Abstract
Natural killer (NK) cells are lymphocytes of innate immune system that function to guard against tumors and infection. Reduced NK cell activities have been suggested in patients undergoing hemodialysis (HD). Sarcopenia, a syndrome of reduction of skeletal muscle mass and function, is quite common in HD patients and has been reported to associate with decrease immune system responsiveness. The aim of this study is to determine the relationship between NK cells activity and sarcopenia in HD patients. We enrolled 77 clinically stable HD patients who volunteered for the study. Patients with active malignancy or those taking immunosuppressant drugs were excluded. Baseline clinical characteristics and hemodialysis data were collected from electronic medical chart review. NK cell activity was assessed using NK Vue™ assay (ATGen Co., Seoul, Korea) that uses serum of ex vivo stimulated whole blood to detect interferon (IFN)-γ secreted from NK cells as an indicator of NK cell activity. The body composition was evaluated by bioimpedance analysis (Inbody S10) and the diagnosis of sarcopenia was made according to the guidelines of Asian Working Group for Sarcopenia (AWGS). The mean age was 63.2 years and 58.4% were men. A total of 22 patients (28.6%) were diagnosed as sarcopenia among 77 HD patients, and sarcopenic HD patients were significantly older (69.2 +/- 13.8 vs. 60.8 +/- 15.4 years, P<0.01), whereas showed lower BMI (20.7 +/- 3.8 vs. 23.4 +/- 6.2 kg/m2, P=0.01), lower appendicular lean muscle mass (ALM, 8.26 +/- 2.8 vs. 9.83 +/- 4.5 kg/m2, P<0.01), and lower activity of NK cell (296 +/- 111 vs. 480 +/- 225 pg/mL, P=0.03). Low NK cell activity had a significant correlation with sarcopenia, and the statistical significance was maintained even after adjustment for age, sex, BMI, ALM in multivariate regression analysis. Our results show that the NK cell activity of sarcopenic HD patients is significantly decreased and such low NK cell activity may contribute to development of sarcopenia in HD patients.
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