Activin A level is associated with physical function in critically ill patients

Yi Tian Wang, Craig A. Harrison, Elizabeth H. Skinner, Kimberley J. Haines, Clare Holdsworth, Jenna K. Lang, Elizabeth Hibbert, David Scott, Nir Eynon, Ravindranath Tiruvoipati, Craig J. French, Nigel K. Stepto, Samantha Bates, Kelly L. Walton, Tim M. Crozier, Terry P. Haines

Research output: Contribution to journalArticleResearchpeer-review


Background: Activin A is a potent negative regulator of muscle mass elevated in critical illness. It is unclear whether muscle strength and physical function in critically ill humans are associated with elevated activin A levels. Objectives: The objective of this study was to investigate the relationship between serum activin A levels, muscle strength, and physical function at discharge from the intensive care unit (ICU) and hospital. Methods: Thirty-six participants were recruited from two tertiary ICUs in Melbourne, Australia. Participants were included if they were mechanically ventilated for >48 h and expected to have a total ICU stay of >5 days. The primary outcome measure was the Six-Minute Walk Test distance at hospital discharge. Secondary outcome measures included handgrip strength, Medical Research Council Sum Score, Physical Function ICU Test Scored, Six-Minute Walk Test, and Timed Up and Go Test assessed throughout the hospital admission. Total serum activin A levels were measured daily in the ICU. Results: High peak activin A was associated with worse Six-Minute Walk Test distance at hospital discharge (linear regression coefficient, 95% confidence interval, p-value: −91.3, −154.2 to −28.4, p = 0.007, respectively). Peak activin A concentration was not associated with the secondary outcome measures. Conclusions: Higher peak activin A may be associated with the functional decline of critically ill patients. Further research is indicated to examine its potential as a therapeutic target and a prospective predictor for muscle wasting in critical illness. Study registration: ACTRN12615000047594.

Original languageEnglish
Pages (from-to)702-707
Number of pages6
JournalAustralian Critical Care
Issue number5
Publication statusPublished - Sept 2023


  • Activins
  • ICU-acquired weakness
  • Mortality
  • Muscle
  • Sarcopenia
  • Skeletal

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