Urinary titin as a potential biomarker of sarcopenia and its association with postoperative complications in colorectal cancer patients

INTRODUCTION: Studies suggest that older individuals are at risk colorectal cancer postoperative complications following colorectal cancer owing to preoperative sarcopenia, and the prevention of these complication is crucial. The Prognostic Nutritional Index is a preoperative nutritional assessment, and its association with postoperative complications and sarcopenia have been previously reported. PURPOSE: A reduction in skeletal muscle mass is essential for diagnosing sarcopenia, there are no available biomarkers that evaluate this. Thus, we focused on titin, a giant elastic protein present in skeletal muscle. MATERIAL AND METHODS: This study was conducted as a prospective observational cohort study. A total of 105 patients who underwent colorectal cancer surgery in our department were included in the study. The patients were divided into two groups: those with and those without postoperative complications of Clavien-Dindo classification II or higher, and those with Prognostic Nutritional Index of 40 or higher or lower. Using blood samples, nutritional markers, inflammatory markers, urinary titin, and psoas volume, univariate and multivariate analyses were performed between the two groups to examine risk factors. RESULTS: Postoperative complication group comprised 12 patients, and comparisons between the two groups revealed a trend toward higher urinary titin in the group with complications with significant differences in univariate and multivariate analysis. The group with Prognostic Nutritional Index of