Respiratory investigation · 2026
Urinary N-terminal titin fragment as a supplementary marker for frailty in chronic obstructive pulmonary disease.
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Kotajima Fumiya, Koga Yasuhiko, Yatomi Masakiyo, Tsurumaki Hiroaki, Aoki-Saito Haruka, Kato Daigo, Ito Isao, Wada Naoki, Hisada Takeshi
Аннотация
BACKGROUND: Frailty is common in patients with chronic obstructive pulmonary disease (COPD); however, its objective assessment in routine clinical management remains challenging. This exploratory study aimed to investigate the association between the urinary N-terminal titin fragment-to-creatinine ratio (N-titin/Cr), a noninvasive biomarker of muscle injury, and physical frailty in COPD.
METHODS: In this cross-sectional study, stable outpatients with COPD (n = 27) were enrolled. Physical frailty was assessed using the Japanese version of the Cardiovascular Health Study (J-CHS) criteria, and patients were classified as frail (J-CHS ≥3) or non-frail (J-CHS ≤2). Urinary N-titin/Cr was measured using enzyme-linked immunosorbent assay. Associations between N-titin/Cr and clinical variables were examined using correlation and multivariable regression analyses, and receiver operating characteristic (ROC) analysis was performed to evaluate frailty discrimination.
RESULTS: Urinary N-titin/Cr levels were significantly higher in the frailty group (median: 15.9 pmol/mg Cr vs. 6.1 pmol/mg Cr, P < 0.01). Multiple regression analysis revealed a significant association between N- titin/Cr and J-CHS scores (β = 4.38, P = 0.004), independent of age, pulmonary function, serum creatine kinase, and walking speed. ROC analysis showed moderate discrimination for frailty (area under the curve = 0.75).
CONCLUSION: These findings suggest that urinary N-titin/Cr reflects chronic muscle damage associated with frailty in COPD and may serve as a noninvasive and quantitative supplementary biomarker for frailty assessment.
METHODS: In this cross-sectional study, stable outpatients with COPD (n = 27) were enrolled. Physical frailty was assessed using the Japanese version of the Cardiovascular Health Study (J-CHS) criteria, and patients were classified as frail (J-CHS ≥3) or non-frail (J-CHS ≤2). Urinary N-titin/Cr was measured using enzyme-linked immunosorbent assay. Associations between N-titin/Cr and clinical variables were examined using correlation and multivariable regression analyses, and receiver operating characteristic (ROC) analysis was performed to evaluate frailty discrimination.
RESULTS: Urinary N-titin/Cr levels were significantly higher in the frailty group (median: 15.9 pmol/mg Cr vs. 6.1 pmol/mg Cr, P < 0.01). Multiple regression analysis revealed a significant association between N- titin/Cr and J-CHS scores (β = 4.38, P = 0.004), independent of age, pulmonary function, serum creatine kinase, and walking speed. ROC analysis showed moderate discrimination for frailty (area under the curve = 0.75).
CONCLUSION: These findings suggest that urinary N-titin/Cr reflects chronic muscle damage associated with frailty in COPD and may serve as a noninvasive and quantitative supplementary biomarker for frailty assessment.