Sarcopenic Obesity Versus Nonobese Sarcopenia in Hemodialysis Patients: Differences in Nutritional Status, Quality of Life, and Clinical Outcomes

Beberashvili, Ilia; Azar, Ada; Khatib, A; Hamad, Ramzia Abu; Neheman, Amos; Efrati, Shai; Doenyas-Barak, Keren

doi:10.1053/j.jrn.2022.05.003

Cited by 16 publications

(14 citation statements)

References 47 publications

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“…Obesity is also well known to influence leptin levels [ 118 ]. Hence, leptin is higher in sarcopenic obese patients than in normal sarcopenic hemodialyzed patients [ 119 ]. The group agrees that at least adiponectin or leptin should be measured in both phase II and phase III trials at baseline and during the whole follow-up.

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Section: Methodsmentioning

confidence: 99%

“…Obesity is also well known to influence leptin levels [118]. Hence, leptin is higher in sarcopenic obese patients than in normal sarcopenic hemodialyzed patients [119].…”

Section: Adipokinesmentioning

confidence: 99%

“…Total IGF-1 is easily measurable through largely available automated methods, and thus, total measurement should be favoured. The major confounding factor Associated with physical performance tests [167] Results are influenced by the ratio male/female [113] Pro-inflammatory factor [168] Muscle-fat crosstalk Modified by non-pharmacological interventions [106,169] Conflicting data [107] Decreased in coronary heart disease [168] Predictive of major outcome (allcause mortality) [110] Decreased in obesity and type 2 diabetes [168] Leptin Increased Associated with appendicular lean mass [103,106,115] Studies in sarcopenic obesity and insulin resistance cohorts rather than normal aging [103,116,119] Influenced by level of adiposity [23] Muscle-fat crosstalk Modified by non-pharmacological interventions [106,116] Highly relevant in sarcopenic obesity [80] Hormones IGF-1 Decreased Associated with muscle mass, handgrip strength and gait speed [30,125] Not accurate enough for diagnosis [122] Decreased with hepatic disorder [170] Anabolic Increased by long-term resistance training [126] DHEAS Decreased DHEAS treatment improve muscle strength and function when combined with exercise [134] Modified secretion is part of aging [171] Modified by diseases of the endocrine system [171] Anabolic Modified by non-pharmacological interventions [133] Cortisol Increased Associate with muscle mass [130,172] Modified secretion is part of aging [171] Modified by diseases of the endocrine system [171] Anabolic Modified by non-pharmacological interventions [133,…”

Section: Hormonesmentioning

confidence: 99%

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Biochemical Markers of Musculoskeletal Health and Aging to be Assessed in Clinical Trials of Drugs Aiming at the Treatment of Sarcopenia: Consensus Paper from an Expert Group Meeting Organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the Centre Académique de Recherche et d'Expérimentation en Santé (CARES SPRL), Under the Auspices of the World Health Organization Collaborating Center for the Epidemiology of Musculoskel

et al. 2023

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In clinical trials, biochemical markers provide useful information on the drug’s mode of action, therapeutic response and side effect monitoring and can act as surrogate endpoints. In pharmacological intervention development for sarcopenia management, there is an urgent need to identify biomarkers to measure in clinical trials and that could be used in the future in clinical practice. The objective of the current consensus paper is to provide a clear list of biochemical markers of musculoskeletal health and aging that can be recommended to be measured in Phase II and Phase III clinical trials evaluating new chemical entities for sarcopenia treatment. A working group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) proposed classifying biochemical markers into 2 series: biochemical markers evaluating musculoskeletal status and biochemical markers evaluating causal factors. For series 1, the group agreed on 4 biochemical markers that should be assessed in Phase II or Phase III trials (i.e., Myostatin-Follistatin, Brain Derived Neurotrophic Factor, N-terminal Type III Procollagen and Serum Creatinine to Serum Cystatin C Ratio – or the Sarcopenia Index). For series 2, the group agreed on 6 biochemical markers that should be assessed in Phase II trials (i.e., the hormones insulin-like growth factor-1 (IGF-I), dehydroepiandrosterone sulphate, and cortisol, and the inflammatory markers C-reactive protein (CRP), interleukin-6 and tumor necrosis factor-α), and 2 in Phase III trials (i.e., IGF-I and CRP). The group also proposed optional biochemical markers that may provide insights into the mode of action of pharmacological therapies. Further research and development of new methods for biochemical marker assays may lead to the evolution of these recommendations.

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…”

Section: Methodsmentioning

confidence: 99%

“…Obesity is also well known to influence leptin levels [118]. Hence, leptin is higher in sarcopenic obese patients than in normal sarcopenic hemodialyzed patients [119].…”

Section: Adipokinesmentioning

confidence: 99%

Section: Hormonesmentioning

confidence: 99%

See 1 more Smart Citation

Biochemical Markers of Musculoskeletal Health and Aging to be Assessed in Clinical Trials of Drugs Aiming at the Treatment of Sarcopenia: Consensus Paper from an Expert Group Meeting Organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the Centre Académique de Recherche et d'Expérimentation en Santé (CARES SPRL), Under the Auspices of the World Health Organization Collaborating Center for the Epidemiology of Musculoskel

et al. 2023

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“…CKD patients could be at greater risk of malnutrition and inflammatory-related diseases due to the release of inflammatory cytokine by adipocytes, and the involvement of regulatory molecules, as myostatin, hepatocyte growth factor and soluble Toll-like receptor 4 ( 25 ). Sarcopenia as a chronic proinflammatory state increases the risk of damage to target organ, such as impaired cardiac function ( 26 – 28 ).…”

Section: Discussionmentioning

confidence: 99%

“…In these patients, increased leptin receptor levels may represent a protective mechanism that decreases the bioavailability of free leptin that would further conserve energy ( 29 , 30 ). Adult patients on hemodialysis and sarcopenia have a worse prognosis for cardiovascular events and mortality, which has been related to low fat content, as a consequence of the proinflammatory state that occurs in sarcopenia ( 26 – 28 ). As well, it has also been reported that high levels of angiotensin II are negatively associated with skeletal muscle strength ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Adipokines as predictive factor of cardiac function in pediatric patients with chronic kidney disease

et al. 2023

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BackgroundAdipokines are associated with cardiovascular disease; in chronic kidney disease (CKD) patients adipokines could be useful prognostic factors.ObjectivesTo explore whether leptin and adiponectin in kidney replacement therapy (KRT) children could have a role on their cardiac function, in the long-term.DesignProspective cohort study was performed with pediatric KRT patients, aged 8 to 17 years who were undergoing hemodialysis or peritoneal dialysis. At enrollment, lipid profile, adipokines (leptin, leptin receptor, free leptin, and adiponectin), anthropometric measurements and cardiological evaluation were determined. At two-year follow-up, a new cardiological evaluation was performed. Statistical analysis: Quantitative data are presented as median and interquartile range (IQR). Mann-Whitney U test and Chi-squared were used for the between-group comparison. Multivariate analyzes were performed to determine the association of adipokines levels with ventricular ejection fraction (LEVF).ResultsWe included 56 patients, with a median age of 12.5 years. In the first cardiological evaluation, median LVEF was 70.0% (IQR 61%, 76%), 20 patients (35.7%) had some cardiovascular condition, and 10 (17.8%) altered LVEF. At 24-month follow-up, the median LVEF was 70.5% (IQR 65.1%, 77%), while the delta-LVEF values was 3% (IQR -6.5%, 7%). Delta-LVEF were correlated with baseline adipokines serum levels, and the only positive correlation found was with free leptin (r=0.303, p=0.025). In multivariate analysis, levels of free leptin (Coef. 0.12, p<0.036) and leptin (coef. 1.72, p=0.049), as well as baseline LVEF (Coef. -0.65, p<0.001) were associated with delta-LVEF.ConclusionsFree leptin, leptin and LVEF at the beginning of follow-up were associated with the LVEF decrease at the 24-month follow-up in KRT children.

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Associations of sarcopenic obesity vs either sarcopenia or obesity alone with cognitive impairment risk in patients requiring maintenance hemodialysis

Zhan

Yuan

et al. 2023

Nut in Clin Prac

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BackgroundThe association between sarcopenic obesity (SO) and cognitive impairment (CI) risk in patients requiring maintenance hemodialysis (MHD) is not known. In this study, we investigated the prevalence of SO in MHD patients. Furthermore, we would explore and compare the associations between SO, sarcopenia, and obesity with CI risk in this population.MethodsA multicenter, cross‐sectional study was conducted. Data from 2743 adult MHD patients were recorded. SO was defined as the co‐occurrence of sarcopenia and obesity. Cognitive function was assessed with the Mini‐Mental State Examination (MMSE). Multiple logistic regression models, stratified analyses, and interactive analyses were conducted.Results21.58% of the participants met the criteria for SO. The overall prevalence of CI was 23.3% in our study. Participants in the SO group had the highest CI prevalence (34.6%). The association between SO and CI was weakened but remained statistically significant after adjusting for age, sex, and educational status (odds ratio, 1.47; 95% CI, 1.11–1.96). However, associations between sarcopenia, obesity, and CI disappeared after adjusting for these variables. The additional adjustment did not attenuate the significant association between SO and CI. Subgroup analyses and interactive analyses showed that the associations were similar across subgroups (P > 0.05 for interaction for all).ConclusionsSO and CI are highly prevalent in MHD patients. Participants with SO are at significantly higher risk of CI than those with sarcopenia or obesity alone. Furthermore, this association is consistent across different subgroups.

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Sarcopenic Obesity Versus Nonobese Sarcopenia in Hemodialysis Patients: Differences in Nutritional Status, Quality of Life, and Clinical Outcomes

Cited by 16 publications

References 47 publications

Adipokines as predictive factor of cardiac function in pediatric patients with chronic kidney disease

Associations of sarcopenic obesity vs either sarcopenia or obesity alone with cognitive impairment risk in patients requiring maintenance hemodialysis

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