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Since eGFRCreat is influenced by muscle more than eGFRCys, muscle mass may explain this association. Previous work could not account for this when considering regional muscle measures by imaging. Deuterated creatine (D\n                      <jats:sub>3<\/jats:sub>\n                      Cr) dilution measures whole body muscle mass (kilograms). We aimed to determine whether eGFRDiff is associated with D\n                      <jats:sub>3<\/jats:sub>\n                      Cr muscle mass and whether muscle mass explains the association between eGFRDiff and frailty.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Cross\u2010sectional analysis within the multicenter MrOS Study at Year 14 (visit 4). 490 men of the original cohort of 5994 MrOS participants (aged \u226565 at enrollment) were included. Exposure was eGFRDiff (= eGFRCys \u2013 eGFRCreat), calculated using CKD\u2010EPI equations 2012\/2021. Primary outcome was D\n                      <jats:sub>3<\/jats:sub>\n                      Cr muscle mass. Secondary outcome was phenotypic pre\u2010frailty (one or two criteria) and frailty (\u2265three criteria) including the following: weight loss, weakness, slow gait, physical activity, poor energy. The association of eGFRDiff with D\n                      <jats:sub>3<\/jats:sub>\n                      Cr muscle mass was examined by linear regression, that with prefrailty \/ frailty by multinomial logistic regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean\u2009\u00b1\u2009SD age was 84\u2009\u00b1\u20094\u2009years, eGFRCreat 68\u2009\u00b1\u200916, eGFRCys 52\u2009\u00b1\u200916, eGFRDiff \u221215\u2009\u00b1\u200912\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      and D\n                      <jats:sub>3<\/jats:sub>\n                      Cr muscle mass 24\u2009\u00b1\u20094\u2009kg. For each SD increment in eGFRDiff, D3Cr muscle mass was 1.4\u2009kg higher on average,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001 (fully adjusted). Higher eGFRDiff was associated with lower odds of frailty (OR\u2009=\u20090.63 95% CI [0.45;0.89]), but this was partially attenuated and insignificant after additionally adjusting for D\n                      <jats:sub>3<\/jats:sub>\n                      Cr muscle mass (OR\u2009=\u20090.85 95% CI [0.58; 1.24]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Higher eGFRDiff is associated with lower odds of frailty among late\u2010life men. D\n                      <jats:sub>3<\/jats:sub>\n                      Cr muscle mass accounts for some of this association. This suggests that non\u2010GFR determinants of creatinine and cystatin C, such as muscle mass, play a role in explaining the association of eGFRDiff with frailty. Future studies are needed to confirm.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.19014","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T10:56:06Z","timestamp":1717152966000},"page":"3163-3170","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Difference between kidney function by cystatin C versus creatinine and association with muscle mass and frailty"],"prefix":"10.1111","volume":"72","author":[{"given":"Julia H.","family":"Yuan","sequence":"first","affiliation":[{"name":"University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dena E.","family":"Rifkin","sequence":"additional","affiliation":[{"name":"University of California San Diego  San Diego California USA"},{"name":"Veterans Affairs San Diego Healthcare System  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Ginsberg","sequence":"additional","affiliation":[{"name":"University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy M.","family":"Cawthon","sequence":"additional","affiliation":[{"name":"University of California San Francisco  San Francisco California USA"},{"name":"United States and Research Institute, California Pacific Medical Center  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah M.","family":"Kado","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center (GRECC) Veterans Healthcare Administration  Palo Alto California USA"},{"name":"Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott R.","family":"Bauer","sequence":"additional","affiliation":[{"name":"University of California San Francisco  San Francisco California USA"},{"name":"San Francisco VA Medical Center  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9069-3036","authenticated-orcid":false,"given":"Kristine E.","family":"Ensrud","sequence":"additional","affiliation":[{"name":"University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O. 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