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Sci Rep. 2024;14(1):22837.

Effect of low muscle mass on total mortality related to metabolic disease in chronic kidney disease patients.

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제1저자 최종욱, 공성혜 · 교신저자 오창명, 문신제

소속 (5)
  1. Department of Internal Medicine, Hanyang University College of Medicine, 222-1 Wangsimni- ro, Seongdong-gu, Seoul, 04763, Korea.
  2. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, 13620, Korea.
  3. Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, 07441, Korea.
  4. Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, 123 Cheomdangwagi-ro, Buk-gu, Gwangju, 61005, Korea. cmoh@gist.ac.kr.
  5. Department of Internal Medicine, Hanyang University College of Medicine, 222-1 Wangsimni- ro, Seongdong-gu, Seoul, 04763, Korea. sinjei1129@gmail.com.

Abstract

Low muscle mass is a risk factor for mortality in patients with chronic kidney disease (CKD). However, it is not clear to what extent low muscle mass contributes to this risk, either independently or in combination with metabolic abnormalities and frailty. This study used data from the National Health and Nutrition Examination Survey 1999-2006 and 2011-2018. Low muscle mass was defined as Appendicular Skeletal Mass Index < 7 kg/m2 in men or < 5.5 kg/m2 in women. The follow-up duration was from the first anthropometric and clinical measurements to death or the last follow-up. This study enrolled 2072 patients with CKD. Low muscle mass was associated with a lower risk of metabolic abnormalities, but was associated with an elevated mortality risk. Conversely, central obesity was associated with a higher likelihood of metabolic abnormalities and frailty, yet showed no significant association with mortality risk. Subsequently conducted mediation analysis indicated that the effect of low muscle mass on mortality was direct, not mediated by frailty and metabolic abnormalities. In spite of the inverse relationship between low muscle mass and metabolic abnormalities, low muscle mass are directly associated with an increased risk of all-cause mortality. Low muscle mass may directly contribute to mortality in patients with CKD, independent of metabolic abnormalities and frailty in these patients.

© 2024. The Author(s).

Figures

Fig. 1
Fig. 1 Flowchart for final selection.
Fig. 2
Fig. 2 The hazard ratio for mortality according to (a) Appendicular Skeletal Mass Index (ASMI) and (b) waist circumference. Adjusted for age, sex, race, smoking status, alcohol consumption, history of cancer, DM, hypertension, dyslipidemia, preexistent CVD, risk of CKD progression, and frailty index.
Fig. 3
Fig. 3 Kaplan-Meier survival curves of survival data in relation to low muscle mass (LMM) and central obesity (COB).
Fig. 4
Fig. 4 Mediation Analysis of the effect of low muscle mass through frailty and metabolic abnormalities in patients with CKD on all-cause mortality.

그림 출처: PubMed Central 공개 논문 (PMC11445479)

Conflict of interest statement

The authors declare no competing interests.

그 밖의 정보
출판 형태
Journal Article
저널
Scientific reports · eISSN 2045-2322
전자 출판
2024-10-01
MeSH
Humans · Renal Insufficiency, Chronic* / mortality / complications / pathology · Female · Male · Middle Aged · Aged · Metabolic Diseases* / mortality / complications / pathology · Nutrition Surveys · Muscle, Skeletal / metabolism / pathology · Risk Factors · Frailty / mortality / complications · Sarcopenia / mortality / complications / metabolism · Adult
참고문헌
35편