{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T11:26:12Z","timestamp":1793705172725,"version":"4.5.1"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DK130839"],"award-info":[{"award-number":["R01DK130839"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23DK125672"],"award-info":[{"award-number":["K23DK125672"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL144566"],"award-info":[{"award-number":["R01HL144566"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DK125786"],"award-info":[{"award-number":["R01DK125786"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DK126685"],"award-info":[{"award-number":["R01DK126685"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Creatinine\u2010based estimated glomerular filtration rate (eGFR\n                      <jats:sub>CRE<\/jats:sub>\n                      ) may overestimate kidney function in patients with sarcopenia. While cystatin C\u2010based eGFR (eGFR\n                      <jats:sub>CYS<\/jats:sub>\n                      ) is less affected by muscle mass, it may underestimate kidney function in patients with obesity. We sought to evaluate the relationship between body composition defined by computed tomography (CT) scans and discordance between creatinine, eGFR\n                      <jats:sub>CRE<\/jats:sub>\n                      and eGFR\n                      <jats:sub>CYS<\/jats:sub>\n                      in adult patients with cancer.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study is a cross\u2010sectional study of consecutive adults with cancer with an abdominal CT scan performed within 90\u00a0days of simultaneous eGFR\n                      <jats:sub>CRE<\/jats:sub>\n                      and eGFR\n                      <jats:sub>CYS<\/jats:sub>\n                      measurements between May 2010 and January 2022. Muscle and adipose tissue cross\u2010sectional areas were measured at the level of the third lumbar vertebral body using a validated deep\u2010learning pipeline. CT\u2010defined sarcopenia was defined using independent sex\u2010specific cut\u2010offs for skeletal muscle index (&lt;39\u00a0cm\n                      <jats:sup>2<\/jats:sup>\n                      \/m\n                      <jats:sup>2<\/jats:sup>\n                      for women and &lt;55\u00a0cm\n                      <jats:sup>2<\/jats:sup>\n                      \/m\n                      <jats:sup>2<\/jats:sup>\n                      for men). High adiposity was defined as the highest sex\u2010specific quartile of the total (visceral plus subcutaneous) adiposity index in the cohort. The primary outcome was eGFR discordance, defined by eGFR\n                      <jats:sub>CYS<\/jats:sub>\n                      \u00a0&gt;\u00a030% lower than eGFR\n                      <jats:sub>CRE<\/jats:sub>\n                      ; the secondary outcome was eGFR\n                      <jats:sub>CYS<\/jats:sub>\n                      \u00a0&gt;\u00a050% lower than eGFR\n                      <jats:sub>CRE<\/jats:sub>\n                      . The odds of eGFR discordance were estimated using multivariable logistic regression modelling. Unadjusted spline regression was used to evaluate the relationship between skeletal muscle index and the difference between eGFR\n                      <jats:sub>CYS<\/jats:sub>\n                      and eGFR\n                      <jats:sub>CRE<\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 545 included patients (mean age 63\u00a0\u00b1\u00a014\u00a0years, 300 [55%] females, 440 [80.7%] non\u2010Hispanic white), 320 (58.7%) met the criteria for CT\u2010defined sarcopenia, and 136 (25%) had high adiposity. A total of 259 patients (48%) had &gt;30% eGFR discordance, and 122 (22.4%) had &gt;50% eGFR discordance. After adjustment for potential confounders, CT\u2010defined sarcopenia and high adiposity were both associated with &gt;30% eGFR discordance (adjusted odds ratio [aOR] 1.90, 95% confidence interval [CI] 1.12\u20133.24; aOR 2.01, 95% CI 1.15\u20133.52, respectively) and &gt;50% eGFR discordance (aOR 2.34, 95% CI 1.21\u20134.51; aOR 2.23, 95% CI 1.19\u20134.17, respectively). A spline model demonstrated that as skeletal muscle index decreases, the predicted difference between eGFR\n                      <jats:sub>CRE<\/jats:sub>\n                      and eGFR\n                      <jats:sub>CYS<\/jats:sub>\n                      widens considerably.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CT\u2010defined sarcopenia and high adiposity are both independently associated with large eGFR discordance. Incorporating valuable information from body composition analysis derived from CT scans performed as a part of routine cancer care can impact the interpretation of GFR estimates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.13469","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T04:59:53Z","timestamp":1713761993000},"page":"1187-1198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Sarcopenia, adiposity and large discordance between cystatin C and creatinine\u2010based estimated glomerular filtration rate in patients with cancer"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4976-9104","authenticated-orcid":false,"given":"Paul E.","family":"Hanna","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine Medical College of Wisconsin  Milwaukee WI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianqi","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail","family":"Tahir","sequence":"additional","affiliation":[{"name":"Department of Radiology Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurit","family":"Katz\u2010Agranov","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Mantz","sequence":"additional","affiliation":[{"name":"Department of Radiology Massachusetts General Hospital  Boston MA USA"},{"name":"Department of Diagnostic and Interventional Radiology University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Strohbehn","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiana","family":"Moreno","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Destiny","family":"Harden","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E.","family":"Dinulos","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duru","family":"Cosar","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harish","family":"Seethapathy","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin F.","family":"Gainor","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin J.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shruti","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Renal Medicine, Department of Medicine Brigham and Women's Hospital  Boston MA USA"},{"name":"Adult Survivorship Program Dana\u2010Farber Cancer Institute  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Leaf","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian J.","family":"Fintelmann","sequence":"additional","affiliation":[{"name":"Department of Radiology Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan E.","family":"Sise","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000180580"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2102953"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/M22-0610"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2008.638"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2016.016832"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70153-0"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.45.2722"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.5040\/9781492596950.ch-007"},{"key":"e_1_2_8_10_1","first-page":"1361","volume-title":"Human Body Composition","author":"Loan MDV","year":"2005"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/80.2.271"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00744.2004"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2019-0813"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.02.016"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/onco.13774"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.05.019"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2007.11.018"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1114248"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2020.7618"},{"key":"e_1_2_8_20_1","volume-title":"Fully\u2010Automated Analysis of Body Composition From CT in Cancer Patients Using Convolutional Neural Networks. OR 20 Context\u2010Aware Operating Theaters, Computer Assisted Robotic Endoscopy, Clinical Image\u2010Based Procedures, and Skin Image Analysis","author":"Bridge CP","year":"2018"},{"key":"e_1_2_8_21_1","first-page":"204","volume-title":"Fully\u2010Automated Analysis of Body Composition From CT in Cancer Patients Using Convolutional Neural Networks. OR 20 Context\u2010Aware Operating Theaters, Computer Assisted Robotic Endoscopy, Clinical Image\u2010Based Procedures, and Skin Image Analysis","author":"Bridge CP","year":"2018"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2020201640"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.12.010"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2021070988"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.48940"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.21715"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-08-2242"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-06-3067"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0037563"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdp605"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2004.00517.x"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1042\/bj2680287"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.09.013"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2009.96"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.3390\/scipharm85010009"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.05.017"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2022.05.011"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-022-02093-4"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2021.11.005"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021210576"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afy169"}],"updated-by":[{"DOI":"10.1002\/jcsm.70422","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T00:00:00Z","timestamp":1793664000000}}],"container-title":["Journal of Cachexia, Sarcopenia and Muscle"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.13469","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T00:21:21Z","timestamp":1717978881000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcsm.13469"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,22]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/jcsm.13469"],"URL":"https:\/\/doi.org\/10.1002\/jcsm.13469","archive":["Portico"],"relation":{},"ISSN":["2190-5991","2190-6009"],"issn-type":[{"value":"2190-5991","type":"print"},{"value":"2190-6009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,22]]},"assertion":[{"value":"2023-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}