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Abstract: SA-PO178

Osteosarcopenia Predicts Fractures and Mortality in Hemodialysis Patients

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Yoshikoshi, Shun, Kitasato University Graduate School of Medical Sciences, Sagamihara, Kanagawa, Japan
  • Yamamoto, Shohei, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
  • Suzuki, Yuta, National Institute of Public Health, Wako, Saitama, Japan
  • Imamura, Keigo, Kitasato University Graduate School of Medical Sciences, Sagamihara, Kanagawa, Japan
  • Harada, Manae, Sagami Circulatory Organ Clinic, Sagamihara, Kanagawa, Japan
  • Uchida, Juri, Kitasato University Graduate School of Medical Sciences, Sagamihara, Kanagawa, Japan
  • Nakajima, Takuya, Kitasato University Graduate School of Medical Sciences, Sagamihara, Kanagawa, Japan
  • Fukuzaki, Narumi, Kitasato University Graduate School of Medical Sciences, Sagamihara, Kanagawa, Japan
  • Matsunaga, Atsuhiko, Kitasato University Graduate School of Medical Sciences, Sagamihara, Kanagawa, Japan
Background

With the aging of patients on hemodialysis (HD), the prevalence of osteoporosis (OP) and sarcopenia (SP) is increasing in the HD population. Osteosarcopenia (OS) is a unique syndrome that describes the co-existence of OP and SP. Since the causes of OP and SP share many common risk factors, OS may have a synergistic effect on the clinical outcomes. We investigated the associations of OS with mortality and fractures in HD patients.

Methods

This was a retrospective cohort study that targeted outpatients undergoing HD in Japan. OP was defined as T-score < -2.5 according to the WHO criteria. SP was defined according to the Asian Working Group for Sarcopenia criteria 2019. Patients were divided into 3 groups: robust (“non-OP and non-SP”), OP or SP alone (“OP and non-SP” or “non-OP and SP”), and OS (“OP and SP”). The outcomes were all-cause mortality and fractures. We used Cox proportional hazard and negative binomial regression models to estimate these associations.

Results

Data from 328 patients (mean age, 66 years; men, 59%) were analyzed. During the follow-up (median, 5 years), 113 fractures and 131 deaths occurred. OP, SP, and OS was identified in 54.6%, 33.5%, and 22.9%, respectively. Compared with the robust group, the incidence of fracture (Figure A) and mortality (Figure B) was significantly higher in those of OP or SP alone and OS, respectively (all P < 0.01). Patients with OP or SP alone (incidence rate ratio [IRR], 1.80; 95% confidence intervals [CIs], 1.08–3.02) and those with OS (IRR: 2.90, 95%CIs: 1.45–5.81) had significantly higher risks for fractures than the robust group. Associations of OS with mortality were similar to those between OS and fractures.

Conclusion

The prevalence of OP, SP, and OS was high among patients on HD. Patients with OP or SP had a poor prognosis, and combining OP and SP further worsened their prognosis, suggesting the need for screening and developing the treatment strategy against both OP and SP.

Kaplan–Meier analysis for the incidence of fractures (A) and mortality (B). OP; osteoporosis, OS; osteosarcopenia, SP; sarcopenia.

Funding

  • Government Support – Non-U.S.