title: Relationship between Stage of Chronic Kidney Disease and Sarcopenia in Korean Aged 40 Years and Older Using the Korea National Health and Nutrition Examination Surveys (KNHANES IV-2, 3, and V-1, 2), 2008-2011.
abstract: BACKGROUND
  Protein-energy wasting is common in patients with end-stage kidney disease. However, few studies have examined the relationship between early stages of chronic kidney disease (CKD) and sarcopenia.
  
  
  METHODS
  We conducted a cross-sectional study based on data in the Korea National Health and Nutrition Examination Survey, 2008-2011. In total, 11,625 subjects aged 40 years or older who underwent dual-energy X-ray absorptiometry were analyzed. Sarcopenia was defined based on values of appendicular skeletal muscle mass as a percentage of body weight (ASM/Wt) two standard deviations below the gender-specific mean for young adults. Estimated glomerular filtration rates (eGFR) were calculated using the CKD-EPI equation.
  
  
  RESULTS
  Mean age, body mass index (BMI), and HOMA-IR were higher and caloric intake, physical activity, and vitamin D level were lower in the sarcopenia groups in both men and women. As the stage of CKD increased, the prevalence of sarcopenia increased, even in the early stages of CKD (normal and CKD1, 2, and 3-5: 2.6%, 5.6%, and 18.1% in men and 5.3%, 7.1%, and 12.6% in women, respectively; p < 0.001). In addition, a correlation analysis showed that GFR and ASM/Wt had significant correlations in both men and women. Logistic regression analyses, after adjusting for age, BMI, caloric intake, log(physical activity), vitamin D level, and log(HOMA-IR), showed that the odds ratio for sarcopenia with respect to CKD 3-5 was 1.93 (95% CI = 1.02-3.68) in men but was not statistically significant in women.
  
  
  CONCLUSIONS
  The prevalence of sarcopenia was higher in elderly Korean patients with even mildly reduced kidney function. Stage of CKD was associated with an increased prevalence of sarcopenia in men but not women. Thus, we should evaluate the risk of sarcopenia and work to prevent it, even in patients with early CKD.
authors.affiliation: Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea.
authors.forename: Sung Jin
authors.initials: SJ
authors.lastname: Moon
authors.affiliation: Department of Internal Medicine, Seoul Medical Center, Seoul, Korea.
authors.forename: Tae Ho
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea.
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Chung
authors.affiliation: Department of Family Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea.
authors.forename: Hee-Jin
authors.initials: HJ
authors.lastname: Hwang
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000473:pathology*; D056910:Republic of Korea / Q000453:epidemiology; D055948:Sarcopenia / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors