Urinary creatinine excretion as a marker of body composition and muscle function in patients with chronic thoracolumbar spinal cord injury
Keywords:
skeletal muscle; urinary creatinine excretion; chronic dorsal lumbar spinal trauma.Abstract
Introduction: Creatinine excretion is an expression of skeletal muscle mass. Its measurement is considered an affordable, sensitive, and effective biomarker for estimating body composition in patients with chronic spinal cord trauma.
Objective: To assess skeletal muscle mass based on urinary creatinine excretion in patients with chronic dorsal lumbar spinal trauma.
Methods: A longitudinal, prospective, and analytical study was conducted on 41 male patients with chronic spinal trauma from T1 to L2, with complete motor spinal cord injury.
Results: Significant changes (p ≤ 0.000) were observed in arm circumference, arm muscle circumference, arm muscle area, and in the creatinine excretion rate. A highly significant change (p ≤ 0.000, t = -5.14) was found in skeletal muscle mass, adjusted for creatinine excretion, according to the lean mass median (kg) of the DEXA Lunar reference population. Significant changes were observed in CD3/CD4 lymphocyte subpopulations in patients with T1 to T6 injuries, where the muscle mass index is below the 3rd percentile (p ≤ 0.028). Increases in CD3/CD8 differences in patients with a muscle mass index below the 3rd percentile (26.8%) showed significant differences (p ≤ 0.021) and ANOVA with F 5.8. Significant increases were observed in the Barthel Index, Catz scale, and ASIA motor score (p ≤ 0.000).
Conclusions: Skeletal muscle mass estimated by urinary creatinine excretion and the creatinine-height index are prognostic indicators that show sensitivity to anthropometric, immunological, and neurofunctional variables during the Neurological Restoration Program.
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