Early-stage chronic kidney disease, insulin resistance, and osteoporosis as risk factors of sarcopenia in aged population: the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV), 2008-2009.
Sarcopenia means the progressive loss of skeletal muscle mass and strength with aging. In this study, we found that insulin resistance, chronic kidney disease stage 3, and osteoporosis at the femur neck were closely associated with sarcopenia in elderly men. These conditions modified to slow down the progression of sarcopenia.


BACKGROUND
Sarcopenia is known to have multiple contributing factors; however, its modifiable risk factors have not yet been determined. The aim of this study was to identify the most influential and modifiable risk factors for sarcopenia in elderly.


METHODS
This was a population-based, cross-sectional study using data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV), 2008-2009. This study included 940 men and 1,324 women aged 65 years and older who completed a body composition analysis using dual-energy X-ray absorptiometry. Sarcopenia was defined as an appendicular skeletal muscle mass divided by height(2) of less than 1 standard deviation below the sex-specific mean for a younger reference group.


RESULTS
Using univariate analysis, age, body mass index (BMI), homeostasis model assessment for insulin resistance (HOMA-IR), limitations in daily activities, regular exercise, high-risk drinking, family income, osteoporosis, daily energy, and protein intake were associated with sarcopenia in men; age, BMI, limitations in daily activities, regular exercise, occupation, osteoporosis at the total hip, and daily energy intake were associated with sarcopenia in women. In the multivariate logistic regression analysis, HOMA-IR ≥2.5 (odds ratio [OR] for sarcopenia, 2.27; 95 % confidence interval [CI], 1.21-4.25), chronic kidney disease stage 3 (OR, 3.13; 95 % CI, 1.14-8.61), and osteoporosis at the femur neck (OR, 6.83; 95 % CI, 1.08-43.41) were identified as risk factors for sarcopenia in men.


CONCLUSIONS
Insulin resistance, chronic kidney disease, and osteoporosis at the femur neck should be modified to prevent the acceleration of skeletal muscle loss in elderly men.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea, kje@yuhs.ac.
J E
JE
Kim
Y-H
YH
Lee
J H
JH
Huh
D R
DR
Kang
Y
Y
Rhee
S-K
SK
Lim
D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D015438:Health Behavior; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D009749:Nutrition Surveys; D010024:Osteoporosis / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D055948:Sarcopenia / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D012923:Social Class