Analysis in related influencing factors of sarcopenia in patients with maintenance hemodialysis for end-stage renal disease

Objective To explore the related influencing factors of sarcopenia in patients with maintenance hemodialysis (MHD) for end-stage renal disease (ESRD).

Methods A total of 197 ESRD patients with regular MHD treatment were selected as research objects. Skeletal muscle mass index (SMI) and other body components were measured by bioelectrical impedance method, the grip strength was measured by electronic grip tester, and the general material, anthropometry indicators and blood test indicators were collected. The related influencing factors of sarcopenia in ESRD patients with MHD were analyzed.

Results The incidence of sarcopenia in 197 ESRD patients with MHD was 36.55% (72/197). There were significant differences in age, dialysis duration, gender, combined with hypertension, body mass index (BMI), thickness of triceps skinfold, grip strength, lean tissue index (LTI), total water of body (TWB), intracellular water (ICW), lean tissue mass (LTM), fat mass (FAT), body cell mass (BCM), fat free mass (FFM), creatinine, β₂ microglobulin, triglyceride and high-density lipoprotein between sarcopenia group (n=72) and non-sarcopenia group (n=125) (P < 0.05). The results of univariate binary Logistic regression analysis showed that advanced age (OR=1.048, P=0.040, 95%CI, 1.021 to 1.078), male (OR=0.371, P=0.001, 95%CI, 0.204 to 0.673), grip strength (OR=0.838, P < 0.001, 95%CI, 0.764 to 0.920) and FFM (OR=0.634, P < 0.001, 95%CI, 0.527 to 0.761) were the influencing factors of sarcopenia in ESRD patients with MHD. Spearman correlation analysis showed that age was negatively correlated with grip strength (r=-0.283, P < 0.001), grip strength was positively correlated with SMI (r=0.455, P < 0.001), FFM was positively correlated with SMI and grip strength (r=0.904, 0.499, P < 0.001), and FFM was negatively correlated with 6-meter walking speed (r=-0.245, P=0.001). The area under the curve (AUC) for diagnosis of sarcopenia in combination of gender, advanced age, grip strength and FFM in ESRD patients with MHD was 0.817 (95%CI, 0.759 to 0.875), with a sensitivity of 100.00% and a specificity of 64.00%.

Conclusion The incidence of sarcopenia is higher in ESRD patients with MHD, and advanced age, male, grip strength and FFM are the influencing factors of sarcopenia in ESRD patients with MHD. FFM can predict the probability of sarcopenia in ESRD patients with MHD, and its predictive efficacy will be higher when combined with gender, age and grip strength.