High prevalence of sarcopenia and myosteatosis in patients undergoing hemodialysis

Chen Fu; Dong Yan; Ling Wang; Fangfang Duan; Dalong Gu; Ning Yao; Mingke Sun; Di Wang; Xuya Lin; Yanglei Wu; Xiaofei Wang; Xiaoguang Cheng; Dongliang Zhang

doi:10.3389/fendo.2023.1117438

High prevalence of sarcopenia and myosteatosis in patients undergoing hemodialysis

Front Endocrinol (Lausanne). 2023 Mar 23:14:1117438. doi: 10.3389/fendo.2023.1117438. eCollection 2023.

Authors

Chen Fu¹, Dong Yan², Ling Wang², Fangfang Duan³, Dalong Gu², Ning Yao², Mingke Sun², Di Wang¹, Xuya Lin¹, Yanglei Wu⁴, Xiaofei Wang¹, Xiaoguang Cheng², Dongliang Zhang¹

Affiliations

¹ Department of Nephrology, Beijing Jishuitan Hospital, Beijing, China.
² Department of Radiology, Beijing Jishuitan Hospital, Beijing, China.
³ Clinical Epidemiology Research Center, Beijing Jishuitan Hospital, Beijing, China.
⁴ MR Collaboration, Siemens Healthineers Ltd., Beijing, China.

Abstract

Background and purpose: Sarcopenia is highly prevalent (28.5-40.3%) in patients undergoing hemodialysis and leads to poor clinical outcomes. However, the association between muscle quality and sarcopenia in patients receiving hemodialysis remains unclear. Therefore, we aimed to explore the association between muscle cross-sectional area (CSA) and proton-density fat-fraction (PDFF) in patients with sarcopenia undergoing hemodialysis.

Methods: Seventy-six patients undergoing hemodialysis for > 3 months were enrolled. Their handgrip strength (HGS), short physical performance battery (SPPB) performance, and appendicular skeletal muscle mass index (ASMI) were measured. Sarcopenia was defined using the Asian Working Group for Sarcopenia 2019 consensus update. All patients underwent quantitative magnetic resonance imaging. CSA and PDFF were measured for the thigh, trunk, and gluteus muscles.

Results: The prevalence of probable, confirmed, and severe sarcopenia in this study was 73.7%, 51.3%, and 22.4%, respectively. Older age (OR: 1.061, P < 0.003); lower body mass index (BMI) (OR: 0.837, P = 0.008), albumin (OR: 0.765, P = 0.004), prealbumin (OR: 0.987, P = 0.001), predialysis blood urea nitrogen (BUN) (OR: 0.842, P < 0.001), predialysis creatinine (OR: 0.993, P < 0.001), phosphorus (OR: 0.396, P = 0.047); lower CSA of the thigh (OR: 0.58, P = 0.035), third lumbar (L3) trunk (OR: 0.37, P = 0.004), gluteus minimus and medius (OR: 0.28, P = 0.001), and gluteus maximus (OR: 0.28, P= 0.001); and higher PDFF of the thigh (OR: 1.89, P = 0.036) and L3 trunk (OR: 1.71, P = 0.040) were identified as sarcopenia risk factors. The gluteus minimus and medius CSA was lower in patients with sarcopenia than in those without after adjusting for age and BMI (OR: 0.37, P = 0.017). Higher thigh (P = 0.031) and L3 trunk (P = 0.006) muscle PDFF were significantly associated with lower HGS. Furthermore, higher thigh (P = 0.011) and L3 trunk (P = 0.010) muscle PDFF were also inversely correlated with lower ASMI.

Conclusion: Our findings demonstrate the high prevalence of sarcopenia and myosteatosis in patients undergoing hemodialysis and might trigger a paradigm shift in intervention strategies for patients receiving hemodialysis.

Keywords: hand-grip strength; hemodialysis; muscle cross-sectional area; myosteatosis; proton-density fat-fraction; quantitative MRI; sarcopenia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Hand Strength
Humans
Muscle, Skeletal / diagnostic imaging
Muscle, Skeletal / pathology
Prevalence
Renal Dialysis / adverse effects
Sarcopenia* / epidemiology
Sarcopenia* / etiology
Sarcopenia* / pathology

Grants and funding

This project was supported by Beijing JST Research Funding (code: ZR-202210, ZR-202214), the National Natural Science Foundation of China (grant no. 81901718), the Beijing Hospitals Authority Youth Programme (code: QML20200402), Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support (code: ZYLX202107), and the Beijing Talents Fund (grant no. 2015000021467G177).