Abstract

Abstract Background and Aims Patients on hemodialysis are prone to undernutrition, malnutrition-inflammation-atherosclerosis (MIA) syndrome, and protein-energy wasting (PEW). One of the major adipocytokines adiponectin (ADPN) is involved in anti-arteriosclerotic and anti-inflammatory processes. However, ADPN is implicated in muscle weakness and loss of muscle mass in the elderly in addition to sarcopenia. At the 2019 ERA-EDTA Congress, we announced that total plasma ADPN levels in patients on hemodialysis (HD) showed a significant inverse correlation with BMI, body fat in percentage, mass and estimated skeletal muscle mass, and ADPN may be involved in sarcopenia in patients on HD. Herein, we investigated the association of ADPN level with sarcopenia in patients on HD using a method different from the one used in our previous study. We examined the relationship between total plasma ADPN level and the rate of change in estimated skeletal muscle mass, bone mineral content, and body fat mass over 5 years after the plasma ADPN measurement. Furthermore, we analyzed whether an elevated ADPN level was predictive of a subsequent decline in these parameters. Method Total plasma ADPN levels were measured using ELISA (Bio Vendor-Laboratorni Medicina a.s., Czech Republic) in 42 male patients on HD (age: 51.1 ± 9.0 years, dialysis vintage: 144.8 ± 99.2 months, BMI: 21.8 ± 3.2, dry BW: 62.0 ± 10.9 kg, dialysis time: 15.6 ± 3.1 hours/week). The estimates of skeletal muscle mass, bone mineral content, and body fat mass were made using multi-frequency bioelectrical impedance analysis (MFBIA) within the same year when total plasma ADPN level were first measured in 2011 as well as in 2016. We then calculated the rates of change in the estimated skeletal muscle mass, bone mineral content, and body fat mass over the 5 years and correlated these parameters with the total plasma ADPN measurements. Results Conclusion Total plasma ADPN levels inversely correlate with larger rates of decrease in estimated skeletal muscle mass and bone mineral content in patients on HD. This suggests that ADPN may play a role in the decline in skeletal muscle mass and bone mineral content over time in patients on HD.

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