Prediction of sarcopenia among peritoneal dialysis patients using a combination of irisin and phase angle

IF 0.7 4区医学 Q4 UROLOGY & NEPHROLOGY Nephrologie & Therapeutique Pub Date : 2023-03-16 DOI:10.1684/ndt.2023.7

Jiaying Wu, Jichao Guan, Shuangxiang Lin, Xiujuan Wu, Miaojia Ding, Zhouhao Ren, Shuijuan Shen

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Abstract

Background: Sarcopenia is associated with significant morbidity and mortality in patients undergoing peritoneal dialysis (PD). Three different tools must be applied to measure the three indices for diagnosing sarcopenia. Considering the cumbersome diagnostic steps and multi-layered mechanisms underlying sarcopenia, we combined new biomarker with bioelectrical impedance analysis (BIA) data to predict PD sarcopenia.

Methods: Patients underwent regular PD were asked to complete sarcopenia screening, including appendicular skeletal muscle mass, handgrip strength, and the 5-time chair stand time test according to the newly revised diagnosis consensus of Asian Working Group for Sarcopenia (AWGS2019). Serum was collected for centralized detection of the irisin levels. BIA data, especially the phase angle (PhA), as well as patient's general clinical information, dialysis related indices, laboratory data and body composition data were recorded.

Results: Among 105 enrolled PD patients (41.0% men, mean age 54.2 ± 8.89 years), the sarcopenia prevalence was 31.4% and the sarcopenic obesity was 8.6%. Binary regression analysis showed that serum irisin concentrations (OR = 0.98; 95% CI,0.97-0.99; p = 0.002), PhA (OR = 0.43; 95% CI, 0.21-0.90; p = 0.025) and body mass index (BMI) (OR = 0.64; 95% CI, 0.49-0.83; p = 0.001) were independently associated with PD sarcopenia. The AUC of the combination use of serum irisin concentrations and PhA for predicting PD sarcopenia was 0.925 with a sensitivity of 100% and specificity of 84.0% in male and was 0.880 with a sensitivity of 92.0% and specificity of 81.5% in female. PD sarcopenia score=1533.48+-0.75*Handgrip strength+4.63*BMI+-18.07*Total body water +-11.87*Extra-cellular water / total body water +9.26*Fat free mass index+-83.41*PhA+22.42*Albumin/Globulin+-26.38*blood phosphorus+-17.04*Total cholesterol+-29.02*Triglyceride+-0.29*Prealbumin+-0.17*Irisin.

Conclusions: Sarcopenia is relatively common among PD patients. The combination of serum irisin concentrations and PhA facilitated the rapid prediction of PD sarcopenia and could serve as an optimal screening tool for PD sarcopenia in clinical settings.

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鸢尾素和相位角联合应用预测腹膜透析患者肌肉减少症

背景:腹膜透析(PD)患者的肌肉减少症与显著的发病率和死亡率相关。三种不同的工具必须用于测量三个指标诊断肌少症。考虑到肌少症的繁琐诊断步骤和多层机制，我们将新的生物标志物与生物电阻抗分析(BIA)数据结合起来预测PD肌少症。方法:根据亚洲肌肉减少症工作组(AWGS2019)新修订的诊断共识，要求常规PD患者完成肌肉减少症筛查，包括阑尾骨骼肌质量、握力和5次椅子站立时间测试。收集血清集中检测鸢尾素水平。记录BIA数据，特别是相位角(PhA)，以及患者一般临床资料、透析相关指标、实验室数据和体成分数据。结果:105例PD患者(男性41.0%，平均年龄54.2±8.89岁)中，肌少症患病率为31.4%，肌少性肥胖患病率为8.6%。二元回归分析显示，血清鸢尾素浓度(OR = 0.98;95%置信区间,0.97 - -0.99;p = 0.002)， PhA (OR = 0.43;95% ci, 0.21-0.90;p = 0.025)和身体质量指数(BMI) (OR = 0.64;95% ci, 0.49-0.83;p = 0.001)与PD肌少症独立相关。血清鸢尾素浓度与PhA联合预测PD肌少症的AUC男性为0.925，敏感性为100%，特异性为84.0%;女性为0.880，敏感性为92.0%，特异性为81.5%。PD肌少症评分=1533.48+-0.75*握力+4.63*BMI+-18.07*全身水分+-11.87*细胞外水分/全身水分+9.26*无脂质量指数+-83.41*PhA+22.42*白蛋白/球蛋白+-26.38*血磷+-17.04*总胆固醇+-29.02*甘油三酯+-0.29*白蛋白前蛋白+-0.17*鸢尾素。结论:肌少症在PD患者中较为常见。血清鸢尾素浓度与PhA的结合有助于PD肌少症的快速预测，可作为临床PD肌少症的最佳筛查工具。

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来源期刊

Nephrologie & Therapeutique 医学-泌尿学与肾脏学

CiteScore

0.80

自引率

14.30%

发文量

485

审稿时长

11.9 weeks

期刊介绍： Organe d''expression de la Société de Néphrologie, de la Société Francophone de Dialyse et de la Société de Néphrologie Pédiatrique, Néphrologie et Thérapeutique a pour vocation de publier des textes en français dans le domaine de la Néphrologie, qu''il s''agisse d''actualisation des connaissances, de recommandations de bonne pratique clinique, de publications originales, ou d''informations sur la vie des trois sociétés fondatrices. La variété des thèmes abordés reflète la richesse de la Néphrologie, qu''il s''agisse d''aspects fondamentaux issus de la physiologie, de l''immunologie, de l''anatomo-pathologie, ou de la génétique, ou de sujets de néphrologie clinique, notamment ceux en rapport avec les thérapeutiques néphrologiques, transplantation, hémodialyse et dialyse péritonéale.

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