Association of diabetes with sarcopenia in patients on hemodialysis: a nationwide cross-sectional study in Portugal.

IF 2.6 Q3 NUTRITION & DIETETICS
Marvery P Duarte, Pedro Martins, Diogo V Leal, Otávio T Nóbrega, Heitor S Ribeiro, João L Viana
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Abstract

Background & aims: Diabetes mellitus is a leading cause of chronic kidney disease and has been linked to an increased risk of sarcopenia. However, evidence on the bidirectional relationships between these conditions remains inconclusive among patients on hemodialysis. This study aimed to investigate the association between diabetes and sarcopenia in this population.

Methods: This cross-sectional analysis used data from a nationwide cohort study conducted across 20 dialysis clinics in Portugal. Sarcopenia was diagnosed based on the revised European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, and diabetes was defined using the American Diabetes Association guidelines.

Results: A total of 715 patients were included (median age: 63 years; 37% female). The prevalence of sarcopenia and diabetes was 16% and 27%, respectively. Sarcopenia was more than twice as common in patients with diabetes (27% vs. 12%, P < 0.001), who also exhibited poorer functionality (all P < 0.001). Adjusted multinomial logistic regression revealed an independent association between diabetes and confirmed sarcopenia (adjusted odds ratio [aOR] 2.41; 95% confidence interval [95% CI], 1.41-4.11). Subgroup analysis showed that this association was specifically observed in males (aOR: 2.64; 95% CI, 1.37-5.09).

Conclusions: In this nationwide cross-sectional and study, diabetes mellitus was independently associated with sarcopenia and its related traits in patients on hemodialysis. Notably, this association was specifically in males, suggesting a potential sex-related difference. These findings highlight the importance of early diabetes detection and the implementation of multidisciplinary strategies to mitigate adverse effects on physical function and muscle mass at a high-risk population.

糖尿病与血液透析患者肌肉减少症的关系:葡萄牙一项全国性横断面研究。
背景与目的:糖尿病是慢性肾脏疾病的主要原因,并与肌少症的风险增加有关。然而,关于这些条件之间的双向关系的证据在血液透析患者中仍然不确定。本研究旨在调查糖尿病和肌肉减少症在这一人群中的关系。方法:本横断面分析使用了来自葡萄牙20个透析诊所的全国性队列研究的数据。肌少症的诊断依据修订后的欧洲老年人肌少症工作组(EWGSOP2)标准,糖尿病的定义依据美国糖尿病协会指南。结果:共纳入715例患者(中位年龄:63岁,37%为女性)。肌肉减少症和糖尿病的患病率分别为16%和27%。肌肉减少症在糖尿病患者中的发生率是前者的两倍多(27% vs. 12%, P < 0.001),糖尿病患者也表现出较差的功能(均P < 0.001)。校正多项逻辑回归显示糖尿病与确诊的肌肉减少症之间存在独立关联(校正优势比[aOR] 2.41; 95%可信区间[95% CI], 1.41-4.11)。亚组分析显示,这种关联在男性中尤为明显(aOR: 2.64; 95% CI, 1.37-5.09)。结论:在这项全国性的横断面研究中,糖尿病与血液透析患者的肌肉减少症及其相关特征独立相关。值得注意的是,这种关联在男性中尤为明显,这表明存在潜在的性别差异。这些发现强调了早期糖尿病检测和实施多学科策略的重要性,以减轻对高危人群身体功能和肌肉质量的不良影响。
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来源期刊
Clinical nutrition ESPEN
Clinical nutrition ESPEN NUTRITION & DIETETICS-
CiteScore
4.90
自引率
3.30%
发文量
512
期刊介绍: Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.
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