Assessment of muscle damage in patients with advanced Duchenne muscular dystrophy based on serum creatinine and the height-to-creatinine ratio

Background Duchenne muscular dystrophy (DMD) is a fatal, X-linked neuromuscular disorder. This study investigated the correlation between serum markers and muscle damage in advanced DMD, retrospectively identified biochemical markers that reflect muscle damage in patients with advanced DMD, and provided a clinical basis for muscle assessment in advanced DMD. Methods We enrolled 70 male patients with DMD who were treated at the Affiliated Hospital of the Institute of Neurology, Anhui University of Chinese Medicine, between January 2018 and December 2025. They were divided into an advanced group (≥12 years) and a non-advanced group ( Results The levels of Scr and CK in the advanced group were lower than those in the non-advanced group, while the height-to-creatinine ratio was higher ( P r = −0.522, P = 0.003), while the height-to-creatinine ratio was significantly positively correlated with MRI scores ( r = 0.52, P = 0.003). Results of multiple linear regression analysis showed that Scr ( B = −0.056, P B = −0.018, P = 0.047) were independent predictors of the degree of muscle damage in patients with advanced DMD. Scr exhibited the strongest effect (standardized β = −1.007), with an adjusted R 2 of 0.375. Conclusion Scr reflects changes in total skeletal muscle mass in patients with advanced DMD. In conjunction with the height-to-creatinine ratio, these parameters provide an assessment indicator for skeletal muscle damage.