Survival predictability of lean and fat mass in men and women undergoing maintenance hemodialysis

Noori, Nazanin; Kövesdy, Csaba P.; Dukkipati, Ramanath; Kim, Youngmee; Duong, Uyen; Bross, Rachelle; Oreopoulos, Antigone; Luna, Amanda; Benner, Debbie; Kopple, Joel D.; Kalantar-Zadeh, Kamyar

doi:10.3945/ajcn.2010.29188

Cited by 88 publications

(64 citation statements)

References 51 publications

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“…In contrast to obesity-related conditions, adipokine dysregulation in centenarians was uniquely associated with very low levels of leptin (less than 2.6 ng/mL) and low BMI, suggesting that age-related fat loss or lipoatrophy is major factor for adipose tissue dysfunction in centenarians. These findings are concordant with studies showing the protective functions of fat mass against morbidity and mortality in geriatric patients 45) and patients undergoing hemodialysis 46) . Although further studies focusing on the distribution of fat pads, adipocyte size and adipocyte metabolism in association with aging and age-related pathology are required, maintaining adipose tissue mass and function, particularly leptin signaling, seems to be indispensable for normal physiological functions under energy-deprived conditions, such as cachexia, or wasting syndrome, and chronic inflammation, which are associated with advanced aging.…”

Section: Human Data On the Adipose Tissue Phenotype In Centenarianssupporting

confidence: 82%

Adipokines and Aging

Arai

Takayama

Abe

et al. 2011

JAT

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Dysregulation of adipose tissue-derived bioactive molecules, termed adipokines, is recognized as common ground for insulin resistance and metabolic syndrome associated with obesity. However, adipokine dysregulation is paradoxically associated with lipodystrophy and lipoatrophy with aging. In familial partial lipodystrophic syndromes and Hutchinson-Gilford progeria syndrome, both of which are caused by mutations in the LMNA gene, loss of adipose tissue is associated with adipokine dysregulation, insulin resistance, and atherosclerosis, suggesting a critical role of adipose tissue function in controlling whole body energy metabolism, age-related pathologies, and longevity. Centenarians, a model of healthy aging and longevity, are reported to exhibit preserved insulin sensitivity as well as favorable adipokine profiles, particularly high levels of circulating adiponectin. Furthermore, adipose tissue dysfunction indicated by dysregulation of leptin, tumor necrosis factor-, and adiponectin is associated with poor prognosis in centenarians. In contrast to results obtained for obesity, adipokine dysregulation in centenarians is associated with very low leptin levels, suggesting that age-related lipoatrophy is the major factor for adipose tissue dysfunction at an advanced age. These observations suggest that adipose tissue excess as well as its aging is implicated in the regulation of adipokines, insulin sensitivity, and lifespan in humans.J Atheroscler Thromb, 2011; 18:545-550.

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Section: Human Data On the Adipose Tissue Phenotype In Centenarianssupporting

confidence: 82%

Adipokines and Aging

Arai

Takayama

Abe

et al. 2011

JAT

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“…fat mass of 808 Japanese maintenance hemodialysis patients using dual-energy X-ray absorptiometry and revealed that higher fat mass index (kg/m 2 ) was related to lower mortality risk, especially noncardiovascular disease mortality (21). Noori et al and Huang et al reported similar results (22,23). They evaluated body fat mass measured by near -infrared interactance and triceps skinfold thickness, respectively.…”

Section: Discussionsupporting

confidence: 52%

Body fat mass is correlated with serum transthyretin levels in maintenance hemodialysis patients

Matsuura

Shirai²,

Kubo

et al. 2017

J. Med. Invest.

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: Serum transthyretin (TTR), also known as prealbumin, is a reliable nutritional indicator and an independent prognostic factor for maintenance hemodialysis patients. However, we recently reported that serum TTR levels did not affect protein−energy wasting (PEW). In this study, we investigated factors affecting serum TTR levels in 60 maintenance hemodialysis patients. The patients were divided into High-TTR and Low-TTR groups according to the median serum TTR level. Albumin levels were significantly higher and C-reactive protein (CRP) levels were significantly lower in the High-TTR group than in the Low-TTR group. Although body fat mass was significantly higher in the High-TTR group than in the Low-TTR group, no significant difference in body fat ratio were observed. These findings suggest that body fat mass is related to serum TTR levels, apart from factors such as albumin and CRP levels, which showed correlations with serum TTR levels. Because body fat mass is related to better survival in maintenance hemodialysis patients, it may contribute to the prognostic value of serum TTR levels. In addition, in such patients, it may be important to evaluate body fat mass rather than body fat ratio and to maintain the minimum necessary body fat mass.

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“…Actually, serum creatinine levels are considered to be unreliable as an indicator of muscle mass because they are dialysis dependent. However, in several studies, serum creatinine levels were found to be associated with lean body mass, confirming our findings (3,11,12). In the univariate correlation analysis, DMS was found to be strongly associated with both anthropometric measurements such as MAC and functions of the muscle mass defined by HGS.…”

Section: Discussionsupporting

confidence: 79%

Handgrip Strength and Serum Uric Acid Levels are Associated with Dialysis-Malnutrition Scores in Chronic Hemodialysis Patients

Başçı¹,

Özkök²,

Kacar³

et al. 2017

Turk Neph Dial Transpl

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OBJECTIVE: Protein-energy-wasting (PEW) is common and contributes to increased mortality in hemodialysis (HD) patients. Herein we aimed to investigate the relationships between the parameters of malnutrition including dialysis malnutrition score (DMS), bioimpedance analysis (BIA), handgrip strength (HGS) in chronic HD patients. MATERIAL and METHODS:Forty chronic HD patients (mean age:58±18 years; males:22) were enrolled. Mid-arm circumference (MAC) measurements and BIA were performed. HGS was measured by a Jamar hydraulic hand dynamometer. RESULTS:HGS, MAC and uric acid levels were higher in patients with mild malnutrition compared to severe malnutrition group. Postdialysis creatinine was associated with lean body ratio (LBR) (r=0.56, p=0.002), DMS (r=-0.57, p=<0.001), HGS (r=0.73, p<0.001) and MAC (r=0.51, p=0.001). DMS was inversely correlated with HGS (r= -0.63, p<0.001), MAC (r= -0.48, p=0.002), total protein (r=-0.36, p=0.02) and uric acid levels (r=-0.54, p<0.001). In linear regression analysis (R 2 =0.58; p<0.001), HGS and uric acid were found to independently predict DMS. HGS was associated with MAC, LBR, uric acid and post-HD urea. HGS was negatively correlated with age, DMS, fat tissue ratio (FTR) and Kt/V. In linear regression analysis (R 2 =0.71; p<0.001), gender, DMS and MAC were found to independently predict HGS.CONCLUSION: HGS and uric acid were significantly associated with dialysis-malnutrition scores. HGS is an easy and reliable test for the evaluation of malnutrition in HD patients.KEy wORDS: Malnutrition, Hemodialysis, Handgrip strength, Dialysis malnutrition score, Uric acid Öz AMAÇ: Protein-enerji tükenmesi sendromu, hemodiyaliz (HD) hastalarında sıktır ve artmış mortalite ile ilişkilidir. Burada, el-sıkma gücünün (ESG); diyaliz malnütrisyon skoru (DMS) ve biyoimpedans analizi (BİA) gibi diğer malnütrisyon parametreleri ile ilişkisinin araştırılması amaçlanmıştır. GEREÇ ve yÖNTEMLER:Kırk kronik HD hastası (ortalama yaş: 58±18 yıl; erkek :22) çalışmaya katıldı. Orta-kol çevresi (OKÇ) ve BİA ölçümleri yapıldı. ESG, Jamar hidrolik el dinamometresi ile ölçüldü.BULGULAR: ESG, OKÇ ve ürik asit seviyeleri, hafif malnütrisyon grubunda, ciddi malnütrisyon grubuna göre daha yüksek saptandı. Postdiyaliz kreatinin seviyeleri, yağsız vücut oranı (YVO) (r=0,56, p=0,002), DMS(r= -0,57, p=<0,001), ESG(r=0,73, p<0,001) ve OKÇ(r=0,51, p=0,001) ile anlamlı olarak ilişkili bulundu. DMS ise ESG 63, p<0,001),48, p=0,002),36, p=0,02) ve ürik asit seviyeleri (r=-0,54, p<0,001) ile ters-ilişkili bulundu. Lineer regresyon analizinde (R 2 =0,58; p<0,001), ESG ve ürik asitin DMS'nin bağımsız öngörücüleri olduğu bulundu. ESG ile OKÇ, YVO, ürik asit ve post-HD üre değerleri ilişkiliydi. Buna karşın ESG; yaş, DMS, yağ doku oranı ve Kt/V ile ters ilişkili bulundu. Lineer regresyon analizinde (R 2 =0,71; p<0,001), cinsiyet, DMS ve OKÇ'nin ESG'nin bağımsız öngörücüleri oldukları gösterildi. SONUÇ: ESG ve ürik asit seviyeleri, diyaliz-malnütrisyon skorlarıyla anlamlı olarak ilişkilidir. ESG, HD hastalarında malnütr...

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Survival predictability of lean and fat mass in men and women undergoing maintenance hemodialysis

Abstract: In MHD patients, higher FM in both sexes and higher LBM in women appear to be protective. The survival advantage of FM appears to be superior to that of LBM. Clinical trials to examine the outcomes of interventions that modify body composition in MHD patients are indicated.

Cited by 88 publications

References 51 publications

Adipokines and Aging

Adipokines and Aging

Body fat mass is correlated with serum transthyretin levels in maintenance hemodialysis patients

Handgrip Strength and Serum Uric Acid Levels are Associated with Dialysis-Malnutrition Scores in Chronic Hemodialysis Patients

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