Decreased serum fatty acid binding protein 4 concentrations are associated with sarcopenia in chronic hemodialysis patients

et al. 2020

Preprint

Background Low physical performance in patients undergoing maintenance hemodialysis is associated with a high mortality rate. We investigated the clinical relevance of gait speed and handgrip strength, the two most commonly used methods of assessing physical performance.Methods We obtained data regarding gait speed and handgrip strength from 277 hemodialysis patients and evaluated their relationships with baseline parameters, mental health, plasma inflammatory markers, and major adverse clinical outcomes. Low physical performance was defined by the recommendations suggested by the Asian Working Group on Sarcopenia.Results The prevalence of low gait speed and handgrip strength was 28.2% and 44.8%, respectively. Old age, low serum albumin levels, high comorbidity index score, and impaired cognitive functions were associated with low physical performance. Patients with isolated low gait speed exhibited a general trend for worse quality of life than those with isolated low handgrip strength. Gait speed and handgrip strength showed very weak correlations with different determining factors (older age, the presence of diabetes, and lower serum albumin level for low gait speed, and lower body mass index and the presence of previous cardiovascular events for low handgrip strength). Patients with low gait speed and handgrip strength had elevated levels of plasma endocan and matrix metalloproteinase-7 and the highest risks for all-cause mortality and cardiovascular events among the groups (adjusted hazard ratio of 2.72, p = 0.024). Elderly patients with low gait speed and handgrip strength were at the highest risk for poor clinical outcomes.Conclusion Gait speed and handgrip strength reflected distinctive aspects of patient characteristics and the use of both factors improved the prediction of adverse clinical outcomes in hemodialysis patients. Gait speed seems to be a better indicator of poor patient outcomes than is handgrip strength.

Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Gait speed and handgrip strength as predictors of all-cause mortality and cardiovascular events in hemodialysis patient

et al. 2020

Preprint

“…The inverse relationship between Kt/V and physical performance was consistently shown in other studies, suggesting that this relationship is likely to be a universal phenomenon [24,33,35,42]. We speculate that the low muscle mass and subsequent decreased volume of distribution of urea in the body (V) in patients with low GS and HS resulted in a relative increase in the value of Kt/V without affecting the true dialysis efficacy [43].…”

Section: Discussionsupporting

confidence: 61%

“…Compared to the elderly population, in which the prevalence of sarcopenia is 11% [32], CKD patients are likely to be much more prone to its occurrence, with an estimated prevalence of 30 -60% [20,21,24,[33][34][35]. The two main components of sarcopenia, muscle strength and mass, are dissociated in the setting of ESRD, and the muscle strength is more important than muscle mass in terms of patient outcomes [20,34].…”

Section: Discussionmentioning

confidence: 99%

Gait speed and handgrip strength as predictors of all-cause mortality and cardiovascular events in hemodialysis patient

et al. 2020

Preprint

Background Low physical performance in patients undergoing maintenance hemodialysis is associated with a high mortality rate. We investigated the clinical relevance of gait speed and handgrip strength, the two most commonly used methods of assessing physical performance. Methods We obtained data regarding gait speed and handgrip strength from 277 hemodialysis patients and evaluated their relationships with baseline parameters, mental health, plasma inflammatory markers, and major adverse clinical outcomes. Low physical performance was defined by the recommendations suggested by the Asian Working Group on Sarcopenia. Results The prevalence of low gait speed and handgrip strength was 28.2% and 44.8%, respectively. Old age, low serum albumin levels, high comorbidity index score, and impaired cognitive functions were associated with low physical performance. Patients with isolated low gait speed exhibited a general trend for worse quality of life than those with isolated low handgrip strength. Gait speed and handgrip strength showed very weak correlations with different determining factors (older age, the presence of diabetes, and lower serum albumin level for low gait speed, and lower body mass index and the presence of previous cardiovascular events for low handgrip strength). Patients with low gait speed and handgrip strength had elevated levels of plasma endocan and matrix metalloproteinase-7 and the highest risks for all-cause mortality and cardiovascular events among the groups (adjusted hazard ratio of 2.72, p = 0.024). Elderly patients with low gait speed and handgrip strength were at the highest risk for poor clinical outcomes. Conclusion Gait speed and handgrip strength reflected distinctive aspects of patient characteristics and the use of both factors improved the prediction of adverse clinical outcomes in hemodialysis patients. Gait speed seems to be a better indicator of poor patient outcomes than is handgrip strength.

“…Compared to the elderly population, in which the prevalence of sarcopenia is 11% [32], CKD patients are likely to be much more prone to its occurrence, with an estimated prevalence of 30 -60% [20,21,24,[33][34][35]. The two main components of sarcopenia, muscle strength and mass, which are dissociated in the settings of ESRD and the functional aspects of skeletal muscle, are more important than muscle mass in terms of patient outcomes [20,34].…”

Section: Discussionmentioning

confidence: 99%

Gait speed and handgrip strength as predictors of all-cause mortality and cardiovascular events in hemodialysis patient

et al. 2020

Preprint

Background Low physical performance in patients undergoing maintenance hemodialysis is associated with a high mortality rate. We investigated the clinical relevance of gait speed and handgrip strength, the two most commonly used methods to assess physical performance.Methods We obtained data regarding gait speed and handgrip strength from 277 hemodialysis patients and evaluated their relationship with baseline parameters, mental health, plasma inflammatory markers, and major adverse clinical outcomes. Low physical performance was defined by the recommendations suggested by the Asian Working Group on Sarcopenia.Results The prevalence of low gait speed and handgrip strength were 28.2% and 44.8%, respectively. Old age, low serum albumin levels, high comorbidity index, and impaired cognitive functions were associated with low physical performance. Patients with isolated low gait speed exhibited a general trend for worse quality of life than those with isolated low handgrip strength. Gait speed and handgrip strength showed very weak correlations with had different determinant factors (older age, the presence of diabetes, and lower serum albumin for low gait speed, and lower body mass index, and the presence of previous cardiovascular events for low handgrip strength). Patients with low gait speed and handgrip strength had elevated levels of plasma endocan and matrix metalloproteinase-7 and the highest risk of all-cause mortality and cardiovascular events among the groups (adjusted hazard ratio of 2.72, p = 0.024).Conclusion Gait speed and handgrip strength reflected distinctive aspects of patient characteristics and that their combination improved the prediction of adverse clinical outcomes in hemodialysis patients. Gait speed seems to be a better indicator for poor patient outcomes compared with handgrip strength.