Association of Ultrasound-Derived Metrics of the Quadriceps Muscle with Protein Energy Wasting in Hemodialysis Patients: A Multicenter Cross-Sectional Study.

Autor: Sahathevan S; Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia., Khor BH; Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia., Singh BKS; Nutrition Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia., Sabatino A; Nephrology Unit, Department of Medicine and Surgery, Parma University Hospital, 43121 Parma, Italy., Fiaccadori E; Nephrology Unit, Department of Medicine and Surgery, Parma University Hospital, 43121 Parma, Italy., Daud ZAM; Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Selangor, Malaysia., Ali MS; Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Selangor, Malaysia., Narayanan SS; School of BioSciences, Faculty of Health and Medical Sciences, Taylor's University Lakeside Campus, No 1, Jalan Taylor's, Subang Jaya 47500, Selangor, Malaysia., Tallman D; Department of Nutrition and Food Science, Wayne State University, Detroit, MI 48202, USA., Chinna K; School of Medicine, Faculty of Health and Medical Sciences, Taylor's University Lakeside Campus, No 1, Jalan Taylor's, Subang Jaya 47500, Selangor, Malaysia., Goh BL; Department of Nephrology, Serdang Hospital, Jalan Puchong, Kajang 43000, Selangor, Malaysia., Gafor AHA; Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia., Ahmad G; Department of Nephrology, Kuala Lumpur Hospital, Jalan Pahang, Wilayah Persekutuan Kuala Lumpur 50856, Malaysia.; Department of Cardiology, National Heart Institute, 145, Jalan Tun Razak, Kuala Lumpur 50400, Malaysia., Morad Z; National Kidney Foundation, 70, Jalan 14/29, Petaling Jaya 46100, Selangor, Malaysia., Khosla P; Department of Nutrition and Food Science, Wayne State University, Detroit, MI 48202, USA., Karupaiah T; School of BioSciences, Faculty of Health and Medical Sciences, Taylor's University Lakeside Campus, No 1, Jalan Taylor's, Subang Jaya 47500, Selangor, Malaysia., On Behalf Of The Patch Study Malaysia Investigators
Jazyk: angličtina
Zdroj: Nutrients [Nutrients] 2020 Nov 23; Vol. 12 (11). Date of Electronic Publication: 2020 Nov 23.
DOI: 10.3390/nu12113597
Abstrakt: This study aimed to assess muscle wasting and risk of protein energy wasting (PEW) in hemodialysis (HD) patients using an ultrasound (US) imaging method. PEW was identified using the ISRNM criteria in 351 HD patients. Quadriceps muscle thickness of rectus femoris (RF) and vastus intermedius (VI) muscles and cross-sectional area (CSA) of the RF muscle (RF CSA ) were measured using US and compared with other physical measures. Associations of US indices with PEW were determined by logistic regression. Irrespective of gender, PEW vs. non-PEW patients had smaller RF, VI muscles, and RF CSA (all p < 0.001). US muscle sites (all p < 0.001) discriminated PEW from non-PEW patients, but the RF CSA compared to bio-impedance spectroscopy had a greater area under the curve (AUC, 0.686 vs. 0.581), sensitivity (72.8% vs. 65.8%), and specificity (55.6% vs. 53.9%). AUC of the RF CSA was greatest for PEW risk in men (0.74, 95% CI: 0.66-0.82) and women (0.80, 95% CI: 0.70-0.90) (both p < 0.001). Gender-specific RF CSA values (men < 6.00 cm 2 ; women < 4.47 cm 2 ) indicated HD patients with smaller RF CSA were 8 times more likely to have PEW (AOR = 8.63, 95% CI: 4.80-15.50, p < 0.001). The US approach enabled discrimination of muscle wasting in HD patients with PEW. The RF CSA was identified as the best US site with gender-specific RF CSA values to associate with PEW risk, suggesting potential diagnostic criteria for muscle wasting.
Databáze: MEDLINE
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