Pierre Delanaye1, Stanislas Bataille2, Kevin Quinonez3, Fanny Buckinx4, Xavier Warling5, Jean-Marie Krzesinski3, Hans Pottel6, Stéphane Burtey7, Olivier Bruyère4, Etienne Cavalier8. 1. Department of Nephrology-Dialysis-Transplantation, University of Liège, CHU Sart Tilman (ULg CHU), Liège, Belgium. Electronic address: pierre_delanaye@yahoo.fr. 2. Centre de Néphrologie et Transplantation Rénale, Assistance Publique des Hôpitaux de Marseille, Marseille, France; ELSAN, Clinique Bouchard, Phocean Institute of Nephrology, Marseille, France; Aix-Marseille University, INSERM, INRA, C2VN, Marseille, France. 3. Department of Nephrology-Dialysis-Transplantation, University of Liège, CHU Sart Tilman (ULg CHU), Liège, Belgium. 4. Department of Public Health, Epidemiology and Health Economics, University of Liège (ULg CHU), Liège, Belgium. 5. Department of Nephrology-Dialysis, Centre Hospitalier Régional (CHR) « La Citadelle », Liège, Belgium. 6. Department of Public Health and Primary Care @ Kulak, University of Leuven, Kulak, Kortrijk, Belgium. 7. Centre de Néphrologie et Transplantation Rénale, Assistance Publique des Hôpitaux de Marseille, Marseille, France; Aix-Marseille University, INSERM, INRA, C2VN, Marseille, France. 8. Department of Clinical Chemistry, University of Liège (ULg CHU), Liège, Belgium.
Abstract
OBJECTIVE: Muscle strength is frequently altered in hemodialysis patients. In the present work, five potential muscle biomarkers have been studied in their ability to assess muscular strength, muscular mass and to predict mortality of hemodialysis patients: activin-A, procollagen III N-terminal peptide, follistatin, myostatin and insulin-like growth factor-1 (IGF-1). DESIGN AND METHODS: Three independent cohorts of prevalent hemodialysis patients (2 from Liège, Belgium and 1 from Marseille, France) were considered in this observational prospective study. The biomarkers were first measured in the Liege1 cohort. Two of them, myostatin and IGF-1, were then assessed in the whole population of patients (Liege1, Liege2 and Marseille). Muscle strength was assessed with handgrip strength (HGS) and muscle mass with bioimpedance analysis. One-year mortality predictive value of biomarkers was also studied in the Liège1 and Marseille cohorts. RESULTS: In the Liège1 cohort (n=67), HGS was only associated with concentrations of myostatin and IGF-1. These associations were confirmed in the whole population of 204 patients (r=0.37, P<0.001 and r=0.46, P<0.001, respectively) and remained significant (P<0.05) in multivariable models. The association between muscle mass and concentrations of myostatin and IGF-1were also significant. The ability of myostatin, IGF-1 and serum creatinine to detect a low HGS compared by Receiver Operating Characteristic curves analysis were not significantly different. Both myostatin and IGF-1 had a significant and comparable area under the curve to predict one-year mortality: 0.73 (95% CI: 0.64 to 0.83) and 0.72 (95% CI: 0.61 to 0.82), respectively. CONCLUSION: Our results suggest that myostatin and IGF-1 are two biomarkers of interest to assess muscle status of dialysis patients. Both biomarkers are associated with HGS, muscular mass, and one-year mortality.
OBJECTIVE: Muscle strength is frequently altered in hemodialysis patients. In the present work, five potential muscle biomarkers have been studied in their ability to assess muscular strength, muscular mass and to predict mortality of hemodialysis patients: activin-A, procollagen III N-terminal peptide, follistatin, myostatin and insulin-like growth factor-1 (IGF-1). DESIGN AND METHODS: Three independent cohorts of prevalent hemodialysis patients (2 from Liège, Belgium and 1 from Marseille, France) were considered in this observational prospective study. The biomarkers were first measured in the Liege1 cohort. Two of them, myostatin and IGF-1, were then assessed in the whole population of patients (Liege1, Liege2 and Marseille). Muscle strength was assessed with handgrip strength (HGS) and muscle mass with bioimpedance analysis. One-year mortality predictive value of biomarkers was also studied in the Liège1 and Marseille cohorts. RESULTS: In the Liège1 cohort (n=67), HGS was only associated with concentrations of myostatin and IGF-1. These associations were confirmed in the whole population of 204 patients (r=0.37, P<0.001 and r=0.46, P<0.001, respectively) and remained significant (P<0.05) in multivariable models. The association between muscle mass and concentrations of myostatin and IGF-1were also significant. The ability of myostatin, IGF-1 and serum creatinine to detect a low HGS compared by Receiver Operating Characteristic curves analysis were not significantly different. Both myostatin and IGF-1 had a significant and comparable area under the curve to predict one-year mortality: 0.73 (95% CI: 0.64 to 0.83) and 0.72 (95% CI: 0.61 to 0.82), respectively. CONCLUSION: Our results suggest that myostatin and IGF-1 are two biomarkers of interest to assess muscle status of dialysis patients. Both biomarkers are associated with HGS, muscular mass, and one-year mortality.
Authors: Soo Jeong Choi; Min Sung Lee; Duk-Hee Kang; Gang Jee Ko; Hee-Sook Lim; Byung Chul Yu; Moo Yong Park; Jin Kuk Kim; Chul-Hee Kim; Seung Duk Hwang; Jun Chul Kim; Chang Won Won; Won Suk An Journal: Int J Environ Res Public Health Date: 2021-07-09 Impact factor: 3.390