Relation between myostatin levels and malnutrition and muscle wasting in hemodialysis patients


Submitted: September 23, 2023
Accepted: November 13, 2023
Published: December 20, 2023
Abstract Views: 422
PDF: 181
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Background and aim: Malnutrition is one of the most troublesome comorbidities among hemodialysis patients (HD). Myostatin (MSTN) belongs to the transforming growth factor-β superfamily. In HD patients, MSTN effects are not limited to skeletal muscle growth. The present study aimed to assess MSTN levels in HD patients and its relation to various clinical and biochemical parameters. Patients and methods: The present case control study included 60 patients on HD for at least three years. In addition, there were age and sex-matched healthy subjects who constitutes the control group. Nutritional status was evaluated using the malnutrition inflammation score (MIS). Muscle wasting in the present study was evaluated using the lean tissue index (LTI) as assessed by the body composition monitor (BCM). Rectus Femoris Muscle (RFM) thickness was also measured as indicator for nutritional status of patient. Results: The present study included 60 HD patients, and ageand sex-matched healthy controls. Patients expressed significantly higher myostatin levels when compared to controls [median (IQR): 221.3 (153.5-688.2) versus 144.8 (97.0-281.7), p < 0.001]. According to MIS, patients were classified into those with no/mild malnutrition (n = 22) and others with moderate/severe malnutrition (n = 38). Comparison between the two subgroups revealed that the former group had significantly lower myostatin levels [167.7 (150.3-236.3) versus 341.7 (160.9-955.9), p = 0.004]. According to LTI, patients were classified into those with muscle wasting (n = 23) and others without muscle wasting (n = 37). Comparative analysis showed that patients in the former group had significantly higher myostatin levels [775.1 (325.1-2133.7) versus 161.8 (142.6-302.3), p < 0.001]. Conclusions: Myostatin seems to be a promising marker for identification of malnutrition and muscle wasting in HD patients.


Badrasawi M, Zidan S, Sharif I, et al. Prevalence and correlates of malnutrition among hemodialysis patients at hebron governmental hospital, Palestine: cross-sectional study. BMC Nephrol. 2021; 22:214. DOI: https://doi.org/10.1186/s12882-021-02413-y

Sahathevan S, Khor BH, Ng HM, et al. Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review. Nutrients. 2020; 12:3147. DOI: https://doi.org/10.3390/nu12103147

Rotondi S, Tartaglione L, Pasquali M, et al. Association between Cognitive Impairment and Malnutrition in Hemodialysis Patients: Two Sides of the Same Coin. Nutrients. 2023; 15:813. DOI: https://doi.org/10.3390/nu15040813

Choi SR, Lee YK, Cho AJ, et al. Malnutrition, inflammation, progression of vascular calcification and survival: Inter relationships in hemodialysis patients. PLoS One. 2019 ; 14: e0216415. DOI: https://doi.org/10.1371/journal.pone.0216415

Sá Martins V, Adragão T, Aguiar L, et al. Prognostic Value of the Malnutrition-inflammation Score in Hospitalization and Mortality on Long-term Hemodialysis. J Ren Nutr. 2022; 32:569-577 DOI: https://doi.org/10.1053/j.jrn.2021.11.002

Bolasco P. Hemodialysis-Nutritional Flaws in Diagnosis and Prescriptions. Could Amino AcidLosses be the sharpest “Sword of Damocles"? Nutrients. 2020; 12: 1773. DOI: https://doi.org/10.3390/nu12061773

Verzola D, Barisione C, Picciotto D, et al. Emerging role of myostatin and its inhibition in the setting of chronic kidney disease. Kidney Int. 2019; 95:506-517. DOI: https://doi.org/10.1016/j.kint.2018.10.010

Kalantar-Zadeh K, Kopple JD, Block G, Humphreys MH. A malnutrition- inflammation score is correlated with morbidity and mortality in maintenance hemodialysis patients. Am J Kidney Dis. 2001; 38:1251-63. DOI: https://doi.org/10.1053/ajkd.2001.29222

Bakkal H, Dizdar OS, Erdem S, et al. The Relationship Between Hand Grip Strength and Nutritional Status Determined by Malnutrition Inflammation Score and Biochemical Parameters in Hemodialysis Patients. J Ren Nutr. 2020; 30:548-555. DOI: https://doi.org/10.1053/j.jrn.2020.01.026

Avesani CM, Sabatino A, Guerra A, et al. A Comparative Analysis of Nutritional Assessment Using Global Leadership Initiative on Malnutrition versus Subjective Global Assessment and Malnutrition Inflammation Score in Maintenance Hemodialysis Patients. J Ren Nutr. 2022;32:476-482. DOI: https://doi.org/10.1053/j.jrn.2021.06.008

Brandão da Cunha Bandeira S, Cansanção K, Pereira de Paula T, Peres WAF. Evaluation of the prognostic significance of the malnutrition inflammation score in hemodialysis patients. Clin Nutr ESPEN. 2020; 35:109-115. DOI: https://doi.org/10.1016/j.clnesp.2019.10.019

Parthasarathy R, Oei E, Fan SL. Clinical value of body composition monitor to evaluate lean and fat tissue mass in peritoneal dialysis. Eur J Clan Nutr. 2019; 73:1520-1528. DOI: https://doi.org/10.1038/s41430-019-0391-3

Hwang SD, Lee JH, Lee SW, et al. Risk of overhydration and low lean tissue index as measured using a body composition monitor in patients on hemodialysis: a systemic review and meta-analysis. Ren Fail 2018; 40:51-59. DOI: https://doi.org/10.1080/0886022X.2017.1419963

Rosenberger J, Kissova V, Majernikova M, et al. Body composition monitor assessing malnutrition in the hemodialysis population independently predicts mortality. J Ren Nutr. 2014; 24:172-6. DOI: https://doi.org/10.1053/j.jrn.2014.01.002

Moorthi RN, Avin KG. Clinical relevance of sarcopenia in chronic kidney disease. Curr Opin Nephrol Hypertens. 2017; 26:219-228. DOI: https://doi.org/10.1097/MNH.0000000000000318

Verzola D, Procopio V, Sofia A, et al. Apoptosis and myostatin mRNA are upregulated in the skeletal muscle of patients with chronic kidney disease. Kidney Int. 2011; 79:773-782. DOI: https://doi.org/10.1038/ki.2010.494

Enoki Y, Watanabe H, Arake R, et al. Indoxyl sulfate potentiates skeletal muscle atrophy by inducing the oxidative stress-mediated expression of myostatin and atrogin-1. Sci Rep. 2016; 6:32084. DOI: https://doi.org/10.1038/srep32084

Lee SJ. Myostatin: A Skeletal Muscle Chalone. Annu Rev Physiol. 2023; 85:269-291. DOI: https://doi.org/10.1146/annurev-physiol-012422-112116

Bataille S, Chauveau P, Fouque D, et al. Myostatin and muscle atrophy during chronic kidney disease. Nephrol Dial Transplant. 2021; 36:1986-1993. DOI: https://doi.org/10.1093/ndt/gfaa129

Esposito P, Picciotto D, Battaglia Y, et al. Myostatin: Basic biology to clinical application. Adv Clin Chem. 2022; 106:181 234. DOI: https://doi.org/10.1016/bs.acc.2021.09.006

Esposito P, Battaglia Y, La Porta E, et al. Significance of serum Myostatin in hemodialysis patients. BMC Nephrol. 2019; 20:462. DOI: https://doi.org/10.1186/s12882-019-1647-9

Esposito P, La Porta E, Calatroni M, et al. Modulation of Myostatin/Hepatocyte Growth Factor Balance by Different Hemodialysis Modalities. Biomed Res Int. 2017; 2017:7635459. DOI: https://doi.org/10.1155/2017/7635459

Koyun D, Nergizoglu G, Kir KM. Evaluation of the relationship between muscle mass and serum myostatin levels in chronic hemodialysis patients. Saudi J Kidney Dis Transpl. 2018; 29:809-815. DOI: https://doi.org/10.4103/1319-2442.239648

Delanaye P, Bataille S, Quinonez K, et al. Myostatin and Insulin- Like Growth Factor 1 Are Biomarkers of Muscle Strength, Muscle Mass, and Mortality in Patients on Hemodialysis. J Ren Nutr. 2019; 29:511-520. DOI: https://doi.org/10.1053/j.jrn.2018.11.010

Han DS, Chen YM, Lin SY, et al. Serum myostatin levels and grip strength in normal subjects and patients on maintenance haemodialysis. Clin Endocrinol. 2011; 75:857-63. DOI: https://doi.org/10.1111/j.1365-2265.2011.04120.x

Yasar E, Tek NA, Tekbudak MY, et al. The Relationship between Myostatin, Inflammatory Markers, and Sarcopenia in Patients with Chronic Kidney Disease. J Ren Nutr. 2022; 32:677-684. DOI: https://doi.org/10.1053/j.jrn.2022.01.011

Bataille S, Dou L, Bartoli M, et al. Mechanisms of myostatin and activin A accumulation in chronic kidney disease. Nephron Dial Transplant. 2022; 37:1249-1260. DOI: https://doi.org/10.1093/ndt/gfac136

Widajanti N, Soelistijo S, Hadi U, et al. Association between Sarcopenia and Insulin-Like Growth Factor-1, Myostatin, and Insulin Resistance in Elderly Patients Undergoing Hemodialysis. J Aging Res. 2022; 2022:1327332. DOI: https://doi.org/10.1155/2022/1327332

Lee SM, Kim SE, Lee JY, et al. Serum myostatin levels are associated with abdominal aortic calcification in dialysis patients. Kidney Res Clin Pract. 2019; 38:481-489. DOI: https://doi.org/10.23876/j.krcp.19.019

Naglaa M. Aboelsoud, Department of Radiology, Faculty of Medicine, Al-Azhar University, Cairo

  

Ahmed A. Aboomar, Department of internal medicine, Nephrology Unit, Faculty Medicine, Tanta University, Tanta

    

Ibrahim , A. H., Kasim, S. A., Ezzat , A. A., Ibrahim, N. E., Hassan, D. A., Ibrahim, A. S., Abouelgreed, T. A., Abdo, E. M., Aboelsoud, N. M., Abdelmonem, N. M., Alnajem , M. T., & Aboomar, A. A. (2023). Relation between myostatin levels and malnutrition and muscle wasting in hemodialysis patients. Archivio Italiano Di Urologia E Andrologia, 95(4). https://doi.org/10.4081/aiua.2023.11869

Downloads

Download data is not yet available.

Citations