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Association of ultrasound-derived metrics of the quadriceps muscle with protein energy wasting in hemodialysis patients: a multicenter cross-sectional study


Citation

Sahathevan, Sharmela and Khor, Ban Hock and Singh, Birinder Kaur Sadu and Sabatino, Alice and Fiaccadori, Enrico and Mat Daud, Zulfitri Azuan and Ali, Mohammad Syafiq and Narayanan, Sreelakshmi Sankara and Tallman, Dina A. and Chinna, Karuthan and Goh, Bak Leong and Abdul Gafor, Abdul Halim and Ahmad, Ghazali and Morad, Zaki and Khosla, Pramod and Karupaiah, Tilakavati (2020) Association of ultrasound-derived metrics of the quadriceps muscle with protein energy wasting in hemodialysis patients: a multicenter cross-sectional study. Nutrients, 12 (11). pp. 1-16. ISSN 2072-6643

Abstract

This study aimed to assess muscle wasting and risk of protein energy wasting (PEW) in hemodialysis (HD) patients using an ultrasound (US) imaging method. PEW was identified using the ISRNM criteria in 351 HD patients. Quadriceps muscle thickness of rectus femoris (RF) and vastus intermedius (VI) muscles and cross-sectional area (CSA) of the RF muscle (RFCSA) were measured using US and compared with other physical measures. Associations of US indices with PEW were determined by logistic regression. Irrespective of gender, PEW vs. non-PEW patients had smaller RF, VI muscles, and RFCSA (all p < 0.001). US muscle sites (all p < 0.001) discriminated PEW from non-PEW patients, but the RFCSA compared to bio-impedance spectroscopy had a greater area under the curve (AUC, 0.686 vs. 0.581), sensitivity (72.8% vs. 65.8%), and specificity (55.6% vs. 53.9%). AUC of the RFCSA was greatest for PEW risk in men (0.74, 95% CI: 0.66–0.82) and women (0.80, 95% CI: 0.70–0.90) (both p < 0.001). Gender-specific RFCSA values (men < 6.00 cm2; women < 4.47 cm2) indicated HD patients with smaller RFCSA were 8 times more likely to have PEW (AOR = 8.63, 95% CI: 4.80–15.50, p < 0.001). The US approach enabled discrimination of muscle wasting in HD patients with PEW. The RFCSA was identified as the best US site with gender-specific RFCSA values to associate with PEW risk, suggesting potential diagnostic criteria for muscle wasting.


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Official URL or Download Paper: https://www.mdpi.com/2072-6643/12/11/3597

Additional Metadata

Item Type: Article
Divisions: Faculty of Medicine and Health Science
DOI Number: https://doi.org/10.3390/nu12113597
Publisher: Multidisciplinary Digital Publishing Institute
Keywords: Ultrasound imaging; Hemodialysis; Protein energy wasting; Muscle wasting; Quadriceps muscle
Depositing User: Ms. Nuraida Ibrahim
Date Deposited: 24 May 2022 07:30
Last Modified: 24 May 2022 07:30
Altmetrics: http://www.altmetric.com/details.php?domain=psasir.upm.edu.my&doi=10.3390/nu12113597
URI: http://psasir.upm.edu.my/id/eprint/87976
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