{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T11:29:35Z","timestamp":1769599775773,"version":"3.49.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100011665","name":"Deanship of Scientific Research, King Saud University","doi-asserted-by":"crossref","award":["RSP#2024R277"],"award-info":[{"award-number":["RSP#2024R277"]}],"id":[{"id":"10.13039\/501100011665","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Aging Clin Exp Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>A low handgrip strength (HGS) is associated with several diseases in older adults. However, predictive biomarkers of future low HGS are poorly known. We investigated the prognostic efficacy of the ratio of plasma cystatin-c and total cholesterol (CT ratio) levels for predicting future low HGS in Europe.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>The data was collected from the Survey of Health, Ageing, and Retirement in Europe (SHARE) between 2015 and 2021-22. The study participants were geriatric adults aged 50 or above (<jats:italic>n<\/jats:italic>\u2009=\u200917,698) from 12 European countries. The baseline data in 2015 included the measurements of CT ratio from participants with normal HGS. The participants who developed low HGS in subsequent years were included. We also investigated the quality of life, difficulties performing daily activities, and several comorbidities in the study population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>In a multivariate-adjusted model, male gender, advancing age, poor quality of life, difficulties performing daily activities, and the presence of depression, high blood pressure, diabetes mellitus, Alzheimer\u2019s disease, and osteoarthritis were associated with a higher risk of developing low HGS. CT ratio exhibited significant prognostic accuracy for low HGS among men and women aged 60\u201379, irrespective of the quality of life, degree of depression, difficulties performing daily activities, and the presence of comorbidities, including depression, high blood pressure, diabetes mellitus, Alzheimer\u2019s disease, and osteoarthritis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Collectively, the CT ratio exhibits adequate prognostic accuracy for low HGS, which is not significantly affected by comorbidities and functional limitations. Our findings have clinical and policy implications in timely identifying older adults at risk of developing low HGS.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s40520-025-03007-6","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T09:58:31Z","timestamp":1742205511000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cystatin-c \/ total cholesterol ratio as a predictor of probable sarcopenia in geriatric population from 12 European countries"],"prefix":"10.1007","volume":"37","author":[{"given":"Rizwan","family":"Qaisar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Azhar","family":"Hussain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asima","family":"Karim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Firdos","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atif","family":"Awad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Alsaeed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaea A.","family":"Alkahtani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"3007_CR1","doi-asserted-by":"crossref","first-page":"1056479","DOI":"10.3389\/fphys.2022.1056479","volume":"13","author":"MS Parvatiyar","year":"2022","unstructured":"Parvatiyar MS, Qaisar R (2022) Editorial: skeletal muscle in age-related diseases: from molecular pathogenesis to potential interventions. Front Physiol 13:1056479","journal-title":"Front Physiol"},{"issue":"18","key":"3007_CR2","doi-asserted-by":"crossref","first-page":"e146","DOI":"10.3346\/jkms.2022.37.e146","volume":"37","author":"MR Cho","year":"2022","unstructured":"Cho MR, Lee S, Song SK (2022) A review of sarcopenia pathophysiology, diagnosis, treatment and future direction. J Korean Med Sci 37(18):e146","journal-title":"J Korean Med Sci"},{"issue":"4","key":"3007_CR3","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1093\/ageing\/afz046","volume":"48","author":"AJ Cruz-Jentoft","year":"2019","unstructured":"Cruz-Jentoft AJ et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48(4):601","journal-title":"Age Ageing"},{"key":"3007_CR4","doi-asserted-by":"crossref","first-page":"260","DOI":"10.3389\/fphys.2012.00260","volume":"3","author":"WK Mitchell","year":"2012","unstructured":"Mitchell WK et al (2012) Sarcopenia, dynapenia, and the impact of advancing age on human skeletal muscle size and strength; a quantitative review. Front Physiol 3:260","journal-title":"Front Physiol"},{"issue":"2","key":"3007_CR5","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1002\/cam4.4362","volume":"11","author":"E Cereda","year":"2022","unstructured":"Cereda E et al (2022) Muscle weakness as an additional criterion for grading sarcopenia-related prognosis in patients with cancer. Cancer Med 11(2):308\u2013316","journal-title":"Cancer Med"},{"key":"3007_CR6","doi-asserted-by":"crossref","first-page":"102148","DOI":"10.1016\/j.arr.2023.102148","volume":"93","author":"R Lian","year":"2024","unstructured":"Lian R et al (2024) Blood biomarkers for sarcopenia: A systematic review and meta-analysis of diagnostic test accuracy studies. Ageing Res Rev 93:102148","journal-title":"Ageing Res Rev"},{"key":"3007_CR7","doi-asserted-by":"crossref","first-page":"1122922","DOI":"10.3389\/fpubh.2023.1122922","volume":"11","author":"Y Wu","year":"2023","unstructured":"Wu Y et al (2023) Sarcopenia index based on serum creatinine and Cystatin C is associated with mortality in middle-aged and older adults in Chinese: A retrospective cohort study from the China health and retirement longitudinal study. Front Public Health 11:1122922","journal-title":"Front Public Health"},{"issue":"3","key":"3007_CR8","doi-asserted-by":"crossref","first-page":"e13182","DOI":"10.1111\/ctr.13182","volume":"32","author":"K Kashani","year":"2018","unstructured":"Kashani K et al (2018) The sarcopenia index: A novel measure of muscle mass in lung transplant candidates. Clin Transpl 32(3):e13182","journal-title":"Clin Transpl"},{"issue":"1","key":"3007_CR9","doi-asserted-by":"crossref","first-page":"e23","DOI":"10.1097\/CCM.0000000000002013","volume":"45","author":"KB Kashani","year":"2017","unstructured":"Kashani KB et al (2017) Evaluating muscle mass by using markers of kidney function: development of the sarcopenia index. Crit Care Med 45(1):e23\u2013e29","journal-title":"Crit Care Med"},{"issue":"1","key":"3007_CR10","doi-asserted-by":"crossref","first-page":"11534","DOI":"10.1038\/s41598-018-29808-6","volume":"8","author":"Q He","year":"2018","unstructured":"He Q et al (2018) A sarcopenia index based on serum creatinine and Cystatin C cannot accurately detect either low muscle mass or sarcopenia in urban community-dwelling older people. Sci Rep 8(1):11534","journal-title":"Sci Rep"},{"key":"3007_CR11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.atherosclerosis.2021.01.016","volume":"325","author":"JH Lee","year":"2021","unstructured":"Lee JH et al (2021) Relationship between muscle mass index and LDL cholesterol target levels: analysis of two studies of the Korean population. Atherosclerosis 325:1\u20137","journal-title":"Atherosclerosis"},{"issue":"3","key":"3007_CR12","doi-asserted-by":"crossref","first-page":"801","DOI":"10.14336\/AD.2021.1107","volume":"13","author":"Q Yang","year":"2022","unstructured":"Yang Q, Chan P (2022) Skeletal muscle metabolic alternation develops sarcopenia. Aging Dis 13(3):801\u2013814","journal-title":"Aging Dis"},{"issue":"3","key":"3007_CR13","doi-asserted-by":"crossref","first-page":"175","DOI":"10.7570\/jomes.2018.27.3.175","volume":"27","author":"OC Du Yang","year":"2018","unstructured":"Du Yang OC, Jaekyung N (2018) Associations between sarcopenia and metabolic risk factors: A systematic review and meta-analysis. J Obes Metabolic Syndrome 27(3):175\u2013185","journal-title":"J Obes Metabolic Syndrome"},{"key":"3007_CR14","doi-asserted-by":"crossref","first-page":"107298","DOI":"10.1016\/j.rmed.2023.107298","volume":"215","author":"R Qaisar","year":"2023","unstructured":"Qaisar R et al (2023) Degradation of neuromuscular junction contributes to muscle weakness but not physical compromise in chronic obstructive pulmonary disease patients taking lipids-lowering medications. Respir Med 215:107298","journal-title":"Respir Med"},{"issue":"3","key":"3007_CR15","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/j.clnu.2024.01.028","volume":"43","author":"L Calcaterra","year":"2024","unstructured":"Calcaterra L et al (2024) Sarcopenia and poor nutritional status in older adults. Clin Nutr 43(3):701\u2013707","journal-title":"Clin Nutr"},{"issue":"6","key":"3007_CR16","first-page":"370","volume":"6","author":"C Monarque-Favard","year":"2002","unstructured":"Monarque-Favard C et al (2002) Malnourished elderly people and lipid status. J Nutr Health Aging 6(6):370\u2013374","journal-title":"J Nutr Health Aging"},{"key":"3007_CR17","unstructured":"B\u00f6rsch-Supan A (2022) Survey of health, ageing and retirement in Europe (SHARE) wave 8. Release version: 8.0.0. SHARE-ERIC. Data set"},{"issue":"4","key":"3007_CR18","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1093\/ije\/dyt088","volume":"42","author":"A Borsch-Supan","year":"2013","unstructured":"Borsch-Supan A et al (2013) Data resource profile: the survey of health, ageing and retirement in Europe (SHARE). Int J Epidemiol 42(4):992\u20131001","journal-title":"Int J Epidemiol"},{"issue":"1","key":"3007_CR19","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1007\/s40520-024-02800-z","volume":"36","author":"R Qaisar","year":"2024","unstructured":"Qaisar R et al (2024) Predictors of the onset of low handgrip strength in Europe: a longitudinal study of 42,183 older adults from 15 countries. Aging Clin Exp Res 36(1):162","journal-title":"Aging Clin Exp Res"},{"issue":"1","key":"3007_CR20","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1681\/ASN.2010050483","volume":"22","author":"CA Peralta","year":"2011","unstructured":"Peralta CA et al (2011) Cystatin C identifies chronic kidney disease patients at higher risk for complications. J Am Soc Nephrol 22(1):147\u2013155","journal-title":"J Am Soc Nephrol"},{"issue":"1","key":"3007_CR21","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1186\/s12877-023-04233-1","volume":"23","author":"R Qaisar","year":"2023","unstructured":"Qaisar R et al (2023) The quality of life in Alzheimer\u2019s disease is not associated with handgrip strength but with activities of daily living-a composite study from 28 European countries. BMC Geriatr 23(1):536","journal-title":"BMC Geriatr"},{"issue":"10","key":"3007_CR22","doi-asserted-by":"crossref","first-page":"e23777","DOI":"10.1002\/ajhb.23777","volume":"34","author":"R Groh","year":"2022","unstructured":"Groh R et al (2022) Effects of spot size on biomarker levels of field-collected dried blood spots: A new algorithm for exact dried blood spot size measurement. Am J Hum Biol 34(10):e23777","journal-title":"Am J Hum Biol"},{"issue":"10","key":"3007_CR23","doi-asserted-by":"crossref","first-page":"e0163917","DOI":"10.1371\/journal.pone.0163917","volume":"11","author":"N Steiber","year":"2016","unstructured":"Steiber N (2016) Strong or weak handgrip?? Normative reference values for the German population across the life course stratified by sex, age, and body height. PLoS ONE 11(10):e0163917","journal-title":"PLoS ONE"},{"issue":"2","key":"3007_CR24","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1093\/ndt\/gfp474","volume":"25","author":"MC Odden","year":"2010","unstructured":"Odden MC et al (2010) Age and Cystatin C in healthy adults: a collaborative study. Nephrol Dial Transpl 25(2):463\u2013469","journal-title":"Nephrol Dial Transpl"},{"issue":"1","key":"3007_CR25","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1038\/s41598-018-38461-y","volume":"9","author":"SW Yi","year":"2019","unstructured":"Yi SW, Yi JJ, Ohrr H (2019) Total cholesterol and all-cause mortality by sex and age: a prospective cohort study among 12.8 million adults. Sci Rep 9(1):1596","journal-title":"Sci Rep"},{"key":"3007_CR26","doi-asserted-by":"crossref","unstructured":"Rodriguez-Blazquez C et al (2020) Psychometric properties of the CASP-12 scale in Portugal: an analysis using SHARE data. Int J Environ Res Public Health, 17(18)","DOI":"10.3390\/ijerph17186610"},{"issue":"10","key":"3007_CR27","doi-asserted-by":"crossref","first-page":"2134","DOI":"10.1016\/j.mayocp.2020.02.035","volume":"95","author":"A Marques","year":"2020","unstructured":"Marques A et al (2020) Grip strength and depression symptoms among Middle-Age and older adults. Mayo Clin Proc 95(10):2134\u20132143","journal-title":"Mayo Clin Proc"},{"key":"3007_CR28","doi-asserted-by":"crossref","first-page":"110801","DOI":"10.1016\/j.exger.2019.110801","volume":"131","author":"J Pacifico","year":"2020","unstructured":"Pacifico J et al (2020) Prevalence of sarcopenia as a comorbid disease: A systematic review and meta-analysis. Exp Gerontol 131:110801","journal-title":"Exp Gerontol"},{"key":"3007_CR29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.yjmcc.2021.08.012","volume":"162","author":"M Papadaki","year":"2022","unstructured":"Papadaki M et al (2022) Myofilament glycation in diabetes reduces contractility by inhibiting Tropomyosin movement, is rescued by cMyBPC domains. J Mol Cell Cardiol 162:1\u20139","journal-title":"J Mol Cell Cardiol"},{"issue":"2","key":"3007_CR30","doi-asserted-by":"crossref","first-page":"641","DOI":"10.3233\/JAD-230201","volume":"94","author":"R Qaisar","year":"2023","unstructured":"Qaisar R et al (2023) ACE inhibitors improve skeletal muscle by preserving neuromuscular junctions in patients with Alzheimer\u2019s disease. J Alzheimers Dis 94(2):641\u2013650","journal-title":"J Alzheimers Dis"},{"issue":"3","key":"3007_CR31","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/s10522-015-9626-4","volume":"17","author":"DJ Tomlinson","year":"2016","unstructured":"Tomlinson DJ et al (2016) The impact of obesity on skeletal muscle strength and structure through adolescence to old age. Biogerontology 17(3):467\u2013483","journal-title":"Biogerontology"},{"issue":"9","key":"3007_CR32","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1038\/s41569-018-0064-2","volume":"15","author":"L Ferrucci","year":"2018","unstructured":"Ferrucci L, Fabbri E (2018) Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty. Nat Rev Cardiol 15(9):505\u2013522","journal-title":"Nat Rev Cardiol"},{"issue":"12","key":"3007_CR33","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1038\/s41430-024-01486-w","volume":"78","author":"J Wang","year":"2024","unstructured":"Wang J et al (2024) The association between inflammatory cytokines and sarcopenia-related traits: a bi-directional Mendelian randomization study. Eur J Clin Nutr 78(12):1032\u20131040","journal-title":"Eur J Clin Nutr"},{"key":"3007_CR34","doi-asserted-by":"crossref","unstructured":"Janssen F et al (2021) Future life expectancy in Europe taking into account the impact of smoking, obesity, and alcohol. Elife, 10","DOI":"10.7554\/eLife.66590"}],"container-title":["Aging Clinical and Experimental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40520-025-03007-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40520-025-03007-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40520-025-03007-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T22:44:22Z","timestamp":1742942662000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40520-025-03007-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,17]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3007"],"URL":"https:\/\/doi.org\/10.1007\/s40520-025-03007-6","relation":{},"ISSN":["1720-8319"],"issn-type":[{"value":"1720-8319","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,17]]},"assertion":[{"value":"3 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial number"}}],"article-number":"94"}}