Abstract: SA-PO903

Relationship between Sarcopenia and Bone Mineral Density in Hemodialysis (HD) Patients

Session Information

  • Mineral Disease: CKD-Bone
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Mineral Disease

  • 1203 Mineral Disease: CKD-Bone

Authors

  • Okuno, Senji, Shirasagi Hospital, Osaka, Japan
  • Okazaki, Hisanori, Shirasagi Hospital, Osaka, Japan
  • Miyawaki, Jiro, Shirasagi Hospital, Osaka, Japan
  • Norimine, Kyoko, Shirasagi Hospital, Osaka, Japan
  • Shoji, Shigeichi, Shirasagi Hospital, Osaka, Japan
  • Yamakawa, Tomoyuki, Shirasagi Hospital, Osaka, Japan
  • Ishimura, Eiji, Osaka City University Graduate School of Medicine, Osaka, Japan
  • Inaba, Masaaki, Osaka City University Graduate School of Medicine, Osaka, Japan
Background

Little is known about the relationship between sarcopenia and bone mass in HD patients. Moreover, definition of sarcopenia was made only in considering the muscle mass in most of the previous studies. The purpose of this study was to strictly assess sarcopenia by both muscle mass and muscle strength in HD patients, and was to compare bone mineral density (BMD) between HD patients with and without sarcopenia.

Methods

A total of 287 patients on maintenance HD were examined. BMD at the 1/3 distal radius and appendicular skeletal muscle mass were measured by dual energy X-ray absorptiometry (DXA). Low muscle mass was defined as skeletal muscle mass index (SMI) of < 6.87 kg/m2 for males and < 5.46 kg/m2 for females. Low muscle strength was defined as hand grip strength of < 26 kg for males and < 18 kg for females, according to the criteria of Asian Working Group for Sarcopenia. Sarcopenia was defined as decline in both hand SMI and grip strength.

Results

There were no significant differences in HD duration or in prevalence of diabetes between patients with and without sarcopenia in both genders. Age was significantly higher in patients with sarcopenia than those without sarcopenia in both genders (62.2 ± 12.7 vs. 53.3 ± 10.4 years, p < 0.0001 in males; and 65.3 ± 8.6 vs. 55.3 ± 11.2 years, p < 0.0001 in females). BMD of the 1/3 distal radius in patients with sarcopenia was significantly lower than that of patients without sarcopenia in both genders (0.62 ± 0.12 vs. 0.69 ± 0.09 g/cm2, p < 0.0001 in males; and 0.44 ± 0.09 vs. 0.53 ± 0.09 g/cm2, p < 0.0001 in females). In a multiple linear regression analysis, presence of sarcopenia (β = - 0.196, p = 0.0075 in males; β = - 0.188, p = 0.0340 in females) was significantly, independenly associated with BMD of the 1/3 distal radius after adjustment with age, HD duration, presence of diabetes, body mass index, and serum parathyroid hormone levels in both genders (R2 = 0.320, p < 0.0001 in males; and R2 = 0.448, p < 0.0001 in females).

Conclusion

These results clearly demonstrate that sarcopenia, which was strictly assessed by muscle mass and strength, is significantly associated with decrease in BMD in HD patients, suggesting that sarcopenia should be regarded as a significant risk factor for either osteoporosis or renal osteodystrophy in these patients.