TY - JOUR
T1 - Estimation of skeletal muscle mass in 4-year-old children using the D3-creatine dilution method
AU - Sidiqi, Aysha
AU - Fariha, Farzana
AU - Shanta, Shaila S
AU - Dasiewicz, Alison
AU - Mahmud, Abdullah Al
AU - Moore, Daniel R
AU - Shankaran, Mahalakshmi
AU - Hellerstein, Marc K
AU - Evans, William J
AU - Gernand, Alison D
AU - Islam, M. Munirul
AU - Abrams, Steven A
AU - Harrington, Jennifer
AU - Nyangau, Edna
AU - Roth, Daniel E
AU - O'Callaghan, Karen M
N1 - Funding Information:
This research was supported by funding from the Canadian Institutes of Health Research (PJT159596) and the Bill and Melinda Gates Foundation (OPP1176987). The funding agencies were not involved in the design, implementation, analysis or interpretation of the data.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/9
Y1 - 2023/9
N2 - Background: Given limited experience in applying the creatine-(methyl-D3) (D3Cr) dilution method to measure skeletal muscle mass (SMM) in young children, the feasibility of deployment in a fielding setting and performance of the method was assessed in a cohort of 4-year-old children in Dhaka, Bangladesh. Methods: Following D3Cr oral dose (10 mg) administration, single fasting urine samples were collected at 2–4 days (n = 100). Twenty-four-hour post-dose collections and serial spot urine samples on days 2, 3 and 4 were obtained in a subset of participants (n = 10). Urinary creatine, creatinine, D3Cr and D3-creatinine enrichment were analyzed by liquid chromatography–tandem mass spectrometry. Appendicular lean mass (ALM) was measured by dual-energy x-ray absorptiometry and grip strength was measured by a hand-held dynamometer. Results: SMM was measured successfully in 91% of participants, and there were no adverse events. Mean ± SD SMM was greater than ALM (4.5 ± 0.4 and 3.2 ± 0.6 kg, respectively). Precision of SMM was low (intraclass correlation = 0.20; 95% CI: 0.02, 0.75; n = 10). Grip strength was not associated with SMM in multivariable analysis (0.004 kg per 100 g of SMM; 95% CI: −0.031, 0.038; n = 91). Conclusions: The D3Cr dilution method was feasible in a community setting. However, high within-child variability in SMM estimates suggests the need for further optimization of this approach. Impact: The D3-creatine (D3Cr) stable isotope dilution method was considered a feasible method for the estimation of skeletal muscle mass (SMM) in young children in a community setting and was well accepted among participants.SMM was weakly associated with both dual-energy x-ray absorptiometry-derived values of appendicular lean mass and grip strength.High within-child variability in estimated values of SMM suggests that further optimization of the D3Cr stable isotope dilution method is required prior to implementation in community research settings.
AB - Background: Given limited experience in applying the creatine-(methyl-D3) (D3Cr) dilution method to measure skeletal muscle mass (SMM) in young children, the feasibility of deployment in a fielding setting and performance of the method was assessed in a cohort of 4-year-old children in Dhaka, Bangladesh. Methods: Following D3Cr oral dose (10 mg) administration, single fasting urine samples were collected at 2–4 days (n = 100). Twenty-four-hour post-dose collections and serial spot urine samples on days 2, 3 and 4 were obtained in a subset of participants (n = 10). Urinary creatine, creatinine, D3Cr and D3-creatinine enrichment were analyzed by liquid chromatography–tandem mass spectrometry. Appendicular lean mass (ALM) was measured by dual-energy x-ray absorptiometry and grip strength was measured by a hand-held dynamometer. Results: SMM was measured successfully in 91% of participants, and there were no adverse events. Mean ± SD SMM was greater than ALM (4.5 ± 0.4 and 3.2 ± 0.6 kg, respectively). Precision of SMM was low (intraclass correlation = 0.20; 95% CI: 0.02, 0.75; n = 10). Grip strength was not associated with SMM in multivariable analysis (0.004 kg per 100 g of SMM; 95% CI: −0.031, 0.038; n = 91). Conclusions: The D3Cr dilution method was feasible in a community setting. However, high within-child variability in SMM estimates suggests the need for further optimization of this approach. Impact: The D3-creatine (D3Cr) stable isotope dilution method was considered a feasible method for the estimation of skeletal muscle mass (SMM) in young children in a community setting and was well accepted among participants.SMM was weakly associated with both dual-energy x-ray absorptiometry-derived values of appendicular lean mass and grip strength.High within-child variability in estimated values of SMM suggests that further optimization of the D3Cr stable isotope dilution method is required prior to implementation in community research settings.
UR - http://www.scopus.com/inward/record.url?scp=85152452817&partnerID=8YFLogxK
U2 - 10.1038/s41390-023-02587-1
DO - 10.1038/s41390-023-02587-1
M3 - Article
SN - 0031-3998
VL - 94
SP - 1195
EP - 1202
JO - Pediatric Research
JF - Pediatric Research
IS - 3
ER -