Abstract
BackgroundProtein-energy wasting is common in patients with end-stage kidney disease. However, few studies have examined the relationship between early stages of chronic kidney disease (CKD) and sarcopenia.MethodsWe conducted a cross-sectional study based on data in the Korea National Health and Nutrition Examination Survey, 2008–2011. In total, 11,625 subjects aged 40 years or older who underwent dual-energy X-ray absorptiometry were analyzed. Sarcopenia was defined based on values of appendicular skeletal muscle mass as a percentage of body weight (ASM/Wt) two standard deviations below the gender-specific mean for young adults. Estimated glomerular filtration rates (eGFR) were calculated using the CKD-EPI equation.ResultsMean age, body mass index (BMI), and HOMA-IR were higher and caloric intake, physical activity, and vitamin D level were lower in the sarcopenia groups in both men and women. As the stage of CKD increased, the prevalence of sarcopenia increased, even in the early stages of CKD (normal and CKD1, 2, and 3-5: 2.6%, 5.6%, and 18.1% in men and 5.3%, 7.1%, and 12.6% in women, respectively; p < 0.001). In addition, a correlation analysis showed that GFR and ASM/Wt had significant correlations in both men and women. Logistic regression analyses, after adjusting for age, BMI, caloric intake, log(physical activity), vitamin D level, and log(HOMA-IR), showed that the odds ratio for sarcopenia with respect to CKD 3–5 was 1.93 (95% CI = 1.02–3.68) in men but was not statistically significant in women.ConclusionsThe prevalence of sarcopenia was higher in elderly Korean patients with even mildly reduced kidney function. Stage of CKD was associated with an increased prevalence of sarcopenia in men but not women. Thus, we should evaluate the risk of sarcopenia and work to prevent it, even in patients with early CKD.
Highlights
Loss of muscle mass, especially skeletal muscle mass, is an important age-related change
Body mass index (BMI), and homeostasis model assessment estimate of insulin resistance (HOMA-IR) were higher and caloric intake, physical activity, and vitamin D level were lower in the sarcopenia groups in both men and women
The prevalence of sarcopenia was higher in elderly Korean patients with even mildly reduced kidney function
Summary
Especially skeletal muscle mass, is an important age-related change. The term ‘sarcopenia’ is used to describe progressive muscle mass loss associated with aging [1]. The reported prevalence of sarcopenia ranges from 7% to 24% due to the lack of a generally accepted definition and heterogeneity within study populations [2]. The European Working Group on Sarcopenia in Older People (EWGSOP) published a report titled “Sarcopenia: European consensus on definition and diagnosis” in 2010 [3]. Loss of lean body mass leads to frequent falls, osteoporosis, and related complications [4]. Protein-energy wasting is common in patients with end-stage kidney disease. Few studies have examined the relationship between early stages of chronic kidney disease (CKD) and sarcopenia
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