Abstract: FR-PO810
Association of Myosteatosis with Poor Physical Function and Mortality in Hemodialysis Patients
Session Information
- Health Maintenance, Nutrition, Metabolism - II
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Cheng, Dongsheng, Department of Nephrology, Shanghai Sixth People's Hospital Affilated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Wang, Niansong, Department of Nephrology, Shanghai Sixth People's Hospital Affilated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
Background
Skeletal muscle area, which is measured by computed tomography (CT), can be divided into normal attenuation muscle area with little fat infiltration and low-attenuation muscle area with high fat infiltration. Herein, we aimed to investigate the differential effects of normal and low-attenuation muscles at the L3 vertebra and myosteatosis on physical function and mortality in patients undergoing hemodialysis.
Methods
All patients underwent non-enhanced abdominal CT. The skeletal muscle index (SMI), normal attenuation SMI (NSMI), low attenuation SMI (LSMI), and fatty muscle fraction (FMF) at the L3 vertebra were determined (as shown in figure 1). Physical function was measured using handgrip strength, gait speed, sit-to-stand in 60 s (STS-60) test, and instrumental activities of the daily living scale.
Results
There were 101 patients on maintenance hemodialysis (mean age 52.73, 39.6% women), and 19 patients died during a median follow-up time of 26.2 months. The NSMI was moderately positively correlated with handgrip strength, gait speed, and STS-60 score (rho:0.363 to 0.542;P < 0.001); In contrast, the LSMI was negatively correlated with all physical function measures ( rho: − 0.439 to -0.317;P < 0.001) . In multivariate regression analyses, larger NSMI, lower LSMI, and lower FMF than SMI were significant predictors of better physical performance . Moreover, according to the Kaplan–Meier curve and Cox regression analysis, high FMF (aHR 4.09, 95% CI [1.36, 12.32])and LSMI (aHR 4.28 [1.42,12.89]) were significantly associated with high mortality.
Conclusion
This study demonstrated distinct effects of normal and low-attenuation muscles on physical function. Moreover, it highlights the importance of myosteatosis in determining poor physical performance and predicting mortality in patients undergoing hemodialysis.
Figure 1. Muscle quality map at L3 derived from abdominal CT using region growing mode. The axial CT images at L3 were segmented into NAMA (red), LAMA (green), and IMAT (purple).