Positive Correlation between Relative Concentration of Spermine to Spermidine in Whole Blood and Skeletal Muscle Mass Index: A Possible Indicator of Sarcopenia and Prognosis of Hemodialysis Patients

Abstract

Several mechanisms strictly regulate polyamine concentration, and blood polyamines are excreted in urine. This indicates polyamine accumulation in renal dysfunction, and studies have shown increased blood polyamine concentrations in patients with renal failure. Hemodialysis (HD) may compensate for polyamine excretion; however, little is known about polyamine excretion. We measured whole-blood polyamine levels in patients on HD and examined the relationship between polyamine concentrations and indicators associated with health status. Study participants were 59 hemodialysis patients (median age: 70.0 years) at Minami-Uonuma City Hospital and 26 healthy volunteers (median age: 44.5 years). Whole-blood spermidine levels were higher and spermine/spermidine ratio (SPM/SPD) was lower in hemodialysis patients. Hemodialysis showed SPD efflux into the dialysate; however, blood polyamine levels were not altered by hemodialysis and appeared to be minimally excreted. The skeletal muscle mass index (SMI), which was positively correlated with hand grip strength and serum albumin level, was positively correlated with SPM/SPD. Given that sarcopenia and low serum albumin levels are reported risk factors for poor prognosis in HD patients, whole blood SPM/SPD in hemodialysis patients may be a new indicator of the prognosis and health status of HD patients.

Basic Knowledge of Polyamines That Researchers Must Know before Starting Research, and the Relationship of Polyamines to Aging, Health and Disease

“…Similarly, no age-related decline in plasma polyamine concentrations has been reported by Chaisiri et.al (as cited in [6]). We also found that whole blood polyamine levels do not change with age [23,24]. Urinary polyamine excretion, which reflects blood polyamine levels, also does not change with age in adults.…”

“…We also found that whole blood SPD levels were higher and SPM/SPD ratios were lower in sarcopenic patients than in non-sarcopenic subjects. And the SPM/SPD ratio tended to decrease with age in sarcopenic patients, while no such decrease was observed in non-sarcopenic elderly [23].…”

“…Although there is no decrease in polyamine levels in the body with age, it is noteworthy that there are large individual differences in blood polyamine levels [23,24]. It is not clear what the biological basis is for the large individual differences in blood polyamine levels.…”

“…Changes in polyamine concentrations with age are not pronounced and do not decrease with age. On the other hand, the SPM/SPD ratio tends to decrease because SPM concentration tends to decrease with age [23,26,27]. And this decline tends to be more pronounced in patients with age-and lifestyle-related diseases [23,26].…”

“…On the other hand, the SPM/SPD ratio tends to decrease because SPM concentration tends to decrease with age [23,26,27]. And this decline tends to be more pronounced in patients with age-and lifestyle-related diseases [23,26]. In particular, it has been reported to be more pronounced in patients with renal failure.…”