Prevalence of obesity and obesity-associated muscle wasting in patients on peritoneal dialysis.


Journal

Nutrition, metabolism, and cardiovascular diseases : NMCD
ISSN: 1590-3729
Titre abrégé: Nutr Metab Cardiovasc Dis
Pays: Netherlands
ID NLM: 9111474

Informations de publication

Date de publication:
12 2019
Historique:
received: 04 02 2019
revised: 30 04 2019
accepted: 08 05 2019
pubmed: 2 11 2019
medline: 20 2 2020
entrez: 1 11 2019
Statut: ppublish

Résumé

A progressive decrease in muscle mass until full-blown sarcopenia may occur in patients on peritoneal dialysis (PD) and worsen their life quality and expectancy. Here we investigate the prevalence of obesity and obesity-associated muscle wasting in PD patients. The study design was observational, cross sectional. Body composition was assessed with BIA and BIVA in 88 PD patients (53.4 ± 13.1 years; 67% male). Patients with obesity and/or with reduced muscle mass were identified using FMI and SM/BW cutoff values, respectively. Inflammatory status was assessed by measuring CRP and fibrinogen blood levels. A total of 44.3% of the patients showed a reduced muscle mass (37.5% moderate and 6.8% severe). The prevalence of obesity was 6.1%, 81.8%, and 100% in patients with normal, moderately, and severely reduced muscle mass, respectively (p < 0.05). Of the total, 15.2% of the patients with normal muscle mass, 18.4% of those with moderately reduced muscle mass, and 66.7% of those with severely reduced muscle mass had diabetes. The prevalence of severe muscle mass loss was higher in those with diabetes than in those without diabetes (22.2% vs. 2.8%, p < 0.05). Patients with obesity-associated muscle wasting showed higher fibrinogen (613.9 ± 155.1 vs. 512.9 ± 159.5 mg/dL, p < 0.05) and CPR (1.4 ± 1.3 vs. 0.6 ± 0.8 mg/dL, p < 0.05) blood concentrations than those with normal body composition. Obesity and diabetes were strongly associated with muscle mass loss in our PD patients. It remains to be established whether prevention of obesity with nutritional interventions can halt the occurrence of muscle mass loss in patients on PD.

Sections du résumé

BACKGROUND AND AIMS
A progressive decrease in muscle mass until full-blown sarcopenia may occur in patients on peritoneal dialysis (PD) and worsen their life quality and expectancy. Here we investigate the prevalence of obesity and obesity-associated muscle wasting in PD patients.
PATIENTS AND METHODS
The study design was observational, cross sectional. Body composition was assessed with BIA and BIVA in 88 PD patients (53.4 ± 13.1 years; 67% male). Patients with obesity and/or with reduced muscle mass were identified using FMI and SM/BW cutoff values, respectively. Inflammatory status was assessed by measuring CRP and fibrinogen blood levels.
RESULTS
A total of 44.3% of the patients showed a reduced muscle mass (37.5% moderate and 6.8% severe). The prevalence of obesity was 6.1%, 81.8%, and 100% in patients with normal, moderately, and severely reduced muscle mass, respectively (p < 0.05). Of the total, 15.2% of the patients with normal muscle mass, 18.4% of those with moderately reduced muscle mass, and 66.7% of those with severely reduced muscle mass had diabetes. The prevalence of severe muscle mass loss was higher in those with diabetes than in those without diabetes (22.2% vs. 2.8%, p < 0.05). Patients with obesity-associated muscle wasting showed higher fibrinogen (613.9 ± 155.1 vs. 512.9 ± 159.5 mg/dL, p < 0.05) and CPR (1.4 ± 1.3 vs. 0.6 ± 0.8 mg/dL, p < 0.05) blood concentrations than those with normal body composition.
CONCLUSION
Obesity and diabetes were strongly associated with muscle mass loss in our PD patients. It remains to be established whether prevention of obesity with nutritional interventions can halt the occurrence of muscle mass loss in patients on PD.

Identifiants

pubmed: 31668791
pii: S0939-4753(19)30204-2
doi: 10.1016/j.numecd.2019.05.057
pii:
doi:

Substances chimiques

Biomarkers 0
Inflammation Mediators 0
Fibrinogen 9001-32-5
C-Reactive Protein 9007-41-4

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1390-1399

Informations de copyright

Copyright © 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Auteurs

Bruna Guida (B)

Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy. Electronic address: bguida@unina.it.

Rossella Trio (R)

Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy.

Martina Di Maro (M)

Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy.

Andrea Memoli (A)

Department of Public Health, Nephrology Section, Federico II University of Naples, Italy.

Teresa Di Lauro (T)

Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy.

Annamaria Belfiore (A)

Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy.

Mariarosaria Santillo (M)

Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy.

Mauro Cataldi (M)

Department of Neuroscience, Reproductive Sciences and Dentistry, Division of Pharmacology, Federico II University of Naples, Italy.

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