"first","affiliation":[{"name":"Institute of Epidemiology Helmholtz Zentrum M\u00fcnchen, German Research Center for Environmental Health (GmbH)  Neuherberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Bauer","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology Helmholtz Zentrum M\u00fcnchen, German Research Center for Environmental Health (GmbH)  Neuherberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnese","family":"Petrera","sequence":"additional","affiliation":[{"name":"Research Unit Protein Science Helmholtz Zentrum M\u00fcnchen, German Research Center for Environmental Health (GmbH)  Neuherberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Scholz","sequence":"additional","affiliation":[{"name":"Institute for Medical Informatics, Statistics and Epidemiology (IMISE) Universit\u00e4t Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie M.","family":"Hauck","sequence":"additional","affiliation":[{"name":"Research Unit Protein Science Helmholtz Zentrum M\u00fcnchen, German Research Center for Environmental Health (GmbH)  Neuherberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Drey","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik IV, Schwerpunkt Akutgeriatrie Klinikum der Universit\u00e4t M\u00fcnchen (LMU)  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Peters","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology Helmholtz Zentrum M\u00fcnchen, German Research Center for Environmental Health (GmbH)  Neuherberg Germany"},{"name":"German Center for Diabetes Research (DZD)  M\u00fcnchen\u2010Neuherberg Germany"},{"name":"Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty Ludwig\u2010Maximilians\u2010Universit\u00e4t M\u00fcnchen  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8416-6440","authenticated-orcid":false,"given":"Barbara","family":"Thorand","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology Helmholtz Zentrum M\u00fcnchen, German Research Center for Environmental Health (GmbH)  Neuherberg Germany"},{"name":"German Center for Diabetes Research (DZD)  M\u00fcnchen\u2010Neuherberg 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