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ID 115044
タイトル別表記
Urinary titin as a biomarker for muscle atrophy
著者
Hara, Kanako Tokushima University
Takashima, Takuya Tokushima University
中瀧, 恵実子 Tokushima Prefectural Central Hospital KAKEN研究者をさがす
Matsuo, Masafumi Kobe Gakuin University
キーワード
urinary titin
ultrasound
muscle atrophy
rectus femoris muscle
diaphragm
intensive care unit-acquired weakness
資料タイプ
学術雑誌論文
抄録
Objective: 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.
Design: Two-center, prospective observational study
Setting: Mixed medical/surgical intensive care unit (ICU) in Japan
Patients: Nonsurgical adult patients who were expected to remain in ICU for >5 days
Interventions: None
Methods: 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-AW), ICU Mobility Scale (IMS), and ICU mortality.
Measurements and Main Results: Fifty-six patients and 232 urinary titin measurements were included. Urinary titin (normal range: 1–3 pmol/mg Cr) 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 Cr 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 incidence of ICU-AW (p = 0.01) and ICU mortality (p = 0.02) but not with IMS (p = 0.18).
Conclusions: 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, incidence of ICU-AW, and ICU mortality.
掲載誌名
Critical Care Medicine
ISSN
00903493
15300293
cat書誌ID
AA00620383
出版者
Society of Critical Care Medicine|Wolters Kluwer Health
48
9
開始ページ
1327
終了ページ
1333
発行日
2020-07-16
備考
論文本文は2021-07-16以降公開予定
EDB ID
出版社版DOI
出版社版URL
言語
eng
著者版フラグ
その他
部局
病院
医学系