Differences in the prevalence of sarcopenia in haemodialysis patients: the effects of gender and ethnicity

Yoowannakul, Suree; Tangvoraphonkchai, Kamonwan; Vongsanim, Surachet; Mohamed, Ahmed F.; Davenport, Andrew

doi:10.1111/jhn.12555

Cited by 46 publications

(35 citation statements)

References 24 publications

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“…Advanced age and multiple morbidities were associated with higher risk of sarcopenia, which are compatible with the findings from previous studies [18–21]. The presence of diabetic nephropathy increased the risk of sarcopenia, which was likely to the direct chronic loss of proteins in the urine in diabetic nephropathy, resulting in reduced body muscle mass.…”

Section: Discussionsupporting

confidence: 90%

Prevalence of and factors associated with sarcopenia among multi-ethnic ambulatory older Asians with type 2 diabetes mellitus in a primary care setting

et al. 2019

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Background Sarcopenia is the age-related loss of muscle mass and function, which increases fall risks in older persons. Hyperglycemia relating to Type-2 Diabetes Mellitus (T2DM) is postulated to aggravate sarcopenia. This study aimed to determine the prevalence of sarcopenia among ambulatory community-dwelling older patients, aged 60–89 years, with T2DM in a primary care setting and to identify factors which mitigate sarcopenia. Methods A total of 387 patients were recruited from a public primary care clinic in Singapore. Data on their socio-demography, clinical and functional status, levels of physical activity (International Physical Activity Questionnaire) and frailty status was collected. The Asian Working Group for Sarcopenia (AWGS) criteria were used to define sarcopenia based on muscle mass, grip strength and gait speed. Results The study population comprised men (53%), Chinese (69%), mean age = 68.3 ± SD5.66 years, lived in public housing (90%), had hypertension (88%) and dyslipidemia (96%). Their mean muscle mass was 6.3 ± SD1.2 kg/m 2 ; mean gait speed was 1.0 ± SD0.2 m/s and mean grip strength was 25.5 ± SD8.1 kg. Overall, 30% had pre-sarcopenia, 24% with sarcopenia and 4% with severe sarcopenia. Age (OR = 1.14; 95%CI = 1.09–1.20; p < 0.001), multi-morbidity (OR = 1.25;95%CI = 1.05–1.49; p = 0.011) diabetic nephropathy (OR = 2.50;95%CI = 1.35–5.13; p = 0.004), hip circumference (OR = 0.86;95%CI = 0.82–0.90;p < 0.001) and number of clinic visits in past 1 year (OR = 0.74; 95%CI = 0.59–0.92; p = 0.008) were associated with sarcopenia. Conclusions Using AWGS criteria, 58% of older patients with T2DM had pre-sarcopenia and sarcopenia. Age, diabetic nephropathy, hip circumference, multi-morbidity and fewer clinic visits, but not a recent single HBA1c reading, were significantly associated with sarcopenia among patients with T2DM. A longitudinal relationship between clinic visits and sarcopenia should be further evaluated. (250 words)

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Section: Discussionsupporting

confidence: 90%

Prevalence of and factors associated with sarcopenia among multi-ethnic ambulatory older Asians with type 2 diabetes mellitus in a primary care setting

et al. 2019

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“…We noted that patients from an Asian background had lower muscle mass compared to white and black patients and had a lower appendicular muscle mass compared to other ethnicities ( 12–29 ) . This supports previous reports conducted in kidney dialysis patients and has been recognised by guideline committees that have proposed different parameters for defining sarcopenia in Asian patients compared to Europeans ( 2,12,18 ) .…”

Section: Discussionmentioning

confidence: 74%

“…The Sarc-F questionnaire provides some information about physical fitness and there was a univariate association between muscle strength and lower Sarc-F scores, whereas there was no such association with co-morbidity scores. We noted that patients from an Asian background had lower muscle mass compared to white and black patients and had a lower appendicular muscle mass compared to other ethnicities (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) . This supports previous reports conducted in kidney dialysis patients and has been recognised by guideline committees that have proposed different parameters for defining sarcopenia in Asian patients compared to Europeans (2,12,18) .…”

Section: Discussionmentioning

confidence: 84%

Body composition and weakness of hand grip strength and pinch strength in patients with chronic kidney disease from different ethnic backgrounds

Jiang

Slee

Davenport

2020

J Human Nutrition Diet

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“…Compared with the general population, the HGS of CKD patients was 5–15 kg lower [ 25 – 27 ] and LMI was more than 2 kg/m 2 lower [ 40 – 43 ]. According to the cut-off values of HGS and LMI for the diagnosis of sarcopenia in the general population recommended by existing guidelines, the prevalence of sarcopenia in dialyzed patients is 11–68% [ 21 , 22 , 44 , 45 ]. This wide range partially represented the lack of commonly-recognized definition for the diagnosis of low muscle mass and low muscle strength [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

The cut-off values of handgrip strength and lean mass index for sarcopenia among patients on peritoneal dialysis

Yang

et al. 2020

Nutr Metab (Lond)

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Background Sarcopenia is common and contributes to a high risk of mortality among general population. There is no consensus regarding the cut-off values for sarcopenia in terms of mortality among chronic kidney disease patients. This study aimed to explore and validate cut-off points of handgrip strength (HGS) and lean mass index (LMI) for estimating the risk of mortality in peritoneal dialysis (PD) patients. Methods This single-center prospective cohort study enrolled 1089 incident PD patients between October 2002 and July 2019. All patients were followed until death, transfer to hemodialysis, receiving renal transplantation or the end date of study (December 2019). All participants were randomly sampled to development cohort (70% participants) and validation cohort (30% participants), matched by gender and diabetes. Lean body mass was calculated by using the equation published by our center. Cubic spline regression analysis was used to examine the relationship between HGS or LMI values and mortality, and explore the cut-off points after adjusting for age, diabetes, cardiovascular disease and serum albumin in the development cohort. The derived cut-off values were verified by the agreement rate for predicting mortality and then compared with cut-off values from various clinical guidelines in the validation cohort. Results All 1089 patients were followed up with the median of 36.0 (18.0, 71.0) months. In the development cohort, cut-off points for predicting the higher mortality were derived as 24.5 kg and 14 kg of HGS for males and females, 16.7 kg/m2 and 13.8 kg/m2 of LMI for males and females respectively. In the validation cohort, these cut-off values significantly predicted worse outcomes, with HR 1.96 (1.35, 2.84) of HGS and HR 1.76 (1.26, 2.47) of LMI for all-cause mortality after multivariate adjustment. The newly derived cut-off points of HGS have numerically higher prognostic values in all-cause mortality compared with those from current clinical guidelines, and agreement rates of HGS were 65.2 versus 62.5–64.6 respectively. Conclusions The derived cut-off values of HGS and LMI have sufficient and better prognostic value in predicting all-cause mortality in PD patients compared with the cut-off values in the existing guidelines. These cut-off values are only validated in a single population, thus limiting the generalizability.

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Differences in the prevalence of sarcopenia in haemodialysis patients: the effects of gender and ethnicity

Cited by 46 publications

References 24 publications

Prevalence of and factors associated with sarcopenia among multi-ethnic ambulatory older Asians with type 2 diabetes mellitus in a primary care setting

Prevalence of and factors associated with sarcopenia among multi-ethnic ambulatory older Asians with type 2 diabetes mellitus in a primary care setting

Body composition and weakness of hand grip strength and pinch strength in patients with chronic kidney disease from different ethnic backgrounds

The cut-off values of handgrip strength and lean mass index for sarcopenia among patients on peritoneal dialysis

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