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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

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) mus...

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Main Authors: Sahathevan, Sharmela, Khor, Ban Hock, Singh, Birinder Kaur Sadu, Sabatino, Alice, Fiaccadori, Enrico, Mat Daud, Zulfitri Azuan, Ali, Mohammad Syafiq, Narayanan, Sreelakshmi Sankara, Tallman, Dina A., Chinna, Karuthan, Goh, Bak Leong, Abdul Gafor, Abdul Halim, Ahmad, Ghazali, Morad, Zaki, Khosla, Pramod, Karupaiah, Tilakavati
Format: Article
Language:English
Published: Multidisciplinary Digital Publishing Institute 2020
Online Access:http://psasir.upm.edu.my/id/eprint/87976/1/ABSTRACT.pdf
http://psasir.upm.edu.my/id/eprint/87976/
https://www.mdpi.com/2072-6643/12/11/3597
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spelling my.upm.eprints.879762022-05-24T07:30:37Z http://psasir.upm.edu.my/id/eprint/87976/ Association of ultrasound-derived metrics of the quadriceps muscle with protein energy wasting in hemodialysis patients: a multicenter cross-sectional study Sahathevan, Sharmela Khor, Ban Hock Singh, Birinder Kaur Sadu Sabatino, Alice Fiaccadori, Enrico Mat Daud, Zulfitri Azuan Ali, Mohammad Syafiq Narayanan, Sreelakshmi Sankara Tallman, Dina A. Chinna, Karuthan Goh, Bak Leong Abdul Gafor, Abdul Halim Ahmad, Ghazali Morad, Zaki Khosla, Pramod Karupaiah, Tilakavati 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. Multidisciplinary Digital Publishing Institute 2020 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/87976/1/ABSTRACT.pdf 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 https://www.mdpi.com/2072-6643/12/11/3597 10.3390/nu12113597
institution Universiti Putra Malaysia
building UPM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Putra Malaysia
content_source UPM Institutional Repository
url_provider http://psasir.upm.edu.my/
language English
description 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.
format Article
author Sahathevan, Sharmela
Khor, Ban Hock
Singh, Birinder Kaur Sadu
Sabatino, Alice
Fiaccadori, Enrico
Mat Daud, Zulfitri Azuan
Ali, Mohammad Syafiq
Narayanan, Sreelakshmi Sankara
Tallman, Dina A.
Chinna, Karuthan
Goh, Bak Leong
Abdul Gafor, Abdul Halim
Ahmad, Ghazali
Morad, Zaki
Khosla, Pramod
Karupaiah, Tilakavati
spellingShingle Sahathevan, Sharmela
Khor, Ban Hock
Singh, Birinder Kaur Sadu
Sabatino, Alice
Fiaccadori, Enrico
Mat Daud, Zulfitri Azuan
Ali, Mohammad Syafiq
Narayanan, Sreelakshmi Sankara
Tallman, Dina A.
Chinna, Karuthan
Goh, Bak Leong
Abdul Gafor, Abdul Halim
Ahmad, Ghazali
Morad, Zaki
Khosla, Pramod
Karupaiah, Tilakavati
Association of ultrasound-derived metrics of the quadriceps muscle with protein energy wasting in hemodialysis patients: a multicenter cross-sectional study
author_facet Sahathevan, Sharmela
Khor, Ban Hock
Singh, Birinder Kaur Sadu
Sabatino, Alice
Fiaccadori, Enrico
Mat Daud, Zulfitri Azuan
Ali, Mohammad Syafiq
Narayanan, Sreelakshmi Sankara
Tallman, Dina A.
Chinna, Karuthan
Goh, Bak Leong
Abdul Gafor, Abdul Halim
Ahmad, Ghazali
Morad, Zaki
Khosla, Pramod
Karupaiah, Tilakavati
author_sort Sahathevan, Sharmela
title Association of ultrasound-derived metrics of the quadriceps muscle with protein energy wasting in hemodialysis patients: a multicenter cross-sectional study
title_short Association of ultrasound-derived metrics of the quadriceps muscle with protein energy wasting in hemodialysis patients: a multicenter cross-sectional study
title_full Association of ultrasound-derived metrics of the quadriceps muscle with protein energy wasting in hemodialysis patients: a multicenter cross-sectional study
title_fullStr Association of ultrasound-derived metrics of the quadriceps muscle with protein energy wasting in hemodialysis patients: a multicenter cross-sectional study
title_full_unstemmed Association of ultrasound-derived metrics of the quadriceps muscle with protein energy wasting in hemodialysis patients: a multicenter cross-sectional study
title_sort association of ultrasound-derived metrics of the quadriceps muscle with protein energy wasting in hemodialysis patients: a multicenter cross-sectional study
publisher Multidisciplinary Digital Publishing Institute
publishDate 2020
url http://psasir.upm.edu.my/id/eprint/87976/1/ABSTRACT.pdf
http://psasir.upm.edu.my/id/eprint/87976/
https://www.mdpi.com/2072-6643/12/11/3597
_version_ 1734301603602628608
score 13.211869

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