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Physical inactivity and protein energy wasting play independent roles in muscle weakness in maintenance haemodialysis patients
BACKGROUND: Muscle weakness is associated with increased mortality risk in chronic haemodialysis (CHD) patients. Protein energy wasting (PEW) and low physical activity could impair muscle quality and contribute to muscle weakness beyond muscle wasting in these patients. Aim of this study was to asse...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070183/ https://www.ncbi.nlm.nih.gov/pubmed/30067754 http://dx.doi.org/10.1371/journal.pone.0200061 |
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author | Souweine, Jean-Sébastien Kuster, Nils Chenine, Leila Rodriguez, Annie Patrier, Laure Morena, Marion Badia, Eric Chalabi, Lotfi Raynal, Nathalie Ohresser, Isabelle Leray-Moragues, Helene Mercier, Jacques Hayot, Maurice Le Quintrec, Moglie Gouzi, Fares Cristol, Jean-Paul |
author_facet | Souweine, Jean-Sébastien Kuster, Nils Chenine, Leila Rodriguez, Annie Patrier, Laure Morena, Marion Badia, Eric Chalabi, Lotfi Raynal, Nathalie Ohresser, Isabelle Leray-Moragues, Helene Mercier, Jacques Hayot, Maurice Le Quintrec, Moglie Gouzi, Fares Cristol, Jean-Paul |
author_sort | Souweine, Jean-Sébastien |
collection | PubMed |
description | BACKGROUND: Muscle weakness is associated with increased mortality risk in chronic haemodialysis (CHD) patients. Protein energy wasting (PEW) and low physical activity could impair muscle quality and contribute to muscle weakness beyond muscle wasting in these patients. Aim of this study was to assess clinical and biological parameters involved in the reduction of muscle strength of CHD patients. METHODS: One hundred and twenty-three CHD patients (80 males, 43 females; 68,8 [57.9–78.8] y.o.) were included in this study. Maximal voluntary force (MVF) of quadriceps was assessed using a belt-stabilized hand-held dynamometer. Muscle quality was evaluated by muscle specific torque, defined as the strength per unit of muscle mass. Muscle mass was estimated using lean tissue index (LTI), skeletal muscle mass (SMM) assessed by bioelectrical impedance analysis and creatinine index (CI). Voorrips questionnaire was used to estimate physical activity. Criteria for the diagnosis of PEW were serum albumin, body mass index < 23 kg/m(2), creatinine index < 18.82 mg/kg/d and low dietary protein intake estimated by nPCR < 0.80g/kg/d. RESULTS: MVF was 76.1 [58.2–111.7] N.m. and was associated with CI (β = 5.3 [2.2–8.4], p = 0.001), LTI (β = 2.8 [0.6–5.1], p = 0.013), Voorrips score (β = 17.4 [2.9–31.9], p = 0.02) and serum albumin (β = 1.9 [0.5–3.2], p = 0.006). Only serum albumin (β = 0.09 [0.03–0.15], p = 0.003), Voorrips score (β = 0.8 [0.2–1.5], p = 0.005) and CI (β = 0.2 [0.1–0.3], p<0.001) remained associated with muscle specific torque. Thirty patients have dynapenia defined as impaired MVF with maintained SMM and were younger with high hs-CRP (p = 0.001), PEW criteria (p<0.001) and low Voorrips score (p = 0.001), and reduced dialysis vintage (p<0.046). CONCLUSIONS: Beyond atrophy, physical inactivity and PEW conspire to impair muscle strength and specific torque in CHD patients and could be related to muscle quality. TRIAL REGISTRATION: ClinicalTrials.gov NCT02806089 |
format | Online Article Text |
id | pubmed-6070183 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-60701832018-08-09 Physical inactivity and protein energy wasting play independent roles in muscle weakness in maintenance haemodialysis patients Souweine, Jean-Sébastien Kuster, Nils Chenine, Leila Rodriguez, Annie Patrier, Laure Morena, Marion Badia, Eric Chalabi, Lotfi Raynal, Nathalie Ohresser, Isabelle Leray-Moragues, Helene Mercier, Jacques Hayot, Maurice Le Quintrec, Moglie Gouzi, Fares Cristol, Jean-Paul PLoS One Research Article BACKGROUND: Muscle weakness is associated with increased mortality risk in chronic haemodialysis (CHD) patients. Protein energy wasting (PEW) and low physical activity could impair muscle quality and contribute to muscle weakness beyond muscle wasting in these patients. Aim of this study was to assess clinical and biological parameters involved in the reduction of muscle strength of CHD patients. METHODS: One hundred and twenty-three CHD patients (80 males, 43 females; 68,8 [57.9–78.8] y.o.) were included in this study. Maximal voluntary force (MVF) of quadriceps was assessed using a belt-stabilized hand-held dynamometer. Muscle quality was evaluated by muscle specific torque, defined as the strength per unit of muscle mass. Muscle mass was estimated using lean tissue index (LTI), skeletal muscle mass (SMM) assessed by bioelectrical impedance analysis and creatinine index (CI). Voorrips questionnaire was used to estimate physical activity. Criteria for the diagnosis of PEW were serum albumin, body mass index < 23 kg/m(2), creatinine index < 18.82 mg/kg/d and low dietary protein intake estimated by nPCR < 0.80g/kg/d. RESULTS: MVF was 76.1 [58.2–111.7] N.m. and was associated with CI (β = 5.3 [2.2–8.4], p = 0.001), LTI (β = 2.8 [0.6–5.1], p = 0.013), Voorrips score (β = 17.4 [2.9–31.9], p = 0.02) and serum albumin (β = 1.9 [0.5–3.2], p = 0.006). Only serum albumin (β = 0.09 [0.03–0.15], p = 0.003), Voorrips score (β = 0.8 [0.2–1.5], p = 0.005) and CI (β = 0.2 [0.1–0.3], p<0.001) remained associated with muscle specific torque. Thirty patients have dynapenia defined as impaired MVF with maintained SMM and were younger with high hs-CRP (p = 0.001), PEW criteria (p<0.001) and low Voorrips score (p = 0.001), and reduced dialysis vintage (p<0.046). CONCLUSIONS: Beyond atrophy, physical inactivity and PEW conspire to impair muscle strength and specific torque in CHD patients and could be related to muscle quality. TRIAL REGISTRATION: ClinicalTrials.gov NCT02806089 Public Library of Science 2018-08-01 /pmc/articles/PMC6070183/ /pubmed/30067754 http://dx.doi.org/10.1371/journal.pone.0200061 Text en © 2018 Souweine et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Souweine, Jean-Sébastien Kuster, Nils Chenine, Leila Rodriguez, Annie Patrier, Laure Morena, Marion Badia, Eric Chalabi, Lotfi Raynal, Nathalie Ohresser, Isabelle Leray-Moragues, Helene Mercier, Jacques Hayot, Maurice Le Quintrec, Moglie Gouzi, Fares Cristol, Jean-Paul Physical inactivity and protein energy wasting play independent roles in muscle weakness in maintenance haemodialysis patients |
title | Physical inactivity and protein energy wasting play independent roles in muscle weakness in maintenance haemodialysis patients |
title_full | Physical inactivity and protein energy wasting play independent roles in muscle weakness in maintenance haemodialysis patients |
title_fullStr | Physical inactivity and protein energy wasting play independent roles in muscle weakness in maintenance haemodialysis patients |
title_full_unstemmed | Physical inactivity and protein energy wasting play independent roles in muscle weakness in maintenance haemodialysis patients |
title_short | Physical inactivity and protein energy wasting play independent roles in muscle weakness in maintenance haemodialysis patients |
title_sort | physical inactivity and protein energy wasting play independent roles in muscle weakness in maintenance haemodialysis patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070183/ https://www.ncbi.nlm.nih.gov/pubmed/30067754 http://dx.doi.org/10.1371/journal.pone.0200061 |
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