Kidney Research and Clinical Practice

Korean Society of Nephrology (대한신장학회)
권호 표지
DOI QR코드

DOI QR Code

Prevalence of dynapenic obesity and sarcopenic obesity and their associations with cardiovascular disease risk factors in peritoneal dialysis patients

  • Tabibi, Hadi (Department of Clinical Nutrition & Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences) ;
  • As'habi, Atefeh (Department of Nutrition, Semnan University of Medical Sciences) ;
  • Najafi, Iraj (Department of Nephrology, Tehran University of Medical Sciences) ;
  • Hedayati, Mehdi (Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences)
  • Received : 2018.06.22
  • Accepted : 2018.09.07
  • Published : 2018.12.31
⟨ Previous Next ⟩

Abstract

Background: Dynapenic obesity and sarcopenic obesity increase cardiovascular disease (CVD) and mortality in nonuremic patients. The present study was designed to determine the prevalence of dynapenic obesity and sarcopenic obesity and their associations with CVD risk factors in peritoneal dialysis (PD) patients. Methods: All eligible PD patients in Tehran peritoneal dialysis centers were included in this cross-sectional study. Skeletal muscle mass and fat mass were assessed using bioelectrical impedance analysis. Muscle strength and physical performance were determined using hand grip strength and a 4-meter walk gait speed test, respectively. In addition, a 5-mL blood sample was obtained from each patient. Results: The prevalence of dynapenic obesity and sarcopenic obesity were 11.4% and 3.8% in PD patients, respectively. Serum high-sensitive C-reactive protein (hs-CRP), soluble intercellular adhesion molecule type 1, triglyceride, total cholesterol, and low-density lipoprotein cholesterol were significantly higher in PD patients with dynapenic obesity than in dynapenic nonobese and nondynapenic nonobese patients. Similarly, serum concentrations of CVD risk factors in PD patients with sarcopenic obesity were higher than in nonsarcopenic nonobese patients, but these differences were statistically significant only for serum hs-CRP and triglyceride. In addition, muscle strength and skeletal muscle mass percentage were negatively associated with markers of inflammation and dyslipidemia, whereas body fat percentage was positively associated with these CVD risk factors. Conclusion: This study indicates that although the prevalence of dynapenic obesity and sarcopenic obesity are relatively low in PD patients, these disorders may be associated with CVD risk factors.

Keywords

Acknowledgement

Supported by : National Nutrition and Food Technology Research Institute of Iran

References

  1. Clark BC, Manini TM. Sarcopenia $\neq$ dynapenia. J Gerontol A Biol Sci Med Sci 63:829-834, 2008 https://doi.org/10.1093/gerona/63.8.829
  2. Clark BC, Manini TM. What is dynapenia? Nutrition 28: 495-503, 2012 https://doi.org/10.1016/j.nut.2011.12.002
  3. Fahal IH. Uraemic sarcopenia: aetiology and implications. Nephrol Dial Transplant 29:1655-1665, 2014 https://doi.org/10.1093/ndt/gft070
  4. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing 39:412-423, 2010 https://doi.org/10.1093/ageing/afq034
  5. Kato A, Ishida J, Endo Y, et al. Association of abdominal visceral adiposity and thigh sarcopenia with changes of arteriosclerosis in haemodialysis patients. Nephrol Dial Transplant 26:1967-1976, 2011 https://doi.org/10.1093/ndt/gfq652
  6. Lawman HG, Troiano RP, Perna FM, Wang CY, Fryar CD, Ogden CL. Associations of relative handgrip strength and cardiovascular disease biomarkers in U.S. adults, 2011-2012. Am J Prev Med 50:677-683, 2016 https://doi.org/10.1016/j.amepre.2015.10.022
  7. Park J, Ahmadi SF, Streja E, et al. Obesity paradox in endstage kidney disease patients. Prog Cardiovasc Dis 56:415-425, 2014 https://doi.org/10.1016/j.pcad.2013.10.005
  8. Kalantar-Zadeh K, Block G, Humphreys MH, Kopple JD. Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney Int 63:793-808, 2003 https://doi.org/10.1046/j.1523-1755.2003.00803.x
  9. Malhotra R, Deger SM, Salat H, et al. Sarcopenic obesity definitions by body composition and mortality in the hemodialysis patients. J Ren Nutr 27:84-90, 2017 https://doi.org/10.1053/j.jrn.2016.09.010
  10. Androga L, Sharma D, Amodu A, Abramowitz MK. Sarcopenia, obesity, and mortality in US adults with and without chronic kidney disease. Kidney Int Rep 2:201-211, 2017 https://doi.org/10.1016/j.ekir.2016.10.008
  11. Stephen WC, Janssen I. Sarcopenic-obesity and cardiovascular disease risk in the elderly. J Nutr Health Aging 13:460-466, 2009 https://doi.org/10.1007/s12603-009-0084-z
  12. Atkins JL, Whincup PH, Morris RW, Lennon LT, Papacosta O, Wannamethee SG. Sarcopenic obesity and risk of cardiovascular disease and mortality: a population-based cohort study of older men. J Am Geriatr Soc 62:253-260, 2014 https://doi.org/10.1111/jgs.12652
  13. Kim JH, Cho JJ, Park YS. Relationship between sarcopenic obesity and cardiovascular disease risk as estimated by the Framingham risk score. J Korean Med Sci 30:264-271, 2015 https://doi.org/10.3346/jkms.2015.30.3.264
  14. Senechal M, Dionne IJ, Brochu M. Dynapenic abdominal obesity and metabolic risk factors in adults 50 years of age and older. J Aging Health 24:812-826, 2012 https://doi.org/10.1177/0898264312440324
  15. Rossi AP, Fantin F, Caliari C, et al. Dynapenic abdominal obesity as predictor of mortality and disability worsening in older adults: a 10-year prospective study. Clin Nutr 35:199-204, 2016 https://doi.org/10.1016/j.clnu.2015.02.005
  16. Pereira RA, Cordeiro AC, Avesani CM, et al. Sarcopenia in chronic kidney disease on conservative therapy: prevalence and association with mortality. Nephrol Dial Transplant 30:1718-1725, 2015 https://doi.org/10.1093/ndt/gfv133
  17. Ren H, Gong D, Jia F, Xu B, Liu Z. Sarcopenia in patients undergoing maintenance hemodialysis: incidence rate, risk factors and its effect on survival risk. Ren Fail 38:364-371, 2016 https://doi.org/10.3109/0886022X.2015.1132173
  18. Hashemi R, Heshmat R, Motlagh AD, et al. Sarcopenia and its determinants among Iranian elderly (SARIR): study protocol. J Diabetes Metab Disord 11:23, 2012 https://doi.org/10.1186/2251-6581-11-23
  19. Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia: consensus report of the Asian working group for sarcopenia. J Am Med Dir Assoc 15:95-101, 2014 https://doi.org/10.1016/j.jamda.2013.11.025
  20. Gracia-Iguacel C, Qureshi AR, Avesani CM, et al. Subclinical versus overt obesity in dialysis patients: more than meets the eye. Nephrol Dial Transplant 28 Suppl 4:iv175-iv181, 2013 https://doi.org/10.1093/ndt/gft113
  21. Tabibi H, Imani H, Hedayati M, Atabak S, Rahmani L. Effects of soy consumption on serum lipids and apoproteins in peritoneal dialysis patients: a randomized controlled trial. Perit Dial Int 30:611-618, 2010 https://doi.org/10.3747/pdi.2009.00161
  22. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18:499-502, 1972
  23. Imani H, Tabibi H, Atabak S, et al. Effects of soy consumption on oxidative stress, blood homocysteine, coagulation factors, and phosphorus in peritoneal dialysis patients. J Ren Nutr 19:389-395, 2009 https://doi.org/10.1053/j.jrn.2009.01.020
  24. Oreopoulos DG, Rao PS. Assessing peritoneal ultrafiltration, solute transport, and volume status. In: Daugirdas JT, Blake PG, Ing TS, eds. Handbook of Dialysis, 3rd edition. Philadelphia: Lippincott Williams & Wilkins, 361-372, 2001
  25. Scott D, Sanders KM, Aitken D, Hayes A, Ebeling PR, Jones G. Sarcopenic obesity and dynapenic obesity: 5-year associations with falls risk in middle-aged and older adults. Obesity (Silver Spring) 22:1568-1574, 2014 https://doi.org/10.1002/oby.20734
  26. Tabibi H, As'habi A, Heshmati BN, Mahdavi-Mazdeh M, Hedayati M. Prevalence of protein-energy wasting and its various types in Iranian hemodialysis patients: a new classification. Ren Fail 34:1200-1205, 2012 https://doi.org/10.3109/0886022X.2012.718710
  27. Cho Y, Hawley CM, Johnson DW. Clinical causes of inflammation in peritoneal dialysis patients. Int J Nephrol 2014:909373, 2014
  28. Tedgui A. The role of inflammation in atherothrombosis: implications for clinical practice. Vasc Med 10:45-53, 2005 https://doi.org/10.1191/1358863x05vm589ra
  29. Iantorno M, Campia U, Di Daniele N, et al. Obesity, inflammation and endothelial dysfunction. J Biol Regul Homeost Agents 28:169-176, 2014
  30. Locatelli F, Canaud B, Eckardt KU, Stenvinkel P, Wanner C, Zoccali C. Oxidative stress in end-stage renal disease: an emerging threat to patient outcome. Nephrol Dial Transplant 18:1272-1280, 2003 https://doi.org/10.1093/ndt/gfg074
  31. Wanner C. Altered lipid metabolism and serum lipids in renal disease and renal failure. In: Kopple JD, Massary SG, eds. Kopple and Massry's Nutritional Management of Renal Disease, 2nd edition. Philadelphia: Lippincott Williams & Wilkins, 42-55, 2004
  32. Lacour B, Massy Z, Drueke TB. Lipid metabolism. In: Massry SG, Glassock RJ, eds. Massry & Glassock's Textbook of Nephrology, 4th edition. Philadelphia: Williams & Wilkins, 1346-1356, 2001
  33. Prichard SS. Metabolic complications of peritoneal dialysis. In: Daugirdas JT, Blake PG, Ing TS, eds. Handbook of Dialysis, 3rd edition. Philadelphia: Lippincott Williams & Wilkins, 405-410, 2001
  34. Lysine LK, Israel DA. Nutrition in weight management. In: Mahan LK, Escott-Stump S, Raymond J, eds. Krause's Food and the Nutrition Care Process, 13th edition. Missouri: Saunders, 462-487, 2012
  35. Cannon JG. Cytokines and eicosanoids. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ, eds. Modern Nutrition in Health and Disease, 10th edition. Philadelphia: Lippincott Williams & Wilkins, 663, 2006
  36. Nishimura F, Taniguchi A, Yamaguchi-Morimoto M, et al. Periodontal infection and dyslipidemia in type 2 diabetics: association with increased HMG-CoA reductase expression. Horm Metab Res 38:530-535, 2006 https://doi.org/10.1055/s-2006-949525
  37. Feingold KR, Spady DK, Pollock AS, Moser AH, Grunfeld C. Endotoxin, TNF, and IL-1 decrease cholesterol 7 alphahydroxylase mRNA levels and activity. J Lipid Res 37:223-228, 1996
  38. Vaziri ND. Altered lipid metabolism and serum lipids in kidney disease and kidney failure. In: Kopple JD, Massry SG, Kalantar-zadeh K, eds. Nutritional Management of Renal Disease, 3rd edition. Amsterdam: Academic Press, 31-48, 2013
  39. Cheung AK. Is lipid control necessary in hemodialysis patients? Clin J Am Soc Nephrol 4 Suppl 1:S95-S101, 2009 https://doi.org/10.2215/CJN.04780709

Cited by

  1. Sarcopenia disease in Iran: an overview vol.18, pp.2, 2018, https://doi.org/10.1007/s40200-019-00452-9
  2. Non-Systematic Review of Diet and Nutritional Risk Factors of Cardiovascular Disease in Obesity vol.12, pp.3, 2020, https://doi.org/10.3390/nu12030814
  3. Long-term clinical outcomes of peritoneal dialysis patients: 9-year experience of a single centre in Turkey vol.44, pp.2, 2020, https://doi.org/10.3906/sag-1909-98
  4. PHYSICAL ACTIVITY AND CARDIORESPIRATORY FITNESS ATTENUATE THE IMPACT OF SARCOPENIC-OBESITY ON CARDIOVASCULAR DISEASE RISK IN KOREAN MEN: A CROSS SECTIONAL STUDY vol.16, pp.2, 2018, https://doi.org/10.15586/jomh.v16i2.251
  5. Physical performance and chronic kidney disease development in elderly adults: results from a nationwide cohort study vol.12, pp.17, 2018, https://doi.org/10.18632/aging.103741
  6. The Effect of Exercise on Nutritional Status and Body Composition in Hemodialysis: A Systematic Review vol.12, pp.10, 2018, https://doi.org/10.3390/nu12103071
  7. The Role of Sarcopenic Obesity in Cancer and Cardiovascular Disease: A Synthesis of the Evidence on Pathophysiological Aspects and Clinical Implications vol.22, pp.9, 2018, https://doi.org/10.3390/ijms22094339
  8. Sarcopenia in hemodialysis patients from Buenos Aires, Argentina vol.7, pp.2, 2018, https://doi.org/10.1016/j.afos.2021.04.001
  9. Significant Association of Diabetes With Mortality of Chronic Hemodialysis Patients, Independent of the Presence of Obesity, Sarcopenia, and Sarcopenic Obesity vol.32, pp.1, 2022, https://doi.org/10.1053/j.jrn.2021.07.003