Creatinine muscle index in UK Biobank: comparison with MRI and associations with frailty and mortality
Year: 2026
Type: article
Abstract: Background: Skeletal muscle wasting due to aging, acute illness, and chronic disease is associated with adverse outcomes including mortality, frailty, and multi-morbidity. We investigated the relationship of creatinine muscle index (CMI), a serum biological signature of muscle mass, in UK Biobank participants with gold standard muscle measurement and adverse outcomes. Method: = 450 812), we utilized Cox-proportional hazards models to investigate associations between CMI with mortality, frailty and comorbidity. Results: CMI demonstrated moderate to good linear correlation with gold-standard MRI muscle mass measurements [R males: 0.68 (0.60-0.76); females: 0.65 (0.56-0.73)], after accounting for data imbalance. CMI discriminated muscle mass ≤2.5 standard deviations from the mean, with an area under the curve of 0.80 (95% CI:0.75-0.86) in males and 0.84 (95% CI:0.78-0.89) in females. CMI consistently decreased with increasing age, frailty and comorbidity. Over an 8-year follow-up, lower CMI was associated with higher morality: adjusted hazard ratio for the 25th vs 75th CMI centiles were 0.61 (95% CI: 0.58-0.66) in males and 0.72 (95% CI: 0.66-0.78) in females. Conclusions: In over 450 000 UK Biobank participants, low CMI was significantly associated with baseline comorbidity, frailty and survival on follow-up (independent of age, sex, and comorbidity). This study supports CMI as a potential biological signature for skeletal muscle wasting in clinical and research settings.
Source: Clinical Kidney Journal
DOI: 10.1093/ckj/sfag139
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,335
Funder: Barts Charity
OpenAlex ID: W7160706029