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Sarcopenia diagnosed by ultrasound-assessed quadriceps muscle thickness and handgrip strength predicts mortality in patients on hemodialysis
Background Estimation of muscle mass is a pivotal component in the diagnosis of protein-energy wasting and sarcopenia. While bioimpedance spectroscopy is a widely accepted technique for the assessment of lean tissue related to the diagnosis of sarcopenia, to date skeletal muscle ultrasound (US) has...
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| Published in: | Journal of nephrology 2024, Vol.37 (4), p.993-1003 |
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| creator | Sabatino, Alice Kooman, Jeroen Avesani, Carla Maria Gregorini, Mariacristina Bianchi, Stefano Regolisti, Giuseppe Fiaccadori, Enrico |
| description | Background
Estimation of muscle mass is a pivotal component in the diagnosis of protein-energy wasting and sarcopenia. While bioimpedance spectroscopy is a widely accepted technique for the assessment of lean tissue related to the diagnosis of sarcopenia, to date skeletal muscle ultrasound (US) has not gained full acceptance for this purpose. The aim of this study was to assess the predictive value for mortality of the indexed thickness of the quadriceps vastus intermedius, as measured by US, compared to lean tissue index as estimated by bioimpedance spectroscopy, both combined with handgrip strength in a group of patients with end-stage kidney disease (ESKD) on maintenance hemodialysis (HD).
Methods
The cut-off values for low handgrip strength were |
| doi_str_mv | 10.1007/s40620-023-01867-7 |
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| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_843769</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2918199247</sourcerecordid><originalsourceid>FETCH-LOGICAL-c435t-3e77111fe47df19da41f77c93e0eb2854938b5700e65e46f2b040ed1d12431543</originalsourceid><addsrcrecordid>eNp9kcuO1DAQRSMEYh7wAyyQl2wy-BnHSzTiJY3EAlhbTlzp9kzazrgcof4HPho33TOwgY1dqjq3ruXbNK8YvWKU6rcoacdpS7loKes73eonzTnTXLYdVebpX_VZc4F4SylXisvnzZnoeSeUYOfNz68uj2mBGBzxwW1iQvBk2JN1LtlhWqNvHSLgoX2_Op_DCAuS3YrjDKRsw3gX65S46Mm2HpscFoIlQ9yULVky-DCWyqdc3BzKnoRIFlcCxNpNkWxhl6rxvMeAL5pnk5sRXp7uy-b7h_ffrj-1N18-fr5-d9OOUqjSCtCaMTaB1H5ixjvJJq1HI4DCwHsljegHpSmFToHsJj5QScEzz7gUTElx2bTHvfgDlnWwSw47l_c2uWBPrbtage2l0J2pvPknv-Tk_4gehNWlM8r0B683R20F71fAYncBR5hnFyGtaLlhPTOGS11RfkTHnBAzTI9GjNpD4vaYuK2J29-J24Po9Wn_OuzAP0oeIq6AOD2-juIGsr1Na471f_-39hdTbLul</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2918199247</pqid></control><display><type>article</type><title>Sarcopenia diagnosed by ultrasound-assessed quadriceps muscle thickness and handgrip strength predicts mortality in patients on hemodialysis</title><source>Springer Nature</source><creator>Sabatino, Alice ; Kooman, Jeroen ; Avesani, Carla Maria ; Gregorini, Mariacristina ; Bianchi, Stefano ; Regolisti, Giuseppe ; Fiaccadori, Enrico</creator><creatorcontrib>Sabatino, Alice ; Kooman, Jeroen ; Avesani, Carla Maria ; Gregorini, Mariacristina ; Bianchi, Stefano ; Regolisti, Giuseppe ; Fiaccadori, Enrico</creatorcontrib><description>Background
Estimation of muscle mass is a pivotal component in the diagnosis of protein-energy wasting and sarcopenia. While bioimpedance spectroscopy is a widely accepted technique for the assessment of lean tissue related to the diagnosis of sarcopenia, to date skeletal muscle ultrasound (US) has not gained full acceptance for this purpose. The aim of this study was to assess the predictive value for mortality of the indexed thickness of the quadriceps vastus intermedius, as measured by US, compared to lean tissue index as estimated by bioimpedance spectroscopy, both combined with handgrip strength in a group of patients with end-stage kidney disease (ESKD) on maintenance hemodialysis (HD).
Methods
The cut-off values for low handgrip strength were < 27 kg for males and < 16 kg for females. The cut-off value for low lean tissue index was obtained from an age-matched healthy control group, with low lean tissue index being defined as values below the 10th percentile of the distribution of healthy subjects. The cut-off values for low quadriceps vastus intermedius thickness index were < 3.44 mm/m
2
for males and < 3.52 mm/m
2
for females.
Results
Ultrasound and bioimpedance spectroscopy were performed in 99 patients, and handgrip strength was assessed in 64 patients, all on maintenance HD. After a median follow-up of 28 months (interquartile range 19–41 months) 38 patients died. Lean tissue index was not associated with mortality, while low quadriceps vastus intermedius thickness index and low handgrip strength were associated with an increased hazard of death. In the fully adjusted model, only the combination of low handgrip strength and low quadriceps vastus intermedius thickness index was significantly associated with higher mortality.
Conclusion
When combined with low handgrip strength, low quadriceps muscle US outperformed low lean tissue index as assessed by bioimpedance spectroscopy in predicting mortality in a cohort of patients on maintenance HD. Ultrasound may be a useful and convenient technique for the assessment of sarcopenia and protein-energy wasting in this patient population.
Graphical Abstract</description><identifier>ISSN: 1724-6059</identifier><identifier>ISSN: 1121-8428</identifier><identifier>EISSN: 1724-6059</identifier><identifier>DOI: 10.1007/s40620-023-01867-7</identifier><identifier>PMID: 38263531</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Aged ; Case-Control Studies ; Dielectric Spectroscopy ; Female ; Hand Strength ; Humans ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - physiopathology ; Kidney Failure, Chronic - therapy ; Male ; Medicin och hälsovetenskap ; Medicine ; Medicine & Public Health ; Middle Aged ; Nephrology ; Nutritional Management of Kidney Diseases ; Original Article ; Predictive Value of Tests ; Quadriceps Muscle - diagnostic imaging ; Quadriceps Muscle - physiopathology ; Renal Dialysis ; Sarcopenia - diagnostic imaging ; Sarcopenia - mortality ; Sarcopenia - physiopathology ; Ultrasonography ; Urology</subject><ispartof>Journal of nephrology, 2024, Vol.37 (4), p.993-1003</ispartof><rights>The Author(s) under exclusive licence to Italian Society of Nephrology 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s) under exclusive licence to Italian Society of Nephrology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c435t-3e77111fe47df19da41f77c93e0eb2854938b5700e65e46f2b040ed1d12431543</citedby><cites>FETCH-LOGICAL-c435t-3e77111fe47df19da41f77c93e0eb2854938b5700e65e46f2b040ed1d12431543</cites><orcidid>0000-0003-2098-7597</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38263531$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:154695984$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Sabatino, Alice</creatorcontrib><creatorcontrib>Kooman, Jeroen</creatorcontrib><creatorcontrib>Avesani, Carla Maria</creatorcontrib><creatorcontrib>Gregorini, Mariacristina</creatorcontrib><creatorcontrib>Bianchi, Stefano</creatorcontrib><creatorcontrib>Regolisti, Giuseppe</creatorcontrib><creatorcontrib>Fiaccadori, Enrico</creatorcontrib><title>Sarcopenia diagnosed by ultrasound-assessed quadriceps muscle thickness and handgrip strength predicts mortality in patients on hemodialysis</title><title>Journal of nephrology</title><addtitle>J Nephrol</addtitle><addtitle>J Nephrol</addtitle><description>Background
Estimation of muscle mass is a pivotal component in the diagnosis of protein-energy wasting and sarcopenia. While bioimpedance spectroscopy is a widely accepted technique for the assessment of lean tissue related to the diagnosis of sarcopenia, to date skeletal muscle ultrasound (US) has not gained full acceptance for this purpose. The aim of this study was to assess the predictive value for mortality of the indexed thickness of the quadriceps vastus intermedius, as measured by US, compared to lean tissue index as estimated by bioimpedance spectroscopy, both combined with handgrip strength in a group of patients with end-stage kidney disease (ESKD) on maintenance hemodialysis (HD).
Methods
The cut-off values for low handgrip strength were < 27 kg for males and < 16 kg for females. The cut-off value for low lean tissue index was obtained from an age-matched healthy control group, with low lean tissue index being defined as values below the 10th percentile of the distribution of healthy subjects. The cut-off values for low quadriceps vastus intermedius thickness index were < 3.44 mm/m
2
for males and < 3.52 mm/m
2
for females.
Results
Ultrasound and bioimpedance spectroscopy were performed in 99 patients, and handgrip strength was assessed in 64 patients, all on maintenance HD. After a median follow-up of 28 months (interquartile range 19–41 months) 38 patients died. Lean tissue index was not associated with mortality, while low quadriceps vastus intermedius thickness index and low handgrip strength were associated with an increased hazard of death. In the fully adjusted model, only the combination of low handgrip strength and low quadriceps vastus intermedius thickness index was significantly associated with higher mortality.
Conclusion
When combined with low handgrip strength, low quadriceps muscle US outperformed low lean tissue index as assessed by bioimpedance spectroscopy in predicting mortality in a cohort of patients on maintenance HD. Ultrasound may be a useful and convenient technique for the assessment of sarcopenia and protein-energy wasting in this patient population.
Graphical Abstract</description><subject>Aged</subject><subject>Case-Control Studies</subject><subject>Dielectric Spectroscopy</subject><subject>Female</subject><subject>Hand Strength</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - mortality</subject><subject>Kidney Failure, Chronic - physiopathology</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Male</subject><subject>Medicin och hälsovetenskap</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nephrology</subject><subject>Nutritional Management of Kidney Diseases</subject><subject>Original Article</subject><subject>Predictive Value of Tests</subject><subject>Quadriceps Muscle - diagnostic imaging</subject><subject>Quadriceps Muscle - physiopathology</subject><subject>Renal Dialysis</subject><subject>Sarcopenia - diagnostic imaging</subject><subject>Sarcopenia - mortality</subject><subject>Sarcopenia - physiopathology</subject><subject>Ultrasonography</subject><subject>Urology</subject><issn>1724-6059</issn><issn>1121-8428</issn><issn>1724-6059</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kcuO1DAQRSMEYh7wAyyQl2wy-BnHSzTiJY3EAlhbTlzp9kzazrgcof4HPho33TOwgY1dqjq3ruXbNK8YvWKU6rcoacdpS7loKes73eonzTnTXLYdVebpX_VZc4F4SylXisvnzZnoeSeUYOfNz68uj2mBGBzxwW1iQvBk2JN1LtlhWqNvHSLgoX2_Op_DCAuS3YrjDKRsw3gX65S46Mm2HpscFoIlQ9yULVky-DCWyqdc3BzKnoRIFlcCxNpNkWxhl6rxvMeAL5pnk5sRXp7uy-b7h_ffrj-1N18-fr5-d9OOUqjSCtCaMTaB1H5ixjvJJq1HI4DCwHsljegHpSmFToHsJj5QScEzz7gUTElx2bTHvfgDlnWwSw47l_c2uWBPrbtage2l0J2pvPknv-Tk_4gehNWlM8r0B683R20F71fAYncBR5hnFyGtaLlhPTOGS11RfkTHnBAzTI9GjNpD4vaYuK2J29-J24Po9Wn_OuzAP0oeIq6AOD2-juIGsr1Na471f_-39hdTbLul</recordid><startdate>2024</startdate><enddate>2024</enddate><creator>Sabatino, Alice</creator><creator>Kooman, Jeroen</creator><creator>Avesani, Carla Maria</creator><creator>Gregorini, Mariacristina</creator><creator>Bianchi, Stefano</creator><creator>Regolisti, Giuseppe</creator><creator>Fiaccadori, Enrico</creator><general>Springer International Publishing</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><orcidid>https://orcid.org/0000-0003-2098-7597</orcidid></search><sort><creationdate>2024</creationdate><title>Sarcopenia diagnosed by ultrasound-assessed quadriceps muscle thickness and handgrip strength predicts mortality in patients on hemodialysis</title><author>Sabatino, Alice ; Kooman, Jeroen ; Avesani, Carla Maria ; Gregorini, Mariacristina ; Bianchi, Stefano ; Regolisti, Giuseppe ; Fiaccadori, Enrico</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c435t-3e77111fe47df19da41f77c93e0eb2854938b5700e65e46f2b040ed1d12431543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Case-Control Studies</topic><topic>Dielectric Spectroscopy</topic><topic>Female</topic><topic>Hand Strength</topic><topic>Humans</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - mortality</topic><topic>Kidney Failure, Chronic - physiopathology</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Male</topic><topic>Medicin och hälsovetenskap</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nephrology</topic><topic>Nutritional Management of Kidney Diseases</topic><topic>Original Article</topic><topic>Predictive Value of Tests</topic><topic>Quadriceps Muscle - diagnostic imaging</topic><topic>Quadriceps Muscle - physiopathology</topic><topic>Renal Dialysis</topic><topic>Sarcopenia - diagnostic imaging</topic><topic>Sarcopenia - mortality</topic><topic>Sarcopenia - physiopathology</topic><topic>Ultrasonography</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sabatino, Alice</creatorcontrib><creatorcontrib>Kooman, Jeroen</creatorcontrib><creatorcontrib>Avesani, Carla Maria</creatorcontrib><creatorcontrib>Gregorini, Mariacristina</creatorcontrib><creatorcontrib>Bianchi, Stefano</creatorcontrib><creatorcontrib>Regolisti, Giuseppe</creatorcontrib><creatorcontrib>Fiaccadori, Enrico</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><jtitle>Journal of nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sabatino, Alice</au><au>Kooman, Jeroen</au><au>Avesani, Carla Maria</au><au>Gregorini, Mariacristina</au><au>Bianchi, Stefano</au><au>Regolisti, Giuseppe</au><au>Fiaccadori, Enrico</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sarcopenia diagnosed by ultrasound-assessed quadriceps muscle thickness and handgrip strength predicts mortality in patients on hemodialysis</atitle><jtitle>Journal of nephrology</jtitle><stitle>J Nephrol</stitle><addtitle>J Nephrol</addtitle><date>2024</date><risdate>2024</risdate><volume>37</volume><issue>4</issue><spage>993</spage><epage>1003</epage><pages>993-1003</pages><issn>1724-6059</issn><issn>1121-8428</issn><eissn>1724-6059</eissn><abstract>Background
Estimation of muscle mass is a pivotal component in the diagnosis of protein-energy wasting and sarcopenia. While bioimpedance spectroscopy is a widely accepted technique for the assessment of lean tissue related to the diagnosis of sarcopenia, to date skeletal muscle ultrasound (US) has not gained full acceptance for this purpose. The aim of this study was to assess the predictive value for mortality of the indexed thickness of the quadriceps vastus intermedius, as measured by US, compared to lean tissue index as estimated by bioimpedance spectroscopy, both combined with handgrip strength in a group of patients with end-stage kidney disease (ESKD) on maintenance hemodialysis (HD).
Methods
The cut-off values for low handgrip strength were < 27 kg for males and < 16 kg for females. The cut-off value for low lean tissue index was obtained from an age-matched healthy control group, with low lean tissue index being defined as values below the 10th percentile of the distribution of healthy subjects. The cut-off values for low quadriceps vastus intermedius thickness index were < 3.44 mm/m
2
for males and < 3.52 mm/m
2
for females.
Results
Ultrasound and bioimpedance spectroscopy were performed in 99 patients, and handgrip strength was assessed in 64 patients, all on maintenance HD. After a median follow-up of 28 months (interquartile range 19–41 months) 38 patients died. Lean tissue index was not associated with mortality, while low quadriceps vastus intermedius thickness index and low handgrip strength were associated with an increased hazard of death. In the fully adjusted model, only the combination of low handgrip strength and low quadriceps vastus intermedius thickness index was significantly associated with higher mortality.
Conclusion
When combined with low handgrip strength, low quadriceps muscle US outperformed low lean tissue index as assessed by bioimpedance spectroscopy in predicting mortality in a cohort of patients on maintenance HD. Ultrasound may be a useful and convenient technique for the assessment of sarcopenia and protein-energy wasting in this patient population.
Graphical Abstract</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>38263531</pmid><doi>10.1007/s40620-023-01867-7</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-2098-7597</orcidid></addata></record> |
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| subjects | Aged Case-Control Studies Dielectric Spectroscopy Female Hand Strength Humans Kidney Failure, Chronic - complications Kidney Failure, Chronic - mortality Kidney Failure, Chronic - physiopathology Kidney Failure, Chronic - therapy Male Medicin och hälsovetenskap Medicine Medicine & Public Health Middle Aged Nephrology Nutritional Management of Kidney Diseases Original Article Predictive Value of Tests Quadriceps Muscle - diagnostic imaging Quadriceps Muscle - physiopathology Renal Dialysis Sarcopenia - diagnostic imaging Sarcopenia - mortality Sarcopenia - physiopathology Ultrasonography Urology |
| title | Sarcopenia diagnosed by ultrasound-assessed quadriceps muscle thickness and handgrip strength predicts mortality in patients on hemodialysis |
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