Fasting Glycemia, Glycosylated Hemoglobin and Malnutrition Inflammation Are Associated With Sarcopenia in Older People With Chronic Kidney Disease Undergoing Hemodialysis Treatment: A Cross-Sectional Study.

BACKGROUND

Contradictory data are available on the possible association between sarcopenia and other clinical disorders in patients with chronic kidney disease (CKD) undergoing hemodialysis.

OBJECTIVE

To determine the association between sarcopenia and markers associated with systemic inflammation, fasting glycemia, and quality of life in older people with CKD undergoing hemodialysis.

METHODS

This was an analytical cross-sectional study. People over 60 years with stage 5 CKD undergoing hemodialysis were invited to participate. Sarcopenia was assessed using the criteria of the European Working Group on Sarcopenia in Older People. Clinical variables such as body mass index, comorbidities, malnutrition inflammation, quality of life, fasting glycemia, glycosylated hemoglobin, hematocrit, uremia, creatinine, sodium, calcium, potassium, albumin, ferritin, C reactive protein were measured.

RESULTS

Twenty-three patients with CKD were included. The prevalence of sarcopenia was 56.5%. Sarcopenic participants showed higher fasting glycemia, glycosylated hemoglobin, and malnutrition inflammation, as well as expected lower physical performance compared to nonsarcopenic participants. Correlations that ranged from moderate to strong were observed between sarcopenia and clinical characteristics such as fasting glycemia (r=0.48; P<0.05), glycosylated hemoglobin (r=0.44; P<0.05), malnutrition inflammation (r=0.46; P<0.05), skeletal muscle mass (r=-0.70; <0.01), and balance capacity (r=-0.66; <0.01). Regression analyses showed that fasting glycemia increased the risk of sarcopenia by 1.82 times (OR=1.82; =0.04).

CONCLUSIONS

In a sample of older people with CKD who underwent hemodialysis, sarcopenia was correlated with fasting glycemia, glycosylated hemoglobin, and malnutrition inflammation. However, only fasting glycemia was found to be a significant predictor of sarcopenia. More studies are needed to determine the influence of glycemic control on sarcopenia in older people with CKD.