Urinary Titin Is a Novel Biomarker for Muscle Atrophy in Nonsurgical Critically Ill Patients: A Two-Center, Prospective Observational Study.
Aged
Aged, 80 and over
Biomarkers
Connectin
/ urine
Creatinine
/ urine
Critical Illness
Diaphragm
/ diagnostic imaging
Female
Hospital Mortality
Humans
Intensive Care Units
Japan
Length of Stay
Male
Middle Aged
Muscle Weakness
/ pathology
Muscular Atrophy
/ diagnostic imaging
Physical Functional Performance
Prospective Studies
Quadriceps Muscle
/ diagnostic imaging
Ultrasonography
Journal
Critical care medicine
ISSN: 1530-0293
Titre abrégé: Crit Care Med
Pays: United States
ID NLM: 0355501
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
pubmed:
25
7
2020
medline:
26
5
2021
entrez:
25
7
2020
Statut:
ppublish
Résumé
Although skeletal muscle atrophy is common in critically ill patients, biomarkers associated with muscle atrophy have not been identified reliably. Titin is a spring-like protein found in muscles and has become a measurable biomarker for muscle breakdown. We hypothesized that urinary titin is useful for monitoring muscle atrophy in critically ill patients. Therefore, we investigated urinary titin level and its association with muscle atrophy in critically ill patients. Two-center, prospective observational study. Mixed medical/surgical ICU in Japan. Nonsurgical adult patients who were expected to remain in ICU for greater than 5 days. None. Urine samples were collected on days 1, 2, 3, 5, and 7 of ICU admission. To assess muscle atrophy, rectus femoris cross-sectional area and diaphragm thickness were measured with ultrasound on days 1, 3, 5, and 7. Secondary outcomes included its relationship with ICU-acquired weakness, ICU Mobility Scale, and ICU mortality. Fifty-six patients and 232 urinary titin measurements were included. Urinary titin (normal range: 1-3 pmol/mg creatinine) was 27.9 (16.8-59.6), 47.6 (23.5-82.4), 46.6 (24.4-97.6), 38.4 (23.6-83.0), and 49.3 (27.4-92.6) pmol/mg creatinine on days 1, 2, 3, 5, and 7, respectively. Cumulative urinary titin level was significantly associated with rectus femoris muscle atrophy on days 3-7 (p ≤ 0.03), although urinary titin level was not associated with change in diaphragm thickness (p = 0.31-0.45). Furthermore, cumulative urinary titin level was associated with occurrence of ICU-acquired weakness (p = 0.01) and ICU mortality (p = 0.02) but not with ICU Mobility Scale (p = 0.18). In nonsurgical critically ill patients, urinary titin level increased 10-30 times compared with the normal level. The increased urinary titin level was associated with lower limb muscle atrophy, occurrence of ICU-acquired weakness, and ICU mortality.
Identifiants
pubmed: 32706557
doi: 10.1097/CCM.0000000000004486
pii: 00003246-202009000-00011
doi:
Substances chimiques
Biomarkers
0
Connectin
0
Creatinine
AYI8EX34EU
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1327-1333Références
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