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Nutrients 2017, 9(5), 434; doi:10.3390/nu9050434

Factors Associated with Decreased Lean Tissue Index in Patients with Chronic Kidney Disease

1
Division of Family Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and School of Medicine, Tzu Chi University, Hualien 970, Taiwan
2
Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and School of Medicine, Tzu Chi University, Hualien 970, Taiwan
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Received: 24 February 2017 / Revised: 3 April 2017 / Accepted: 25 April 2017 / Published: 27 April 2017
(This article belongs to the Special Issue Nutrition and Chronic Kidney Disease)
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Abstract

Muscle wasting is common and is associated with increased morbidity and mortality in patients with chronic kidney disease (CKD). However, factors associated with decreased muscle mass in CKD patients are seldom reported. We performed a cross-sectional study of 326 patients (age 65.8 ± 13.3 years) with stage 3–5 CKD who were not yet on dialysis. Muscle mass was determined using the Body Composition Monitor (BCM), a multifrequency bioimpedance spectroscopy device, and was expressed as the lean tissue index (LTI, lean tissue mass/height2). An LTI of less than 10% of the normal value (low LTI) indicates muscle wasting. Patients with low LTI (n = 40) tended to be diabetic, had significantly higher fat tissue index, urine protein creatinine ratio, and interleukin-6 and tumor necrosis factor-α levels, but had significantly lower serum albumin and hemoglobin levels compared with those with normal LTI. In multivariate linear regression analysis, age, sex, cardiovascular disease, and interleukin-6 were independently associated with LTI. Additionally, diabetes mellitus remained an independent predictor of muscle wasting according to low LTI by multivariate logistic regression analysis. We conclude that LTI has important clinical correlations. Determination of LTI may aid in clinical assessment by helping to identify muscle wasting among patients with stage 3–5 CKD. View Full-Text
Keywords: bioimpedance; body composition; cardiovascular disease; chronic kidney disease; inflammation; lean tissue index; muscle mass; protein energy wasting bioimpedance; body composition; cardiovascular disease; chronic kidney disease; inflammation; lean tissue index; muscle mass; protein energy wasting
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Wang, Y.-W.; Lin, T.-Y.; Peng, C.-H.; Huang, J.-L.; Hung, S.-C. Factors Associated with Decreased Lean Tissue Index in Patients with Chronic Kidney Disease. Nutrients 2017, 9, 434.

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