Kidney Week

Abstract: SA-PO153

Influence of Diabetes on Sarcopenia in Hemodialysis Patients

Session Information

• Nutrition, Inflammation, Metabolism: Clinical Trials, Biomarkers, Epidemiology
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Nutrition, Inflammation, and Metabolism

• 1401 Nutrition, Inflammation, Metabolism

Authors

• Okuno, Senji, Shirasagi Hospital, Osaka, Japan

Senji Okuno,

• Miyawaki, Jiro, Shirasagi Hospital, Osaka, Japan

Jiro Miyawaki,

• Okazaki, Hisanori, Shirasagi Hospital, Osaka, Japan

Hisanori Okazaki,

• Norimine, Kyoko, Shirasagi Hospital, Osaka, Japan

Kyoko Norimine,

• Shoji, Shigeichi, Shirasagi Hospital, Osaka, Japan

Shigeichi Shoji,

• Yamakawa, Tomoyuki, Shirasagi Hospital, Osaka, Japan

Tomoyuki Yamakawa,

• Ishimura, Eiji, Osaka City University Graduate School of Medicine, Osaka, Japan

Eiji Ishimura,

• Inaba, Masaaki, Osaka City University Graduate School of Medicine, Osaka, Japan

Masaaki Inaba,

Background

Recently, the associations between sarcopania and diabetes and between sarcopenia and chronic kidney disease, including hemodialysis (HD) condition, have been reported. However, there have been few reports that examine the relationship between sarcopenia and diabetes in HD patients. Little is known how far diabetes affects sarcopenia in HD patients. Moreover, definition of sarcopenia was made only in considering the low muscle mass in most of the previous studies. The purpose of this study was to assess sarcopenia which was strictly assessed by both muscle mass and muscle strength, and was to examine the association of diabetes with sarcopenia in HD patients.

Methods

A total of 308 patients on maintenance HD (age 58.1 ± 11.9 years, HD duration 6.5 ± 6.0 years, 60 % males, and 33 % diabetics) were examined. Appendicular skeletal muscle mass was 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. Sarcopenia was defined as decline in both SMI hand grip strength.

Results

There were no significant differences in HD duration or in hemoglobin between patients with and without sarcopenia. Age was significantly higher, and body mass index and serum albumin were significantly lower in patients with sarcopenia than in those without sarcopenia (63.5 ± 11.0 vs. 54.1 ± 11.0 years, p < 0.0001; 19.4 ± 2.5 vs. 21.2 ± 2.3 kg/m², p < 0.0001 and 3.9 ± 0.3 vs. 4.1 ± 0.3 g/dL, p < 0.0001, respectively). Prevalence of sarcopenia in diabetic patients was significantly higher than that in non-diabetic patients (51 % vs. 36 %, p = 0.0151). In a multiple logistic regression analysis, presence of diabetes (OR = 3.02, p = 0.0008) was significantly, independenly associated with sarcopenia after adjustment with age, gender, HD duration, body mass index, hemoglobin, serum albumin, and C-reactive protein levels (R² = 0.273, p < 0.0001).

Conclusion

Present study clearly demonstrates, for the first time, that, in HD patients who are considered to be at higher prevalence of sarcopenia, diabetes is further an additional, strong risk factor for sarcopenia, which was strictly assessed by both muscle mass and muscle strength.