{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T01:41:12Z","timestamp":1792460472933,"version":"4.5.0"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sarcopenia is a gradual decline in skeletal muscle mass and strength, which eventually leads to reduced physical performance. 50% of people aged 60\u201380\u2009years suffer from sarcopenia. Considering the devastating outcomes and the importance of promoting healthy ageing, the diagnosis and prevention of sarcopenia is of utmost importance. Recently, C\u2010terminal agrin fragment (CAF) has been identified as an indicator for early diagnosis of sarcopenia. So far, systematic reviews demonstrating CAF as a biomarker for sarcopenia have been conducted, but a meta\u2010analysis is still needed. This study contains systematic review as well as detailed meta\u2010analysis to better understand the association of CAF and sarcopenia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Articles were primarily obtained from four different databases. Studies demonstrating the association between CAF and sarcopenia were selected. Data extraction and analysis were performed using STATASE 16 software. The risk of bias and quality assessment of each study was carried out using Joanna Briggs Institute (JBI) Critical Appraisal Tool. Meta\u2010regression, subgroup and sensitivity analysis were conducted to identify the source of heterogeneity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventeen studies were included in the qualitative analysis, out of which 10 were included in the quantitative analysis. The meta\u2010analysis showed that CAF levels were significantly higher in sarcopenia patients, with an effect size of 1.93 (ROM\u2009=\u20091.93, 95% CI [1.49 to 2.36];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.00) and 1.38 (ROM\u2009=\u20091.38, 95% CI [0.94 to 1.83],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.00) when compared with non\u2010sarcopenic and non\u2010sarcopenic (other co\u2010morbidities) group, respectively. CAF levels were also negatively associated with hand grip strength (HGS) and skeletal muscle index (SMI) with an effect size of 1.09 (ROM\u2009=\u20091.09 with 95% CI [1.05 to 1.13],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.00) and 1.10 (ROM\u2009=\u20091.10 with 95% CI [1.05 to 1.14],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.00), respectively. Meta\u2010regression and subgroup analysis revealed that although sarcopenia is associated with increasing age, the correlation between CAF and age was statistically insignificant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.44), suggesting that the variation of age among sarcopenia patients could be source of heterogeneity among studies. All the studies included in the meta\u2010analysis reported low risk of bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our meta\u2010analysis concluded that elevated CAF levels were associated with sarcopenia and decreased HGS and SMI. CAF could serve as a valuable marker for the early detection and monitoring of sarcopenia, ultimately facilitating the management and treatment of this debilitating condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.13707","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T04:25:12Z","timestamp":1738211112000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["C\u2010Terminal Agrin Fragment as a Biomarker for Sarcopenia: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"16","author":[{"given":"Rida","family":"Fatima","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Science Graduate School of Inje University  Gimhae South Korea"},{"name":"Biohealth Products Research Center (BPRC) Inje University  Gimhae South Korea"},{"name":"Research Center for Aged\u2010Life Redesign (RCAR) Inje University  Gimhae South 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