Evidence map›Paper›PMID 41580653›Full record

ArticleBMC neurology2026

Serum creatinine to cystatin C ratio as a biomarker for monitoring motor-function in children with spinal muscular atrophy treated with nusinersen: a retrospective cohort study.

Yuan Yuan Zhang, Jie Wang, Zhen Qiong Cui, Kai Ma

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Article in BMC neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Yuan Yuan Zhang *Department of Paediatrics, Affiliated Liaocheng Second People's Hospital of Shandong First Medical University, Liaocheng, Shandong Province, China.
Jie Wang *Department of Neurology, Jinan Children's Hospital (Children's Hospital Affiliated to Shandong University), Jinan, Shandong Province, China.
Zhen Qiong CuiDepartment of Neurology, Jinan Children's Hospital (Children's Hospital Affiliated to Shandong University), Jinan, Shandong Province, China.
Kai MaDepartment of Neurology, Jinan Children's Hospital (Children's Hospital Affiliated to Shandong University), Jinan, Shandong Province, China. shdhmmk@126.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo validate the clinical utility of creatinine-to-cystatin C ratio (CCR) as a biomarker for monitoring nusinersen treatment response in Chinese paediatric patients receiving nusinersen monotherapy.

methodsIn this retrospective, single-center study, 33 genetically confirmed 5q-SMA patients (≤ 18 years) treated with intrathecal nusinersen for ≥ 26 months (2020.2-2025.6) were enrolled. Motor function was serially evaluated using the Hammersmith Functional Motor Scale Expanded (HFMSE), Revised Upper Limb Module (RULM), and Hammersmith Infant Neurological Exam Part 2 (HINE-2). Serum biomarkers, such as creatinine (Cr), creatine kinase (CK), and cystatin C, were measured at multiple time points. A linear mixed-effects model (adjusted for age, body mass index, SMA type, and treatment duration) was used to assess the biomarker-function associations.

resultsAmbulant patients and those with four SMN2 copies demonstrated elevated CCR and Cr levels compared to non-ambulant patients and those with three SMN2 copies at baseline. Serum CCR levels were significantly higher than the baseline at V4-V8 (10-26 months). Cr levels were significantly higher than the baseline at V8 (26 months), whereas CK and cystatin C levels remained unchanged. In the fully adjusted linear mixed-effects models, both CCR and Cr were positively associated with HFMSE and RULM scores. However, only CCR remained significant after adjustment. Cystatin C levels were inversely correlated with the HINE-2 scores.

conclusionCCR is a promising biomarker in paediatric SMA patients receiving nusinersen monotherapy; however, its validity and generalizability require confirmation in larger, more diverse multicenter cohorts.

Indexed as

CreatinineCystatin CMuscular Atrophy, SpinalOligonucleotidesSpinal Muscular Atrophies of ChildhoodAdolescentBiomarkersChildChild, PreschoolFemaleHumansInfantMaleRetrospective StudiesTreatment OutcomeBiomarkersCreatinineCystatin CnusinersenOligonucleotidesChildrenCreatinine-to-cystatin C ratioNusinersenRetrospective cohort studySerum biomarkersSpinal muscular atrophy

Identifiers

PMID41580653
PMCPMC12910726

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.