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- Title
Lower thigh muscle mass is associated with all-cause and cardiovascular mortality in elderly hemodialysis patients.
- Authors
Fukasawa, H; Kaneko, M; Niwa, H; Matsuyama, T; Yasuda, H; Kumagai, H; Furuya, R
- Abstract
<bold>Background/objectives: </bold>Higher body mass index appears protective in hemodialysis patients, although it remains to be determined which component of muscle or fat mass is primarily associated with this survival advantage.<bold>Subjects/methods: </bold>Eighty-one hemodialysis patients in our institution were prospectively followed from July 2011 to August 2015. Muscle and fat mass were evaluated by measuring the cross-sectional areas of the thigh and abdomen using computed tomography. The relationship between muscle and fat mass, and all-cause and cardiovascular mortality was studied using the Kaplan-Meier analyses and multivariate Cox proportional hazard models.<bold>Results: </bold>During more than 4 years of follow-up, 26 patients (32%) died. In the Kaplan-Meier curve analyses, lower thigh muscle mass was significantly associated with all-cause and cardiovascular mortality (log-rank test, P<0.01 and P<0.001, respectively), but there was no such association with thigh fat, abdominal muscle and fat mass levels. In multivariate Cox proportional hazard models, each 0.1 cm2/kg increase in the thigh muscle area adjusted by dry weight was associated with an estimated 22% lower risk of all-cause mortality (95% confidence interval (95% CI), 0.64-0.95, P<0.05) and a 30% lower risk of cardiovascular mortality (95% CI, 0.54-0.90, P<0.01).<bold>Conclusions: </bold>Lower thigh muscle mass is significantly associated with all-cause and cardiovascular mortality in hemodialysis patients. Our findings indicate the importance of focusing on the muscle mass of lower extremities to predict the clinical outcomes of hemodialysis patients.
- Subjects
CARDIOVASCULAR disease related mortality; ABDOMEN; THIGH; ABDOMINAL muscles; ADIPOSE tissues; HUMAN body composition; CAUSES of death; HEMODIALYSIS; LONGITUDINAL method; MULTIVARIATE analysis; BODY mass index; PROPORTIONAL hazards models; SKELETAL muscle; KAPLAN-Meier estimator; ANATOMY
- Publication
European Journal of Clinical Nutrition, 2017, Vol 71, Issue 1, p64
- ISSN
0954-3007
- Publication type
journal article
- DOI
10.1038/ejcn.2016.186