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Seet C, Clementoni L, Akhtar MR, Chandak P, Saoud M, Elsaadany A, Yaqoob MM, Mohamed IH, Khurram MA. Assessing Patients beyond the Simple Optics of BMI: The Concomitant Role of Sarcopenia and BMI in Predicting Kidney Transplant Outcomes. Life (Basel) 2024; 14:1036. [PMID: 39202778 PMCID: PMC11355760 DOI: 10.3390/life14081036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 08/09/2024] [Accepted: 08/13/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND Body composition is associated with prognosis in many clinical settings, and patients undergoing kidney transplantation are often high risk with multiple comorbidities. We aimed to assess the effect of sarcopenia and body composition on transplant outcomes. METHODS We performed a retrospective analysis of 274 kidney transplants with CT scans within 3 years of transplantation. The skeletal muscle index (SMI) at the L3 vertebrae was used to evaluate sarcopenia (SMI < 40.31 cm2/m2 in males, <30.88 cm2/m2 in females). Sarcopenia, body mass index (BMI), and the visceral-to-subcutaneous-fat ratio (VSR) were assessed separately. We also used a composite BMI/sarcopenia measurement in four patient groups: BMI < 25/Non-Sarcopenic, BMI < 25/Sarcopenic, BMI > 25/Non-Sarcopenic, and BMI > 25/Sarcopenic. The outcomes measured were eGFR (1 and 3 months; and 1, 3, and 5 years), delayed graft function (DGF), rejection, major adverse cardiovascular events (MACE), and post-operative complications. RESULTS Sarcopenia was associated with an increased 1-year risk of MACE (OR 3.41, p = 0.036). BMI alone had no effect on function, DGF, MACE, or on other complications. High VSR was associated with a lower risk of DGF (OR 0.473, p = 0.016). When sarcopenia and BMI were assessed together, the BMI > 25/sarcopenic patients had the poorest outcomes, with increased risk of MACE (OR 26.06, p = 0.001); poorer eGFR at 1, 3, 12, and 36 months; (p < 0.05 at all timepoints), and poorer graft survival (p = 0.002). CONCLUSIONS Sarcopenia alone is associated with an increased risk of MACE. Overweight sarcopenic patients are additionally at increased risk of graft loss and have poorer graft function for up to three years.
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Affiliation(s)
- Christopher Seet
- Department of Nephrology and Transplantation, The Royal London Hospital, Bart’s Health NHS Trust, London E1 1FR, UK
| | - Laura Clementoni
- Department of Nephrology and Transplantation, The Royal London Hospital, Bart’s Health NHS Trust, London E1 1FR, UK
| | - Mohammed Rashid Akhtar
- Department of Radiology, The Royal London Hospital, Bart’s Health NHS Trust, London E1 1FR, UK
| | - Pankaj Chandak
- Department of Nephrology and Transplantation, The Royal London Hospital, Bart’s Health NHS Trust, London E1 1FR, UK
| | - Mohammed Saoud
- Department of Radiology, The Royal London Hospital, Bart’s Health NHS Trust, London E1 1FR, UK
| | - Amr Elsaadany
- Department of Radiology, The Royal London Hospital, Bart’s Health NHS Trust, London E1 1FR, UK
| | - Muhammad Magdi Yaqoob
- Department of Nephrology and Transplantation, The Royal London Hospital, Bart’s Health NHS Trust, London E1 1FR, UK
- William Harvey Research Institute, Queen Mary University London, London E1 4NS, UK
| | - Ismail Heyder Mohamed
- Department of Nephrology and Transplantation, The Royal London Hospital, Bart’s Health NHS Trust, London E1 1FR, UK
- William Harvey Research Institute, Queen Mary University London, London E1 4NS, UK
| | - Muhammad Arslan Khurram
- Department of Nephrology and Transplantation, The Royal London Hospital, Bart’s Health NHS Trust, London E1 1FR, UK
- William Harvey Research Institute, Queen Mary University London, London E1 4NS, UK
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Kosoku A, Iwai T, Kabei K, Nishide S, Machida Y, Ishihara T, Uchida J. Sarcopenia as a predictor of mortality in kidney transplant recipients: A 5-year prospective cohort study with propensity score matching. Int J Urol 2024. [PMID: 39010785 DOI: 10.1111/iju.15539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 06/24/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Sarcopenia is known to bring about adverse outcomes in elderly populations and dialysis patients. However, whether it is a risk factor in kidney transplant recipients (KTRs) has not yet been established. In the present study, the association of sarcopenia with mortality was investigated in KTRs. METHODS We conducted a single-center prospective cohort study and recruited KTRs who were more than 1-year posttransplant from August 2017 to January 2018. The participants were followed for 5 years, and the Kaplan-Meier method and Cox proportional hazards model were used to assess patient survival. RESULTS A total of 212 KTRs with a median age of 54 years and median transplant vintage of 79 months were enrolled in this study. Among them, 33 (16%) had sarcopenia according to the Asia Working Group for Sarcopenia 2019 at baseline. During the 5-year follow-up period, 20 (9.4%) died, 5 returned to dialysis after graft loss, and 4 were lost to follow-up. The 5-year overall survival rate was 90%. After 1:1 propensity score matching, a matched cohort with 60 KTRs was generated. The overall survival rate was significantly lower in the sarcopenia group compared to the non-sarcopenia group (p = 0.025, log-rank test). Furthermore, mortality risk was significantly higher in the sarcopenia group compared to the non-sarcopenia group (hazard ratio = 7.57, 95% confidence interval = 0.94-62). CONCLUSION Sarcopenia was a predictor of mortality in KTRs. KTRs with suboptimal muscle status who were at risk for poor survival could have a clinical benefit by interventions for sarcopenia.
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Affiliation(s)
- Akihiro Kosoku
- Department of Urology, Meijibashi Hospital, Matsubara, Japan
- Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Tomoaki Iwai
- Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Kazuya Kabei
- Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Shunji Nishide
- Department of Urology, Osaka City General Hospital, Osaka, Japan
| | - Yuichi Machida
- Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Takuma Ishihara
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan
| | - Junji Uchida
- Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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Alajous S, Budhiraja P. New-Onset Diabetes Mellitus after Kidney Transplantation. J Clin Med 2024; 13:1928. [PMID: 38610694 PMCID: PMC11012473 DOI: 10.3390/jcm13071928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/19/2024] [Accepted: 03/24/2024] [Indexed: 04/14/2024] Open
Abstract
New-Onset Diabetes Mellitus after Transplantation (NODAT) emerges as a prevalent complication post-kidney transplantation, with its incidence influenced by variations in NODAT definitions and follow-up periods. The condition's pathophysiology is marked by impaired insulin sensitivity and β-cell dysfunction. Significant risk factors encompass age, gender, obesity, and genetics, among others, with the use of post-transplant immunosuppressants intensifying the condition. NODAT's significant impact on patient survival and graft durability underscores the need for its prevention, early detection, and treatment. This review addresses the complexities of managing NODAT, including the challenges posed by various immunosuppressive regimens crucial for transplant success yet harmful to glucose metabolism. It discusses management strategies involving adjustments in immunosuppressive protocols, lifestyle modifications, and pharmacological interventions to minimize diabetes risk while maintaining transplant longevity. The importance of early detection and proactive, personalized intervention strategies to modify NODAT's trajectory is also emphasized, advocating for a shift towards more anticipatory post-transplant care.
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Affiliation(s)
| | - Pooja Budhiraja
- Division of Medicine, Mayo Clinic Arizona, Phoenix, AZ 85054, USA;
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Hirata M, Ito K, Ookawara S, Tanno K, Morino J, Minato S, Mutsuyoshi Y, Kitano T, Hirai K, Morishita Y. Factors Affecting Psoas Muscle Mass Index in Patients Undergoing Peritoneal Dialysis. Cureus 2024; 16:e56347. [PMID: 38633934 PMCID: PMC11021792 DOI: 10.7759/cureus.56347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION Many patients with chronic kidney disease (CKD), including peritoneal dialysis (PD), have sarcopenia. It is important to evaluate muscle mass to prevent sarcopenia in the field of CKD management. Recently, muscle mass assessment using psoas muscle evaluated by computed tomography (CT) has been reported in patients undergoing hemodialysis. However, few clinical studies have investigated the clinical factors associated with the evaluation of psoas muscle in patients undergoing PD. METHODS Psoas muscle mass index (PMI) was measured in cross-sectional areas of the bilateral psoas muscles at the third lumbar spine level to evaluate psoas muscle status. The associations between PMI and possible clinical factors were investigated in 68 patients undergoing PD. RESULTS The mean PMI was 6.3 ± 2.0 cm2/m2, and the PMI was higher in men than in women (p < 0.001). In a multivariable linear regression analysis of the factors associated with PMI, male gender (standardized coefficient: 0.331), body mass index (standardized coefficient: 0.283), serum creatinine concentration (standardized coefficient: 0.289), serum albumin concentration (standardized coefficient: 0.235), and the use of vitamin D (standardized coefficient: 0.195) were independently identified. CONCLUSION PMI was independently and significantly associated with gender, BMI, serum creatinine concentration, serum albumin concentration and the use of vitamin D. Further prospective studies are needed to clarify whether the maintenance of nutritional status or vitamin D administration could affect muscle mass in patients undergoing PD.
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Affiliation(s)
- Momoko Hirata
- First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Kiyonori Ito
- First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Susumu Ookawara
- First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Keisuke Tanno
- First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Junki Morino
- First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Saori Minato
- First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Yuko Mutsuyoshi
- First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Taisuke Kitano
- First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Keiji Hirai
- First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, JPN
| | - Yoshiyuki Morishita
- First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, JPN
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Kosoku A, Iwai T, Kabei K, Nishide S, Machida Y, Uchida J. Frailty and sarcopenia in older kidney transplant recipients: a cross-sectional study. Eur Geriatr Med 2023; 14:861-868. [PMID: 37219724 DOI: 10.1007/s41999-023-00803-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
PURPOSE The aging of the kidney transplant population is accelerating, and measures against geriatric syndromes including frailty and sarcopenia, which elevate the risk of needing long-term care and even death, are being considered important. Recently, both the frailty and sarcopenia criteria for Asians were revised based on various research reports and clinical experiences. The purpose of this study is twofold: firstly, to investigate the prevalence of frailty based on the revised Japanese version of the Cardiovascular Health Study (J-CHS) criteria and the Kihon Checklist (KCL) and that of sarcopenia based on the Asian Working Group for Sarcopenia (AWGS) 2019 as well as the relationship between frailty and sarcopenia, and secondly, to determine the concurrent validity of the KCL with the revised J-CHScriteria in older kidney transplant recipients. METHODS This study was a single-center cross-sectional investigation carried out on older kidney transplant recipients who visited our hospital from August 2017 to February 2019. The diagnosis of frailty was assessed using the revised J-CHS criteria and the KCL. The diagnosis of sarcopenia was made by low skeletal muscle mass and either low physical performance or low muscle strength based on the AWGS 2019. To examine the relationship between frailty and sarcopenia, categorical variables were compared using chi-squared test and continuous variables Mann-Whitney U test. Spearman's correlation analysis was used to investigate the correlation between the KCL score and the revised J-CHS score. The concurrent validity of the KCL for estimating frailty based on the revised J-CHS criteria was evaluated using the receiver operating characteristics (ROC) curve analysis. RESULTS A total of 100 older kidney transplant recipients were enrolled in this study. The median age was 67, 63 (63%) were males, and the median time after transplant was 95 months. The prevalence of frailty based on the revised J-CHS criteria and the KCL, and sarcopenia based on the AWGS 2019 was 15%, and 19%, and 16% respectively. Sarcopenia was significantly associated with frailty based on the KCL (p = 0.016), while not with frailty based on the revised J-CHS criteria (p = 0.11). The KCL score significantly correlated with the revised J-CHS score (p < 0.001). The area under the ROC curve was 0.91. CONCLUSION Frailty and sarcopenia are interrelated complex geriatric syndromes that are risk factors for adverse health outcomes. In older kidney transplant recipients, frailty and sarcopenia were highly prevalent and frequently co-existed. Furthermore, the KCL was verified as a useful tool for frailty screening in these patient. Easy identification of patients with frailty, which is reversible, can help clinicians institute appropriate corrective measures for kidney transplant recipients to improve transplant outcomes.
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Affiliation(s)
- Akihiro Kosoku
- Department of Urology, Meijibashi Hospital, 1-358-3, Miyakenishi, Matsubara, 580-0045, Japan.
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan.
| | - Tomoaki Iwai
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Kazuya Kabei
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Shunji Nishide
- Department of Urology, Osaka City General Hospital, 2-13-22, Miyakojima-Hondori, Miyakojima-Ku, Osaka, 534-0021, Japan
| | - Yuichi Machida
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Junji Uchida
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
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6
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Lu Y, Zhang R, Zheng Q. Depression and sarcopenia: a Mendelian randomization analysis. Psychiatr Genet 2023; 33:145-151. [PMID: 37463392 DOI: 10.1097/ypg.0000000000000346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND The association between depression and sarcopenia has been reported in observational studies but the causality of depression on sarcopenia remained unknown. We aimed to assess the causal effect between major depressive disorder (MDD) and sarcopenia using the two-sample Mendelian randomization (MR) method. METHODS A set of genetics instruments were used for analysis, derived from publicly available genetic summary data. Clinically, appendicular lean mass (ALM) and low hand grip strength (LHGS) have been widely used for the diagnosis of sarcopenia. Inverse-variance weighted method, weighted median method, MR-Egger, MR Pleiotropy RESidual Sum and Outlier test were used for the bidirectional MR analyses. RESULTS No evidence for an effect of MDD on sarcopenia risk was found. MDD was not associated with ALM [effect = -0.17 (-0.60 to 0.27), P = 0.449] and LHGS [effect = 0.24 (-0.46 to 0.93), P = 0.506]. Sarcopenia was not associated with MDD [ALM: odds ratio (OR) = 0.999 (0.996-1.001), P = 0.374; LHGS: OR = 0.999 (0.996-1.002), P = 0.556]. CONCLUSION MDD and Sarcopenia might mutually have no causal effect on each other.
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Affiliation(s)
- Yehong Lu
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University
- Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
| | - Ruijie Zhang
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University
- Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
| | - Qiang Zheng
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University
- Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
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Influence of protein intake on the changes in skeletal muscle mass after kidney transplantation. Clin Nutr 2022; 41:1881-1888. [DOI: 10.1016/j.clnu.2022.07.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/10/2022] [Accepted: 07/18/2022] [Indexed: 12/18/2022]
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Wan T, Xiao Z, Wang X, Tan H, Guo W, Tang G, Chen L, Mei Z, Cao Q. Sarcopenia for outcomes in patients undergoing spinal surgery: A protocol for a systematic review and pooled analysis of observational studies. PLoS One 2022; 17:e0264268. [PMID: 35275924 PMCID: PMC8916656 DOI: 10.1371/journal.pone.0264268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 01/30/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Sarcopenia is a progressive age-related skeletal muscle disorder characterized by decreased muscle mass and loss of muscle function. Recent studies have shown that sarcopenia is able to predict a variety of clinical outcomes after spinal surgery. Controversy still exists among previous reports in terms of the definition and measurement of sarcopenia, these findings are heterogeneous so far. Therefore, the aim of the current study is to assess the up-to-date evidence of sarcopenia for postoperative outcomes among people undergoing spinal surgery. METHODS AND ANALYSIS This protocol was carried out based on the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) statement. It has been pre-registered in PROSPERO with the registration number of CRD42021260459. Three databases (including Pubmed, EMBASE, and Cochrane Library) will be searched from inception through May 10, 2021 to determine related cohort studies examining sarcopenia on multidimensional outcomes in patients undergoing spinal surgery. Major outcomes will be involved including mortality, morbidity, length of stay, postoperative complications or adverse events. DerSimonian & Laird random-effects meta-analysis will be used to calculate pooled odds ratio (OR) for binary data and pooled weighted mean differences (WMDs) or standardized mean differences (SMDs) for continuous data. The Newcastle-Ottawa Scale (NOS) will be used to assess the risk of bias of included studies. Narrative synthesis will be carried out if a pooled analysis is not possible. ETHICS AND DISSEMINATION Ethical approval is not required for this study as the data involved are from the published literatures. We intend to disseminate or share the results of the study in a peer-reviewed journal or at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42021260459.
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Affiliation(s)
- Teng Wan
- Department of Spine Surgery, The Second Affiliated Hospital, University of South China, Hengyang, Hunan, China
- Departments of Physiology and Biochemistry, Hengyang Medical College, University of South China, Hengyang, Hunan, China
| | - Zhihong Xiao
- Department of Spine Surgery, The Second Affiliated Hospital, University of South China, Hengyang, Hunan, China
| | - Xitao Wang
- Department of Surgery, Binhai New Area Hospital of Traditional Chinese Medicine, Tianjin, China
| | - Haifeng Tan
- Department of Spine Surgery, The Second Affiliated Hospital, University of South China, Hengyang, Hunan, China
- Departments of Physiology and Biochemistry, Hengyang Medical College, University of South China, Hengyang, Hunan, China
| | - Weiming Guo
- Department of Spine Surgery, The Second Affiliated Hospital, University of South China, Hengyang, Hunan, China
| | - Guojun Tang
- Department of Spine Surgery, The Second Affiliated Hospital, University of South China, Hengyang, Hunan, China
| | - Liangyuan Chen
- Department of Spine Surgery, The Second Affiliated Hospital, University of South China, Hengyang, Hunan, China
| | - Zubing Mei
- Department of Spine Surgery, The Second Affiliated Hospital, University of South China, Hengyang, Hunan, China
- Department of Anorectal Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Anorectal Disease Institute of Shuguang Hospital, Shanghai, China
| | - Qi Cao
- Department of Spine Surgery, The Second Affiliated Hospital, University of South China, Hengyang, Hunan, China
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Kosoku A, Ishihara T, Iwai T, Nishide S, Kabei K, Maeda K, Kumada N, Uchida J. The Change in Muscle Mass Among Kidney Transplant Recipients: A Prospective Cohort Study. Transplant Proc 2022; 54:346-350. [PMID: 35022134 DOI: 10.1016/j.transproceed.2021.08.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/25/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Recovery of renal function after transplantation leads to improved uremic conditions, increased physical activity, and liberation from severe dietary restrictions. Consequently, the muscle mass of kidney transplant recipients increases for several years after their transplant. However, the change in muscle mass and its associated factors among these patients remain largely unknown. Herein, we carried out a prospective cohort study with 1-year follow-up to investigate how muscle mass changes and to identify its risk factors among kidney transplant recipients. PATIENTS AND METHODS We performed a single-center, 1-year, prospective, observational cohort study from August 2017 to February 2019 at Osaka City University Hospital in Japan. The skeletal muscle mass index (SMI) was measured by bioelectrical impedance analysis. The risk factors related to the change in muscle mass were analyzed using multivariate linear regression models of age, sex, body mass index (BMI), dialysis vintage, transplant vintage, diabetes mellitus, hemoglobin, C-reactive protein, estimated glomerular filtration rate, and SMI at baseline. RESULTS A total of 180 kidney transplant recipients were enrolled in the present study. The median age was 55 years, and the median transplant vintage was 78 months. The median rate of change in SMI was +2.07%, and SMI increased in 118 (66%) patients during the 1-year follow-up. By multivariate analysis, the change in SMI at 1-year follow-up was independently associated with age (P = 0.017) and BMI (P = .023). CONCLUSIONS SMI increased in most of the kidney transplant recipients, and age and BMI might be the risk factors for this change in muscle mass among these patients.
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Affiliation(s)
- Akihiro Kosoku
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan.
| | - Takuma Ishihara
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan
| | - Tomoaki Iwai
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shunji Nishide
- Department of Urology, Osaka City General Hospital, Osaka, Japan
| | - Kazuya Kabei
- Department of Urology, Minamiosaka Hospital, Osaka, Japan
| | - Keiko Maeda
- Department of Nursing, Osaka City University Hospital, Osaka, Japan
| | - Norihiko Kumada
- Department of Urology, Suita Municipal Hospital, Suita, Japan
| | - Junji Uchida
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
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Luo J, Yao W, Zhang T, Ge H, Zhang D. Exploring the bidirectional associations between handgrip strength and depression in middle and older Americans. J Psychosom Res 2021; 152:110678. [PMID: 34839124 DOI: 10.1016/j.jpsychores.2021.110678] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Current evidence on the relationship between decreased handgrip strength and depression risk is controversial, and there is limited study focus on the potential bidirectional associations between them. We aim to explore their bidirectional relationships. METHODS This study used panel data from the Health and Retirement Study involving 17,713 aging Americans (≥50 years old) who participated in at least 2 waves. Smedley spring-type hand-held dynamometer was used to assess the handgrip strength. Depression was evaluated by the 8-item Center for Epidemiologic Studies-Depression (CESD) scale. Time-lagged general estimating equations (GEE) were used to assess the bidirectional association between handgrip strength and the depression risk. RESULTS In the fully adjusted model, every 5 kg decreased handgrip strength was associated with a 6% (95%CI: 3%-9%) increased risk of depression. Compared with non-weakness participants, those with weakness had a higher depression risk (OR = 1.22, 95%CI: 1.09-1.36). Conversely, depression might associate with a 0.33 kg (95% CI: 0.09-0.56) decrease in handgrip strength and increased the risk of weakness by 18% (95% CI: 6%-33%). In addition, the results remained stable in the stratified analyses by gender and sex. Interestingly, the above-mentioned associations were also observed in overweight and obese participants. CONCLUSIONS The present study found bidirectional associations between handgrip strength and depression risk. Our results indicated early interventions for depression and handgrip strength might achieve reciprocal benefits over time.
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Affiliation(s)
- Jia Luo
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao, University, Qingdao, Shandong Province, China
| | - Wenqin Yao
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao, University, Qingdao, Shandong Province, China
| | - Tianhao Zhang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao, University, Qingdao, Shandong Province, China
| | - Honghan Ge
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao, University, Qingdao, Shandong Province, China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao, University, Qingdao, Shandong Province, China.
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Pham Vu T, Can Van M, Dang Thanh C, Nguyen Minh T, Nguyen Trung K, Nguyen Duy T, Do Q, Tran Viet T, Le Viet T. Association of serum adiponectin and leptin levels with renal function in kidney transplant recipients with or without new-onset diabetes after transplantation. J Clin Lab Anal 2021; 35:e24000. [PMID: 34519108 PMCID: PMC8551688 DOI: 10.1002/jcla.24000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To evaluate serum adiponectin and leptin concentration in new-onset diabetes after transplantation (NODAT) and non-NODAT patients and association with renal function in kidney transplant recipients (KTRs). PATIENTS AND METHODS A study of 314 consecutive adults KTRs divided into four groups: 236 individuals without NODAT who had renal insufficiency (RI; n = 56) or normal renal function (n = 180) and 78 patients with NODAT who had RI (n = 17) or normal renal function (n = 61). NODAT was diagnosed based on venous fasting blood glucose or HbA1c with the criteria of the American Diabetes Association. Renal insufficiency was defined according to KDOQI 2002 guidelines. RESULTS In the NODAT group, the median level of serum adiponectin was lower than that of non-NODAT one (30 µg/ml vs 37.15 µg/ml, p < 0.001); in contrast, the median leptin concentration was higher (4.27 ng/ml vs 4.05 ng/ml, p = 0.024). In the RI group, both median serum adiponectin and leptin levels were higher than those of non-RI one (Adiponectin: 40.01 µg/ml vs 33.7 µg/ml; Leptin: 4.51 ng/ml vs 3.91 ng/ml, p < 0.001 both). We found that BMI was related to both adiponectin and leptin levels in both NODAT, non-NODAT, and all subject groups, based on univariate and multivariate linear regression analysis. CONCLUSION New-onset diabetes after transplantation, BMI, and renal insufficiency were affected to the serum level of adiponectin and leptin in KTRs.
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Affiliation(s)
- Thuy Pham Vu
- Kinh 7 Charity ClinicKien GiangViet Nam
- Vietnam Military Medical UniversityHa NoiViet Nam
| | - Mao Can Van
- Vietnam Military Medical UniversityHa NoiViet Nam
| | | | | | - Kien Nguyen Trung
- Vietnam Military Medical UniversityHa NoiViet Nam
- Military Hospital 103Ha NoiViet Nam
| | - Toan Nguyen Duy
- Vietnam Military Medical UniversityHa NoiViet Nam
- Military Hospital 103Ha NoiViet Nam
| | - Quyet Do
- Vietnam Military Medical UniversityHa NoiViet Nam
| | - Tien Tran Viet
- Vietnam Military Medical UniversityHa NoiViet Nam
- Military Hospital 103Ha NoiViet Nam
| | - Thang Le Viet
- Vietnam Military Medical UniversityHa NoiViet Nam
- Military Hospital 103Ha NoiViet Nam
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12
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Ito K, Ookawara S, Imai S, Kakuda H, Bandai Y, Fueki M, Yasuda M, Kamimura T, Kiryu S, Wada N, Hamashima Y, Shindo M, Kobayashi T, Sanayama H, Kaku Y, Tanno K, Ohnishi Y, Iino N, Dezaki K, Kakei M, Tabei K, Morishita Y. Muscle mass evaluation using psoas muscle mass index by computed tomography imaging in hemodialysis patients. Clin Nutr ESPEN 2021; 44:410-414. [PMID: 34330498 DOI: 10.1016/j.clnesp.2021.04.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 04/01/2021] [Accepted: 04/29/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS The use of the psoas muscle mass index (PMI) using computed tomography (CT) has become a marker of interest to evaluate whole body muscle mass. However, in hemodialysis (HD) patients, reports about the clinical significance of psoas muscle evaluation are limited. We aimed to clarify the association between PMI and skeletal muscle mass index (SMI) using bioelectrical impedance analysis (BIA), and to investigate factors affecting PMI in HD patients. METHODS In this prospective observational study, to evaluate muscle mass, SMI was measured using BIA after HD, and PMI was measured by the manual trace method on routinely available CT scans. PMI measurement was assessed twice by two physicians to compute intra-rater and inter-rater reliability. The correlations between PMI and the clinical factors were evaluated using Pearson's correlation coefficient and a linear regression analysis. Variables with a p-value < 0.05 in the simple linear regression analysis were included in the multivariable linear regression analysis to identify the factors that affected PMI of the HD patients. RESULTS Fifty HD patients were recruited (31 males and 19 females; HD duration, 9.0 ± 8.8 years). The SMI was 6.10 ± 1.20 kg/m2, and the PMI was 4.79 ± 1.61 cm2/m2. Regarding the reliability of PMI measurements, intra-rater reliability [intra-class correlation (ICC) = 0.999] and inter-rater reliability (ICC = 0.998) were high in this study. The mean PMI of male patients was 5.40 ± 1.62 cm2/m2, while that of female patients was significantly lower (3.78 ± 0.98 cm2/m2; p < 0.001). The PMI was significantly and positively correlated with SMI (r = 0.630, p < 0.001), in addition to HD duration, body mass index (BMI), serum phosphate and serum creatinine (Cr). In the multivariate linear regression analysis by two models using SMI or BMI, they were respectively extracted as an independent factor associating with PMI, in addition to serum Cr and the difference of sex. CONCLUSIONS PMI assessed with CT positively correlated with SMI measured using BIA. PMI might be one of the methods for evaluating the muscle mass in HD patients, when CT scans are taken as part of routine care.
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Affiliation(s)
- Kiyonori Ito
- Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Susumu Ookawara
- Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
| | - Sojiro Imai
- Department of Dialysis, Minami-Uonuma City Hospital, Niigata, Japan
| | - Hideo Kakuda
- Department of Radiology, Minami-Uonuma City Hospital, Niigata, Japan
| | - Yusaku Bandai
- Department of Dialysis, Minami-Uonuma City Hospital, Niigata, Japan
| | - Mariko Fueki
- Department of Dialysis, Minami-Uonuma City Hospital, Niigata, Japan
| | - Masatoshi Yasuda
- Department of Dialysis, Minami-Uonuma City Hospital, Niigata, Japan
| | - Tatsuya Kamimura
- Department of Dialysis, Minami-Uonuma City Hospital, Niigata, Japan
| | - Satoshi Kiryu
- Department of Dialysis, Minami-Uonuma City Hospital, Niigata, Japan
| | - Noriko Wada
- Department of Dialysis, Minami-Uonuma City Hospital, Niigata, Japan
| | - Yuri Hamashima
- Department of Population Health Science, Bristol Medical School, University of Bristol, England, UK
| | - Mitsutoshi Shindo
- Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Tadanao Kobayashi
- Department of Internal Medicine, Minami-Uonuma City Hospital, Niigata, Japan
| | - Hidenori Sanayama
- Division of Neurology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yoshio Kaku
- Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Keisuke Tanno
- Division of Radiology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yasushi Ohnishi
- Department of Internal Medicine, Minami-Uonuma City Hospital, Niigata, Japan
| | - Noriaki Iino
- Division of Nephrology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Katsuya Dezaki
- Division of Integrative Physiology, Department of Physiology, Jichi Medical University, Tochigi, Japan; Department of Pharmacy, Iryo Sosei University, Fukushima, Japan
| | - Masafumi Kakei
- Department of Internal Medicine, Minami-Uonuma City Hospital, Niigata, Japan
| | - Kaoru Tabei
- Department of Internal Medicine, Minami-Uonuma City Hospital, Niigata, Japan
| | - Yoshiyuki Morishita
- Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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Roy B, Palaniyandi SS. Tissue-specific role and associated downstream signaling pathways of adiponectin. Cell Biosci 2021; 11:77. [PMID: 33902691 PMCID: PMC8073961 DOI: 10.1186/s13578-021-00587-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/07/2021] [Indexed: 12/12/2022] Open
Abstract
According to the World Health Organization, metabolic syndrome (MetS) can be defined as a pathological condition characterized by abdominal obesity, insulin resistance, hypertension, and hyperlipidemia. The incidence of MetS keeps rising, as at least 35% of the USA population suffers from MetS. One of the worst comorbidities of metabolic syndrome are cardiovascular diseases that significantly amplifies the mortality associated with this syndrome. There is an urgent need to understand the pathophysiology of MetS to find novel diagnosis, treatment and management to mitigate the MetS and associated complications. Altered circulatory adiponectin levels have been implicated in MetS. Adiponectin has numerous biologic functions including antioxidative, anti-nitrative, anti-inflammatory, and cardioprotective effects. Being a pleiotropic hormone of multiple tissues, tissue-specific key signaling pathways of adiponectin will help finding specific target/s to blunt the pathophysiology of metabolic syndrome and associated disorders. The purpose of this review is to elucidate tissue-specific signaling pathways of adiponectin and possibly identify potential therapeutic targets for MetS as well as to evaluate the potential of adiponectin as a biomarker/therapeutic option in MetS.
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Affiliation(s)
- Bipradas Roy
- Division of Hypertension and Vascular Research, Department of Internal Medicine, Henry Ford Health System, Integrative Biosciences Center (IBio), Room #3402, 6135 Woodward, Detroit, MI 48202 USA
- Department of Physiology, Wayne State University, Detroit, MI 48202 USA
| | - Suresh Selvaraj Palaniyandi
- Division of Hypertension and Vascular Research, Department of Internal Medicine, Henry Ford Health System, Integrative Biosciences Center (IBio), Room #3402, 6135 Woodward, Detroit, MI 48202 USA
- Department of Physiology, Wayne State University, Detroit, MI 48202 USA
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