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BMC Geriatrics
Published in: BMC Geriatrics 1/2023

Open Access 01-12-2023 | Obesity | Research

Decreased intracellular water is associated with sarcopenic obesity in chronic haemodialysis patients

Authors: Maolu Tian, Jing Yuan, Fangfang Yu, Pinghong He, Qian Zhang, Yan Zha

Published in: BMC Geriatrics | Issue 1/2023

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Abstract

Objective

To explore the association between intracellular water (ICW) and sarcopenic obesity in patients undergoing chronic haemodialysis (HD).

Methods

A multicentre, cross-sectional study of 3354 adult chronic HD patients was conducted in 20 haemodialysis centres from June 1, 2021, to August 30, 2021. The diagnosis of sarcopenic obesity was made according to the revised Asian Working Group’s definition of sarcopenia combined with obesity per the body fat percentage definition. Body composition was evaluated by a body composition monitor using bioimpedance spectroscopy. Multiple logistic regression models, stratified analyses, interactive analyses, and receiver-operating characteristic analyses were conducted.

Results

A total of 752 patients were diagnosed with sarcopenic obesity among 3354 participants. The patients were grouped by sex-specific ICW median levels, and the prevalence of sarcopenic obesity was significantly higher in the low ICW group than in the high ICW group (41.3%vs 3.0%). Decreased ICW was significantly associated with sarcopenic obesity. The association remained statistically significant even after adjusting for dialysis vintage, age, body mass index, biochemical indicators, and various medical histories. The odds ratios of the low ICW group were much higher than those of the high ICW group in both males and females (P for trend < 0.001). The association was stable across subgroups, and the interaction analysis showed that age, body mass index and history of diabetes had interactive roles in the association between ICW and sarcopenic obesity (P for interaction < 0.05). Furthermore, the ICW cut-off values for identifying sarcopenic obesity were 19.1 kg and 14.5 kg for males and females, respectively.

Conclusion

Decreased ICW was an independent risk factor for sarcopenic obesity in chronic HD patients. The measurement of ICW by bioimpedance spectroscopy might be a non-invasive and valid means for identifying the risk of future sarcopenic obesity in HD patients.
Literature
1.
Batsis JA, Villareal DT. Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nat Rev Endocrinol. 2018;14(9):513–37.PubMedPubMedCentral
2.
Barazzoni R, Bischoff S, Boirie Y, Busetto L, Cederholm T, Dicker D, Toplak H, Van Gossum A, Yumuk V, Vettor R. Sarcopenic Obesity: Time to Meet the Challenge. Obes Facts. 2018;11(4):294–305.PubMedPubMedCentral
3.
Peng TC, Chen WL, Chen YY, Chao YP, Wu LW, Kao TW. Associations between different measurements of sarcopenic obesity and health outcomes among non-frail community-dwelling older adults in Taiwan. Br J Nutr. 2021;126(11):1749–57.PubMed
4.
Atkins JL, Wannamathee SG. Sarcopenic obesity in ageing: cardiovascular outcomes and mortality. Br J Nutr. 2020;124(10):1102–13.PubMed
5.
Du Y, Wang X, Xie H, Zheng S, Wu X, Zhu X, Zhang X, Xue S, Li H, Hong W, Tang W, Chen M, Cheng Q, Sun J. Sex differences in the prevalence and adverse outcomes of sarcopenia and sarcopenic obesity in community dwelling elderly in East China using the AWGS criteria. BMC Endocr Disord. 2019;19(1):109.PubMedPubMedCentral
6.
Hong S, Chang Y, Jung HS, Yun KE, Shin H, Ryu S. Relative muscle mass and the risk of incident type 2 diabetes: A cohort study. PLoS ONE. 2017;12(11):e0188650.PubMedPubMedCentral
7.
Ahmadi B, Alimohammadian M, Yaseri M, Majidi A, Boreiri M, Islami F, Poustchi H, Derakhshan MH, Feizesani A, Pourshams A, Abnet CC, Brennan P, Dawsey SM, Kamangar F, Boffetta P, Sadjadi A, Malekzadeh R. Multimorbidity: Epidemiology and Risk Factors in the Golestan Cohort Study, Iran: A Cross-Sectional Analysis. Medicine (Baltimore). 2016;95(7):e2756.PubMed
8.
An KO, Kim J. Association of Sarcopenia and Obesity With Multimorbidity in Korean Adults: A Nationwide Cross-Sectional Study. J Am Med Dir Assoc. 2016;17(10):960.e1–7.PubMed
9.
Baumgartner RN, Wayne SJ, Waters DL, Janssen I, Gallagher D, Morley JE. Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obes Res. 2004;12(12):1995–2004.PubMed
10.
Yoshimura Y, Wakabayashi H, Nagano F, Bise T, Shimazu S, Kudo M, Shiraishi A. Sarcopenic Obesity Is Associated With Activities of Daily Living and Home Discharge in Post-Acute Rehabilitation. J Am Med Dir Assoc. 2020;21(10):1475–80.PubMed
11.
Wannamethee SG, Atkins JL. Muscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity. Proc Nutr Soc. 2015;74(4):405–12.PubMed
12.
Zamboni M, Mazzali G, Fantin F, Rossi A, Di Francesco V. Sarcopenic obesity: a new category of obesity in the elderly. Nutr Metab Cardiovasc Dis. 2008;18(5):388–95.PubMed
13.
Bouchard DR, Janssen I. Dynapenic-obesity and physical function in older adults. J Gerontol A Biol Sci Med Sci. 2010;65(1):71–7.PubMed
14.
Seo DH, Suh YJ, Cho Y, Ahn SH, Seo S, Hong S, Lee YH, Choi YJ, Lee E, Kim SH. Effect of low skeletal muscle mass and sarcopenic obesity on chronic kidney disease in patients with type 2 diabetes. Obesity (Silver Spring). 2022;30(10):2034–43.PubMed
15.
Deschenes MR. Effects of aging on muscle fibre type and size. Sports Med. 2004;34(12):809–24.PubMed
16.
Bilski J, Pierzchalski P, Szczepanik M, Bonior J, Zoladz JA. Multifactorial Mechanism of Sarcopenia and Sarcopenic Obesity. Role of Physical Exercise, Microbiota and Myokines. Cells. 2022;11(1):160.PubMedPubMedCentral
17.
Waters DL. Intermuscular Adipose Tissue: A Brief Review of Etiology, Association With Physical Function and Weight Loss in Older Adults. Ann Geriatr Med Res. 2019;23(1):3–8.PubMedPubMedCentral
18.
Mastrocola R, Collino M, Nigro D, Chiazza F, D’Antona G, Aragno M, Minetto MA. Accumulation of advanced glycation end-products and activation of the SCAP/SREBP Lipogenetic pathway occur in diet-induced obese mouse skeletal muscle. PLoS ONE. 2015;10(3):e0119587.PubMedPubMedCentral
19.
Avesani CM, de Abreu AM, Ribeiro HS, Brismar TB, Stenvinkel P, Sabatino A, Lindholm B. Muscle fat infiltration in chronic kidney disease: a marker related to muscle quality, muscle strength and sarcopenia. J Nephrol. 2023;36(3):895–910.PubMedPubMedCentral
20.
Li CW, Yu K, Shyh-Chang N, Jiang Z, Liu T, Ma S, Luo L, Guang L, Liang K, Ma W, Miao H, Cao W, Liu R, Jiang LJ, Yu SL, Li C, Liu HJ, Xu LY, Liu RJ, Zhang XY, Liu GS. Pathogenesis of sarcopenia and the relationship with fat mass: descriptive review. J Cachexia Sarcopenia Muscle. 2022;13(2):781–94.PubMedPubMedCentral
21.
Kooman JP, Kotanko P, Schols AM, Shiels PG, Stenvinkel P. Chronic kidney disease and premature ageing. Nat Rev Nephrol. 2014;10(12):732–42.PubMed
22.
Sharma D, Hawkins M, Abramowitz MK. Association of sarcopenia with eGFR and misclassification of obesity in adults with CKD in the United States. Clin J Am Soc Nephrol. 2014;9(12):2079–88.PubMedPubMedCentral
23.
de Oliveira MB, da Costa Rosa CS, Ribeiro HS, Marcos NM, Losilla MPR, Monteiro HL, Gimenes C. Obesity phenotypes are, in part, associated with physical activity in diabetic hemodialysis patients. Int Urol Nephrol. 2022;54(7):1751–9.
24.
Ishimura E, Okuno S, Nakatani S, Mori K, Miyawaki J, Okazaki H, Sugie N, Norimine K, Yamakawa K, Tsujimoto Y, Shoji S, Inaba M, Yamakawa T, Emoto M. Significant Association of Diabetes With Mortality of Chronic Hemodialysis Patients, Independent of the Presence of Obesity, Sarcopenia, and Sarcopenic Obesity. J Ren Nutr. 2022;32(1):94–101.PubMed
25.
Bellafronte NT, de QueirósMattoso Ono A, Chiarello PG. Sarcopenic Obesity in Chronic Kidney Disease: Challenges in Diagnosis Using Different Diagnostic Criteria. Med Princ Pract. 2021;30(5):477–86.PubMedPubMedCentral
26.
Androga L, Sharma D, Amodu A, Abramowitz MK. Sarcopenia, obesity, and mortality in US adults with and without chronic kidney disease. Kidney Int Rep. 2017;2(2):201–11.PubMed
27.
Beberashvili I, Azar A, Khatib A, Abu Hamad R, Neheman A, Efrati S, Doenyas-Barak K. Sarcopenic Obesity Versus Nonobese Sarcopenia in Hemodialysis Patients: Differences in Nutritional Status, Quality of Life, and Clinical Outcomes. J Ren Nutr. 2023;33(1):147–56.PubMed
28.
Honda H, Qureshi AR, Axelsson J, Heimburger O, Suliman ME, Barany P, Stenvinkel P, Lindholm B. Obese sarcopenia in patients with end-stage renal disease is associated with inflammation and increased mortality. Am J Clin Nutr. 2007;86(3):633–8.PubMed
29.
Tabibi H, As’habi A, Najafi I, Hedayati M. Prevalence of dynapenic obesity and sarcopenic obesity and their associations with cardiovascular disease risk factors in peritoneal dialysis patients. Kidney Res Clin Pract. 2018;37(4):404–13.PubMedPubMedCentral
30.
Malhotra R, Deger SM, Salat H, Bian A, Stewart TG, Booker C, Vincz A, Pouliot B, Ikizler TA. Sarcopenic Obesity Definitions by Body Composition and Mortality in the Hemodialysis Patients. J Ren Nutr. 2017;27(2):84–90.PubMed
31.
Lin TY, Lim PS, Hung SC. Impact of Misclassification of Obesity by Body Mass Index on Mortality in Patients With CKD. Kidney Int Rep. 2017;3(2):447–55.PubMedPubMedCentral
32.
Tian SL, Zhang K, Xu PC. Increased prevalence of peripheral arterial disease in patients with obese sarcopenia undergoing hemodialysis. Exp Ther Med. 2018;15(6):5148–52.PubMedPubMedCentral
33.
Kato A, Ishida J, Endo Y, Takita T, Furuhashi M, Maruyama Y, Odamaki M. Association of abdominal visceral adiposity and thigh sarcopenia with changes of arteriosclerosis in haemodialysis patients. Nephrol Dial Transplant. 2011;26(6):1967–76.PubMed
34.
Martinson M, Ikizler TA, Morrell G, Wei G, Almeida N, Marcus RL, Filipowicz R, Greene TH, Beddhu S. Associations of body size and body composition with functional ability and quality of life in hemodialysis patients. Clin J Am Soc Nephrol. 2014;9(6):1082–90.PubMedPubMedCentral
35.
Kalantar-Zadeh K, Rhee CM, Chou J, Ahmadi SF, Park J, Chen JL, Amin AN. The Obesity Paradox in Kidney Disease: How to Reconcile it with Obesity Management. Kidney Int Rep. 2017;2(2):271–81.PubMedPubMedCentral
36.
Cauley JA. An Overview of Sarcopenic Obesity. J Clin Densitom. 2015;18(4):499–505.PubMed
37.
Zamboni M, Rubele S, Rossi AP. Sarcopenia and obesity. Curr Opin Clin Nutr Metab Care. 2019;22(1):13–9.PubMed
38.
Silva AM, Matias CN, Santos DA, Rocha PM, Minderico CS, Sardinha LB. Increases in intracellular water explain strength and power improvements over a season. Int J Sports Med. 2014;35(13):1101–5.PubMed
39.
Serra-Prat M, Lorenzo I, Palomera E, Ramírez S, Yébenes JC. Total Body Water and Intracellular Water Relationships with Muscle Strength, Frailty and Functional Performance in an Elderly Population. J Nutr Health Aging. 2019;23(1):96–101.PubMed
40.
Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, Jang HC, Kang L, Kim M, Kim S, Kojima T, Kuzuya M, Lee JSW, Lee SY, Lee WJ, Lee Y, Liang CK, Lim JY, Lim WS, Peng LN, Sugimoto K, Tanaka T, Won CW, Yamada M, Zhang T, Akishita M, Arai H. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020;21(3):300–7.PubMed
41.
Lin TY, Wu MY, Chen HS, Hung SC, Lim PS. Development and validation of a multifrequency bioimpedance spectroscopy equation to predict appendicular skeletal muscle mass in hemodialysis patients. Clin Nutr. 2021;40(5):3288–95.PubMed
42.
Zoccali C, Mallamaci F, Tripepi G. Adipose tissue as a source of inflammatory cytokines in health and disease: focus on end-stage renal disease. Kidney Int Suppl. 2003;84:S65–8.
43.
Stenvinkel P, Ketteler M, Johnson RJ, Lindholm B, Pecoits-Filho R, Riella M, Heimbürger O, Cederholm T, Girndt M. IL-10, IL-6, and TNF-alpha: central factors in the altered cytokine network of uremia–the good, the bad, and the ugly. Kidney Int. 2005;67(4):1216–33.PubMed
44.
Gallagher D, Heymsfield SB, Heo M, Jebb SA, Murgatroyd PR, Sakamoto Y. Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr. 2000;72(3):694–701.PubMed
45.
Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995;854:1–452.
46.
Mourtzakis M, Prado CM, Lieffers JR, Reiman T, McCargar LJ, Baracos VE. A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care. Appl Physiol Nutr Metab. 2008;33(5):997–1006.PubMed
47.
Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12(5):489–95.PubMed
48.
Rutten IJG, Ubachs J, Kruitwagen RFPM, Beets-Tan RGH, OldeDamink SWM, Van Gorp T. Psoas muscle area is not representative of total skeletal muscle area in the assessment of sarcopenia in ovarian cancer. J Cachexia Sarcopenia Muscle. 2017;8(4):630–8.PubMedPubMedCentral
49.
Baracos VE. Psoas as a sentinel muscle for sarcopenia: a flawed premise. J Cachexia Sarcopenia Muscle. 2017;8(4):527–8.PubMedPubMedCentral
50.
Häussinger D, Roth E, Lang F, Gerok W. Cellular hydration state: an important determinant of protein catabolism in health and disease. Lancet. 1993;341(8856):1330–2.PubMed
51.
Keller U, Szinnai G, Bilz S, Berneis K. Effects of changes in hydration on protein, glucose and lipid metabolism in man: impact on health. Eur J Clin Nutr. 2003;57(Suppl 2):S69–74.PubMed
52.
Burg MB, Ferraris JD, Dmitrieva NI. Cellular response to hyperosmotic stresses. Physiol Rev. 2007;87(4):1441–74.PubMed
53.
Serra-Prat M, Lorenzo I, Papiol M, Palomera E, Bartolomé M, Pleguezuelos E, Burdoy E. Intracellular Water Content in Lean Mass as an Indicator of Muscle Quality in an Older Obese Population. J Clin Med. 2020;9(5):1580.PubMedPubMedCentral
54.
Serra-Prat M, Lorenzo I, Palomera E, Yébenes JC, Campins L, Cabré M. Intracellular Water Content in Lean Mass is Associated with Muscle Strength, Functional Capacity, and Frailty in Community-Dwelling Elderly Individuals A Cross-Sectional Study. Nutrients. 2019;11(3):661.PubMedPubMedCentral
55.
Gracia-Iguacel C, González-Parra E, Mahillo I, Ortiz A. Low Intracellular Water, Overhydration, and Mortality in Hemodialysis Patients. J Clin Med. 2020;9(11):3616.PubMedPubMedCentral
56.
Hsu KJ, Liao CD, Tsai MW, Chen CN. Effects of Exercise and Nutritional Intervention on Body Composition, Metabolic Health, and Physical Performance in Adults with Sarcopenic Obesity: A Meta-Analysis. Nutrients. 2019;11(9):2163.PubMedPubMedCentral
57.
Petroni ML, Caletti MT, Dalle Grave R, Bazzocchi A, Aparisi Gómez MP, Marchesini G. Prevention and Treatment of Sarcopenic Obesity in Women. Nutrients. 2019;11(6):1302.PubMedPubMedCentral
58.
Andrade FP, Ribeiro HS, EidtRovedder PM. Comments on “Supervised Exercise Intervention and Overall Activity in CKD” by Pike et al. Kidney Int Rep. 2020;5(12):2404–5.PubMedPubMedCentral
59.
Hargreaves M, Spriet LL. Skeletal muscle energy metabolism during exercise. Nat Metab. 2020;2(9):817–28.PubMed
60.
Colleluori G, Villareal DT. Aging, obesity, sarcopenia and the effect of diet and exercise intervention. Exp Gerontol. 2021;155: 111561.PubMedPubMedCentral
61.
Mankhong S, Kim S, Moon S, Lee JS, Cho EJ, Kwak HB, Park DH, Ryu JK, Kang JH. Melatonin and Exercise Counteract Sarcopenic Obesity through Preservation of Satellite Cell Function. Int J Mol Sci. 2023;24(7):6097.PubMedPubMedCentral
62.
Dantas WS, Zunica ERM, Heintz EC, Vandanmagsar B, Floyd ZE, Yu Y, Fujioka H, Hoppel CL, Belmont KP, Axelrod CL, Kirwan JP. Mitochondrial uncoupling attenuates sarcopenic obesity by enhancing skeletal muscle mitophagy and quality control. J Cachexia Sarcopenia Muscle. 2022;13(3):1821–36.PubMedPubMedCentral
63.
Lin TY, Lim PS, Hung SC. Normal-weight obesity and clinical outcomes in nondiabetic chronic kidney disease patients: a cohort study. Am J Clin Nutr. 2018;107(4):664–72.PubMed
64.
Van Eyck A, Eerens S, Trouet D, Lauwers E, Wouters K, De Winter BY, van der Lee JH, Van Hoeck K, Ledeganck KJ. Body composition monitoring in children and adolescents: reproducibility and reference values. Eur J Pediatr. 2021;180(6):1721–32.PubMedPubMedCentral
Metadata
Title
Decreased intracellular water is associated with sarcopenic obesity in chronic haemodialysis patients
Authors
Maolu Tian
Jing Yuan
Fangfang Yu
Pinghong He
Qian Zhang
Yan Zha
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2023
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-023-04357-4

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