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Abstract: TH-PO827

Appropriate Evaluation of Sarcopenia Among Hemodialysis Patients: Impact of Different Indices of Muscle Mass and Myokines

Session Information

Category: Health Maintenance‚ Nutrition‚ and Metabolism

  • 1400 Health Maintenance‚ Nutrition‚ and Metabolism

Authors

  • Oh, Donghwan, Gangnam Severance Hospital, Seoul, Korea (the Republic of)
  • Park, Hae Yeul, Gangnam Severance Hospital, Seoul, Korea (the Republic of)
  • Jhee, Jong Hyun, Gangnam Severance Hospital, Seoul, Korea (the Republic of)
  • Lee, Jung eun, Yongin Severance Hospital, Yongin, Korea (the Republic of)
  • Choi, Hoon Young, Gangnam Severance Hospital, Seoul, Korea (the Republic of)
  • Park, Hyeong cheon, Gangnam Severance Hospital, Seoul, Korea (the Republic of)
Background

No consensus exists for appropriate adjustment methods and cutoff values for the diagnosis of sarcopenia in hemodialysis (HD) patients. The aim of study was to investigate proper method for normalizing skeletal muscle mass to define low muscle mass (LMM) and assess myokines as potential biomarkers for sarcopenia.

Methods

We conducted a cross-sectional observational study in a cohort of 139 Korean HD patients. All patients underwent bioelectrical impedance analysis (BIA) to measure muscle mass after HD session. Appendicular skeletal muscle mass (ASM) was indexed to height-squared (HT2), body surface area (BSA), body mass index (BMI), and body weight (BW). Handgrip strength (HGS) and muscle function were evaluated using a handgrip dynamometer and a gait speed test, respectively. Serum myostatin was measured by enzyme-linked immunosorbent assay kit.

Results

The mean age of participants was 63.9±13.1 years, and 49.6% was male. Depending on the equation used to standardize ASM, the prevalence of LMM ranged from 17.3 to 29.5% and the prevalence of sarcopenia ranged from 11.5 to 20.9%. The prevalence of LMM adjusted for HT2 and BW was not constant, in contrast no significant difference in LMM indexed to BSA and BMI was observed among the different BMI groups (normal:BMI<23kg/m2, overweight:23kg/m2≤BMI<25kg/m2, obese:BMI>25 kg/m2). Muscle strength was positively correlated with muscle mass normalized by HT2, BSA, and BMI (r=0.63, 0.62 and 0.60, P<0.001, respectively), but the association was less robust in muscle mass indexed to BW (r=0.49, P<0.001). In term of the correlation between muscle mass and performance, there were significant direct corrections with all muscle mass indices, although the correlation was less robust. Patients with LMM by all definitions, especially BSA, were more likely to have muscle weakness compared to those with normal muscle mass (OR 3.07, 95% CI 1.19-7.91, P=0.021). Serum myostatin level was proportional to muscle mass (r=0.417, P<0.001) and was positively correlated with muscle strength (r=0.527, P<0.001) and performance (r=0.343, P<0.001).

Conclusion

Muscle mass index adjusted to BSA and BMI is superior to height or weight alone in terms of diagnosis of sarcopenia in HD patients. Moreover, serum myostatin may act as an adjunct biomarker for sarcopenia in HD patients.