Endocrine Abstracts

Background: Sarcopenia is associated with mortality in patients with chronic kidney disease (CKD). However, the extent to which sarcopenia contributes to this risk, either independently or in conjunction with metabolic abnormalities and frailty, remains unclear. Therefore, this study aimed to explore the associations among sarcopenia, frailty, central obesity, metabolic abnormalities, cardiovascular risks, and mortality.

Methods: This study used data from the National Health and Nutrition Examination Survey (NHANES) 1999–2006 and 2011–2018. Low muscle mass was defined as Appendicular Skeletal Mass Index<7 kg/m² in men or <5.5 kg/m² in women. The follow-up duration was from the first anthropometric and clinical measurements to death or the last follow-up (December 31, 2019).

Results: This study enrolled 2072 patients with CKD. Low muscle mass was associated with a significantly reduced risk of metabolic abnormalities. Conversely, central obesity was associated with a significant increase in the risk of metabolic abnormalities and frailty. Notably, although low muscle mass was associated with an elevated mortality risk, central obesity did not show a significant association. Subsequent analysis using propensity score matching showed similar results. Furthermore, mediation analysis indicated that the effect of low muscle mass on mortality was mediated directly through frailty and metabolic abnormalities. Despite the inverse relationship between low muscle mass and metabolic abnormalities, low muscle mass is directly associated with an increased risk of all-cause mortality.

Conclusion: Low muscle mass may play a direct role in the pathogenesis of mortality in patients with CKD, independent of metabolic abnormalities and frailty.