Decreased haemoglobin levels are associated with lower muscle mass and strength in kidney transplant recipients.

Autor: Vinke JSJ; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Wouters HJCM; Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.; Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Stam SP; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Douwes RM; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Post A; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Gomes-Neto AW; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., van der Klauw MM; Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Berger SP; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Bakker SJL; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., De Borst MH; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Eisenga MF; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Jazyk: angličtina
Zdroj: Journal of cachexia, sarcopenia and muscle [J Cachexia Sarcopenia Muscle] 2022 Aug; Vol. 13 (4), pp. 2044-2053. Date of Electronic Publication: 2022 Jun 03.
DOI: 10.1002/jcsm.12999
Abstrakt: Background: Post-transplant anaemia and reduced muscle mass and strength are highly prevalent in kidney transplant recipients (KTRs). Decreased haemoglobin levels, a marker of anaemia, could adversely affect muscle mass and strength through multiple mechanisms, among others, through diminished tissue oxygenation. We aimed to investigate the association between haemoglobin levels with muscle mass and strength in KTRs.
Methods: We included stable KTRs from the TransplantLines Biobank and Cohort study with a functional graft ≥1 year post-transplantation. Muscle mass was assessed using 24 h urinary creatinine excretion rate (CER) and bioelectrical impedance analysis (BIA). Muscle strength was assessed with a handgrip strength test using a dynamometer and, in a subgroup (n = 290), with the five-times sit-to-stand (FTSTS) test. We used multivariable linear and logistic regression analyses to investigate the associations of haemoglobin levels with muscle mass and strength.
Results: In 871 included KTRs [median age 58 (interquartile range (IQR), 48-66)] years; 60% men; eGFR 51 ± 18 mL/min/1.73 m 2 ) who were 3.5 (1.0-10.2) years post-transplantation, the mean serum haemoglobin level was 13.9 ± 1.8 g/dL in men and 12.8 ± 1.5 g/dL in women. Lower haemoglobin levels were independently associated with a lower CER (std. β = 0.07, P = 0.01), BIA-derived skeletal muscle mass (std. β = 0.22, P < 0.001), handgrip strength (std. β = 0.15, P < 0.001), and worse FTSTS test scores (std. β = -0.17, P = 0.02). KTRs in the lowest age-specific and sex-specific quartile of haemoglobin levels had an increased risk of being in the worst age-specific and sex-specific quartile of CER (fully adjusted OR, 2.09; 95% CI 1.15-3.77; P = 0.02), handgrip strength (fully adjusted OR, 3.30; 95% CI 1.95-5.59; P < 0.001), and FTSTS test score (fully adjusted OR, 7.21; 95% CI 2.59-20.05; P < 0.001).
Conclusions: Low haemoglobin levels are strongly associated with decreased muscle mass and strength in KTRs. Future investigation will need to investigate whether maintaining higher haemoglobin levels may improve muscle mass and strength in KTRs.
(© 2022 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders.)
Databáze: MEDLINE
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