Hyperhomocysteinemia Associated with Low Muscle Mass, Muscle Function in Elderly Hemodialysis Patients

An Analysis of Multiple Dialysis Centers

Chi Sin Wang, Te Chih Wong, Tuyen Van Duong, Chien Tien Su, Hsi Hsien Chen, Tso Hsiao Chen, Yung Ho Hsu, Sheng Jeng Peng, Ko Lin Kuo, Hsiang Chung Liu, En Tzu Lin, Yi Wei Feng, Shwu Huey Yang

Research output: Contribution to journalArticle

Abstract

Background. The hyperhomocysteinemia was with high prevalence and has been considered as a risk factor for cardiovascular disease in hemodialysis patients. These patients also experienced a high risk of muscle wasting caused by the comorbidity, malnutrition, and low physical activity. We investigated the associations of homocysteinemia with muscle mass, muscle function in elderly hemodialysis patients. Methods. A clinical cross-sectional study was conducted on 138 hemodialysis patients aged 65 years and above in seven hospital-based hemodialysis centers in Taiwan. The data on anthropometry, laboratory, and 3-day dietary intake was examined. The skeletal muscle mass (SMM) was measured by the bioelectrical impedance analysis; the SMM was adjusted by height or weight as SMMHt2 (kg/m2) and SMMWt (%). Muscle function was defined as handgrip strength (HGS) (kg) measured by handgrip dynamometer. Statistical analyses were conducted using simple regression and multivariable stepwise regression analysis. Results. In the total sample, 74.6 % of hemodialysis patients were hyperhomocysteinemia (≥ 15 μmol/L). The means of SMMHt2, SMMWt, arm lean mass, hand grip strength, and muscle quality were 8.7 ± 1.2, 37.7 ± 5.6, 1.7 ± 0.5, 21.1 ± 7.4, and 10.0 ± 3.0, respectively. The multivariable stepwise regression analysis showed that homocysteinemia level was significantly inversely associated with SMMWt (B-coeff. =-0.03, p = 0.02) in hemodialysis patients above 65 years old, but not with muscle function. Conclusions. Hyperhomocysteinemia is common and associated with decreased muscle mass in the elderly hemodialysis patients. Future studies are suggested to explore the impact of the homocysteine-lowering therapy on muscle decline.

Original languageEnglish
Article number9276097
JournalBioMed Research International
Volume2019
DOIs
Publication statusPublished - Jan 1 2019

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Hyperhomocysteinemia
Dialysis
Renal Dialysis
Muscle
Muscles
Hand Strength
Skeletal Muscle
Regression analysis
Regression Analysis
Anthropometry
Homocysteine
Electric Impedance
Taiwan
Malnutrition
Acoustic impedance
Dynamometers
Comorbidity
Cardiovascular Diseases
Cross-Sectional Studies
Exercise

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

Cite this

Hyperhomocysteinemia Associated with Low Muscle Mass, Muscle Function in Elderly Hemodialysis Patients : An Analysis of Multiple Dialysis Centers. / Wang, Chi Sin; Wong, Te Chih; Duong, Tuyen Van; Su, Chien Tien; Chen, Hsi Hsien; Chen, Tso Hsiao; Hsu, Yung Ho; Peng, Sheng Jeng; Kuo, Ko Lin; Liu, Hsiang Chung; Lin, En Tzu; Feng, Yi Wei; Yang, Shwu Huey.

In: BioMed Research International, Vol. 2019, 9276097, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Background. The hyperhomocysteinemia was with high prevalence and has been considered as a risk factor for cardiovascular disease in hemodialysis patients. These patients also experienced a high risk of muscle wasting caused by the comorbidity, malnutrition, and low physical activity. We investigated the associations of homocysteinemia with muscle mass, muscle function in elderly hemodialysis patients. Methods. A clinical cross-sectional study was conducted on 138 hemodialysis patients aged 65 years and above in seven hospital-based hemodialysis centers in Taiwan. The data on anthropometry, laboratory, and 3-day dietary intake was examined. The skeletal muscle mass (SMM) was measured by the bioelectrical impedance analysis; the SMM was adjusted by height or weight as SMMHt2 (kg/m2) and SMMWt ({\%}). Muscle function was defined as handgrip strength (HGS) (kg) measured by handgrip dynamometer. Statistical analyses were conducted using simple regression and multivariable stepwise regression analysis. Results. In the total sample, 74.6 {\%} of hemodialysis patients were hyperhomocysteinemia (≥ 15 μmol/L). The means of SMMHt2, SMMWt, arm lean mass, hand grip strength, and muscle quality were 8.7 ± 1.2, 37.7 ± 5.6, 1.7 ± 0.5, 21.1 ± 7.4, and 10.0 ± 3.0, respectively. The multivariable stepwise regression analysis showed that homocysteinemia level was significantly inversely associated with SMMWt (B-coeff. =-0.03, p = 0.02) in hemodialysis patients above 65 years old, but not with muscle function. Conclusions. Hyperhomocysteinemia is common and associated with decreased muscle mass in the elderly hemodialysis patients. Future studies are suggested to explore the impact of the homocysteine-lowering therapy on muscle decline.",
author = "Wang, {Chi Sin} and Wong, {Te Chih} and Duong, {Tuyen Van} and Su, {Chien Tien} and Chen, {Hsi Hsien} and Chen, {Tso Hsiao} and Hsu, {Yung Ho} and Peng, {Sheng Jeng} and Kuo, {Ko Lin} and Liu, {Hsiang Chung} and Lin, {En Tzu} and Feng, {Yi Wei} and Yang, {Shwu Huey}",
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T1 - Hyperhomocysteinemia Associated with Low Muscle Mass, Muscle Function in Elderly Hemodialysis Patients

T2 - An Analysis of Multiple Dialysis Centers

AU - Wang, Chi Sin

AU - Wong, Te Chih

AU - Duong, Tuyen Van

AU - Su, Chien Tien

AU - Chen, Hsi Hsien

AU - Chen, Tso Hsiao

AU - Hsu, Yung Ho

AU - Peng, Sheng Jeng

AU - Kuo, Ko Lin

AU - Liu, Hsiang Chung

AU - Lin, En Tzu

AU - Feng, Yi Wei

AU - Yang, Shwu Huey

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background. The hyperhomocysteinemia was with high prevalence and has been considered as a risk factor for cardiovascular disease in hemodialysis patients. These patients also experienced a high risk of muscle wasting caused by the comorbidity, malnutrition, and low physical activity. We investigated the associations of homocysteinemia with muscle mass, muscle function in elderly hemodialysis patients. Methods. A clinical cross-sectional study was conducted on 138 hemodialysis patients aged 65 years and above in seven hospital-based hemodialysis centers in Taiwan. The data on anthropometry, laboratory, and 3-day dietary intake was examined. The skeletal muscle mass (SMM) was measured by the bioelectrical impedance analysis; the SMM was adjusted by height or weight as SMMHt2 (kg/m2) and SMMWt (%). Muscle function was defined as handgrip strength (HGS) (kg) measured by handgrip dynamometer. Statistical analyses were conducted using simple regression and multivariable stepwise regression analysis. Results. In the total sample, 74.6 % of hemodialysis patients were hyperhomocysteinemia (≥ 15 μmol/L). The means of SMMHt2, SMMWt, arm lean mass, hand grip strength, and muscle quality were 8.7 ± 1.2, 37.7 ± 5.6, 1.7 ± 0.5, 21.1 ± 7.4, and 10.0 ± 3.0, respectively. The multivariable stepwise regression analysis showed that homocysteinemia level was significantly inversely associated with SMMWt (B-coeff. =-0.03, p = 0.02) in hemodialysis patients above 65 years old, but not with muscle function. Conclusions. Hyperhomocysteinemia is common and associated with decreased muscle mass in the elderly hemodialysis patients. Future studies are suggested to explore the impact of the homocysteine-lowering therapy on muscle decline.

AB - Background. The hyperhomocysteinemia was with high prevalence and has been considered as a risk factor for cardiovascular disease in hemodialysis patients. These patients also experienced a high risk of muscle wasting caused by the comorbidity, malnutrition, and low physical activity. We investigated the associations of homocysteinemia with muscle mass, muscle function in elderly hemodialysis patients. Methods. A clinical cross-sectional study was conducted on 138 hemodialysis patients aged 65 years and above in seven hospital-based hemodialysis centers in Taiwan. The data on anthropometry, laboratory, and 3-day dietary intake was examined. The skeletal muscle mass (SMM) was measured by the bioelectrical impedance analysis; the SMM was adjusted by height or weight as SMMHt2 (kg/m2) and SMMWt (%). Muscle function was defined as handgrip strength (HGS) (kg) measured by handgrip dynamometer. Statistical analyses were conducted using simple regression and multivariable stepwise regression analysis. Results. In the total sample, 74.6 % of hemodialysis patients were hyperhomocysteinemia (≥ 15 μmol/L). The means of SMMHt2, SMMWt, arm lean mass, hand grip strength, and muscle quality were 8.7 ± 1.2, 37.7 ± 5.6, 1.7 ± 0.5, 21.1 ± 7.4, and 10.0 ± 3.0, respectively. The multivariable stepwise regression analysis showed that homocysteinemia level was significantly inversely associated with SMMWt (B-coeff. =-0.03, p = 0.02) in hemodialysis patients above 65 years old, but not with muscle function. Conclusions. Hyperhomocysteinemia is common and associated with decreased muscle mass in the elderly hemodialysis patients. Future studies are suggested to explore the impact of the homocysteine-lowering therapy on muscle decline.

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