Identification of the most clinically useful skeletal muscle mass indices pertinent to sarcopenia and physical performance in chronic kidney disease

Wilkinson, Thomas J; Nixon, Daniel; Richler-Potts, Danielle; Neale, Jill; Song, Yan; Smith, Alice C.

doi:10.1111/nep.13678

Cited by 12 publications

(9 citation statements)

References 42 publications

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“…Our study showed that the proportion of individuals of sarcopenia was high and consistent with those reported in some previous studies. For instance, Thomas et al found a 19% prevalence of sarcopenia in a research involving British non-dialysis adults [19]. In Dutch patients, the prevalence of sarcopenia was 23.3% [20].…”

Section: Discussionmentioning

confidence: 98%

Frailty and sarcopenia in elderly non-dialysis patients with chronic kidney disease stage 3-5: a cross sectional study

Chang

Wang

Hou

et al. 2020

Preprint

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Background With the aging of the population, chronic kidney disease (CKD) and sarcopenia are the common diseases among the elderly. Non-dialysis patients with CKD account for a relatively high proportion, and the analysis of their general clinical characteristics has been more familiar. However, the study of sarcopenia in non-dialysis with CKD is not enough. Methods This is a cross sectional study. Non-dialysis patients with CKD stage 3–5 were continuously selected. Patients were divided into 3 groups based on the Fried scale, Non-frail group, Pre-frail group and Frail group. At the same time, muscle mass of the hospitalized patients was measured by dual-energy X-ray absorptiometry (DXA), and according to the test results, they were divided into sarcopenia and non-sarcopenia group. Baseline data and the measurement of the sarcopenia of the two groups were analyzed. Results A total of 102 elderly patients with chronic kidney disease stage 3–5 were continuously enrolled. There were 21 patients (20.6%) categorized as sarcopenia, 81 patients (79.4%) categorized as non-sarcopenia according to the measurement results of DXA. Frailty was assessed by the criteria of frailty phenotype, there were 13 patients of sarcopenia in the frail group, 6 patients of sarcopenia in the pre-frail group, and 2 patients of sarcopenia in the non-frail group, accounting for 31.7%, 20.0%, 6.5%, respectively. Moreover, the analysis of the related risk factors of sarcopenia showed that body mass index (BMI)༜23 kg/m2(OR = 3.82, 95%CI 1.33–10.97, P = 0.013), MNA-SF ≤ 11(OR = 3.97, 95%CI 1.08–14.58, P = 0.038) were the independent risk factors for sarcopenia in non-dialysis patients with chronic kidney disease stage 3–5. Conclusions The prevalence of sarcopenia in elderly non-dialysis patients with chronic kidney disease stage 3–5 was high, and sarcopenia was common in the frail patients. BMI༜23 kg/m2 and MNA-SF ≤ 11were the independent risk factors for sarcopenia in non-dialysis patients with chronic kidney disease stage 3–5.

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Section: Discussionmentioning

confidence: 98%

Frailty and sarcopenia in elderly non-dialysis patients with chronic kidney disease stage 3-5: a cross sectional study

Chang

Wang

Hou

et al. 2020

Preprint

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“…Physical function and strength were assessed using frequently used assessments previously described in Wilkinson et al 1 Handgrip strength (HGS) of the dominant and non-dominant hands were assessed using a JAMAR hydraulic handheld dynamometer (Fabrication Enterprises Inc, Irvington, New York). Each participant had three attempts with each hand and the maximal score was taken for both.…”

Section: Methodsmentioning

confidence: 99%

“…Skeletal muscle health decreases with advancing age and several disease states, including chronic kidney disease (CKD). 1 , 2 This loss of skeletal muscle mass contributes to impairments in strength and physical function; 3 however, these adverse changes cannot be entirely accounted for by changes in muscle size. The concept of muscle quality is increasingly being used to assess skeletal muscle health.…”

Section: Introductionmentioning

confidence: 99%

Quantitative Muscle Ultrasonography Using 2D Textural Analysis: A Novel Approach to Assess Skeletal Muscle Structure and Quality in Chronic Kidney Disease

et al. 2021

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Chronic kidney disease (CKD) is characterized by progressive reductions in skeletal muscle function and size. The concept of muscle quality is increasingly being used to assess muscle health, although the best means of assessment remains unidentified. The use of muscle echogenicity is limited by an inability to be compared across devices. Gray level of co-occurrence matrix (GLCM), a form of image texture analysis, may provide a measure of muscle quality, robust to scanner settings. This study aimed to identify GLCM values from skeletal muscle images in CKD and investigate their association with physical performance and strength (a surrogate of muscle function). Transverse images of the rectus femoris muscle were obtained using B-mode 2D ultrasound imaging. Texture analysis (GLCM) was performed using ImageJ. Five different GLCM features were quantified: energy or angular second moment (ASM), entropy, homogeneity, or inverse difference moment (IDM), correlation, and contrast. Physical function and strength were assessed using tests of handgrip strength, sit to stand-60, gait speed, incremental shuttle walk test, and timed up-and-go. Correlation coefficients between GLCM indices were compared to each objective functional measure. A total of 90 CKD patients (age 64.6 (10.9) years, 44% male, eGFR 33.8 (15.7) mL/minutes/1.73 m2) were included. Better muscle function was largely associated with those values suggestive of greater image texture homogeneity (i.e., greater ASM, correlation, and IDM, lower entropy and contrast). Entropy showed the greatest association across all the functional assessments ( r = −.177). All GLCM parameters, a form of higher-order texture analysis, were associated with muscle function, although the largest association as seen with image entropy. Image homogeneity likely indicates lower muscle infiltration of fat and fibrosis. Texture analysis may provide a novel indicator of muscle quality that is robust to changes in scanner settings. Further research is needed to substantiate our findings.

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“…Described as a having model of “accelerated aging,” patients with chronic kidney disease (CKD) have aberrant changes in body composition, including wasting of skeletal muscle 1–5 . These changes are associated with increased mortality and adverse clinical outcomes 6,7 .…”

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confidence: 99%

“…Numerous factors are involved in these changes, including malnutrition, inflammation, and physical inactivity 1,8 . Prevalent in around one‐third of patients with CKD, 4,6 the term “sarcopenia” is hallmarked by the presence of low muscle mass 9 . Although tools such as bioelectrical impedance analysis (BIA), magnetic resonance imaging, dual‐energy x‐ray absorptiometry (DXA), and computed tomography are suggested by the European Working Group for Sarcopenia in Older People, access to these techniques may be limited by a lack of facilities, technical expertise, cost, and methodological concerns (eg, exposure to radiation) 10 .…”

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confidence: 99%

Utility of Ultrasound as a Valid and Accurate Diagnostic Tool for Sarcopenia

Wilkinson

Gore

Vadaszy

et al. 2020

J of Ultrasound Medicine

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Objectives Patients with chronic kidney disease (CKD) have aberrant changes in body composition, including low skeletal muscle mass, a feature of “sarcopenia.” The measurement of the (quadriceps) rectus femoris (RF) cross‐sectional area (CSA) is widely used as a marker of muscle size. Cutoff values are needed to help discriminate the condition of an individual's muscle (eg, presence of sarcopenia) quickly and accurately. This could help distinguish those at greater risk and aid in targeted treatment programs. Methods Transverse images of the RF were obtained by B‐mode 2‐dimensional ultrasound imaging. Sarcopenic levels of muscle mass were defined by established criteria (1, appendicular skeletal muscle mass [ASM]; 2, ASM/height2; and 3, ASM/body mass index) based on the ASM and total muscle mass measured by a bioelectrical impedance analysis. The discriminative power of RF‐CSA was assessed by receiver operating characteristic curves, and optimal cutoffs were determined by the maximum Youden index (J). Results One hundred thirteen patients with CKD (mean age [SD], 62.0 [14.1] years; 48% male; estimated glomerular filtration rate, 38.0 [21.5] mL/min/1.73m2) were included. The RF‐CSA was a moderate predictor of ASM (R2 = 0.426; P < .001) and total muscle mass (R2 = 0.438; P < .001). With a maximum J of 0.47, in male patients, an RF‐CSA cutoff of less than 8.9 cm2 was deemed an appropriate cutoff for detecting sarcopenic muscle mass. In female patients, an RF‐CSA cutoff of less than 5.7 cm2 was calculated on the basis of ASM/height2 (J = 0.71). Conclusions Ultrasound may provide a low‐cost and simple means to diagnose sarcopenia in patients with CKD. This would allow for early management and timely intervention to help mitigate the effects in this group.

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Identification of the most clinically useful skeletal muscle mass indices pertinent to sarcopenia and physical performance in chronic kidney disease

Cited by 12 publications

References 42 publications

Frailty and sarcopenia in elderly non-dialysis patients with chronic kidney disease stage 3-5: a cross sectional study

Frailty and sarcopenia in elderly non-dialysis patients with chronic kidney disease stage 3-5: a cross sectional study

Quantitative Muscle Ultrasonography Using 2D Textural Analysis: A Novel Approach to Assess Skeletal Muscle Structure and Quality in Chronic Kidney Disease

Utility of Ultrasound as a Valid and Accurate Diagnostic Tool for Sarcopenia

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