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The prevalence of muscle wasting (sarcopenia) in peritoneal dialysis patients varies with ethnicity due to differences in muscle mass measured by bioimpedance

European Journal of Clinical Nutrition volume 72, pages 381–387 (2018)Cite this article

Subjects

Abstract

Background/objectives

Sarcopenia is associated with increased mortality. European and North American recommended screening for low muscle mass uses gender specific cut points, with no adjustment for ethnicity. We wished to determine whether the prevalence of sarcopenia was altered by ethnicity in peritoneal dialysis (PD) patients.

Subjects/methods

We measured appendicular lean mass indexed to height (ALMI) in PD patients by segmental bioimpedance and determined sarcopenia using different cut off points for reduced muscle mass.

Results

We measured ALMI in 434 PD patients, 55.1% males, mean age 55.3 ± 16.2 years, 32.3% diabetic, 54.1% white, 23.7% Asian, 19.1% black. ALMI was lower in Asian women, compared to white and black women (6.4 ± 1.1 vs. 6.6 ± 1.0 and 6.9 ± 1.4 kg/m2), and lower in Asian men (7.5 ± 1.3 vs. 8.5 ± 1.2 and 8.7 ± 1.3 kg/m2), p < 0.001. Depending on the ALM/ALMI cut point; the prevalence of sarcopenia was greater in Asian patients (25.6–41.2% using North American or European cut points) compared to white (12.3–18.7%) and black patients (3.8–15.7%), p < 0.001, but <11% when using Asian-specific cut points. The prevalence of sarcopenia obesity (BMI ≥ 30 kg/m2) was <3%, for all groups. There was no association with duration of PD, dialysis prescription, residual renal function or small solute clearances.

Conclusions

There is no universally agreed consensus definition for loss of muscle mass (sarcopenia) and current European and North American recommended cut points for screening are adjusted only for gender. As body composition differs also with age and ethnicity, then ideally cut points should be based on age, gender and ethnicity normative values.

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Authors and Affiliations

  1. Bhumibol Adulyadej Hospital, Royal Thai Air Force, Klong thanon, Saimai, Bangkok, Thailand

    Suree Yoowannakul

  2. Faculty of Medicine, Mahasarakham University, Maha Sarakham, Thailand

    Kamonwan Tangvoraphonkchai

  3. UCL Centre for Nephrology, Royal Free Hospital, University College London, Rowland Hill Street, London, NW3 2PF, UK

    Andrew Davenport

Authors
  1. Suree Yoowannakul
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  3. Andrew Davenport
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Correspondence to Suree Yoowannakul, Kamonwan Tangvoraphonkchai or Andrew Davenport.

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Yoowannakul, S., Tangvoraphonkchai, K. & Davenport, A. The prevalence of muscle wasting (sarcopenia) in peritoneal dialysis patients varies with ethnicity due to differences in muscle mass measured by bioimpedance. Eur J Clin Nutr 72, 381–387 (2018). https://doi.org/10.1038/s41430-017-0033-6

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