Changes of serum irisin in maintenance hemodialysis patients with sarcopenia_West China Medical Journal

Authors：

SHAO Wen ,  LI Rongshan ,  ZHOU Xiaoshuang

Department of Nephrology, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi 030001, P. R. China;

Corresponding author：

LI Rongshan, Email: rongshanli13@163.com; ZHOU Xiaoshuang, Email: xiaoshuangzhou66@163.com

Keywords：

Uremia; Maintenance hemodialysis; Sarcopenia; Irisin

DOI：

10.7507/1002-0179.202005092

Video：

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Objective To explore the changes of serum irisin in maintenance hemodialysis (MHD) patients with sarcopenia.Methods From January to June 2019, 56 MHD patients from Shanxi Provincial People’s Hospital were selected. Judging by the results of body composition analyzer, the MHD patients were divided into the sarcopenia group (n=31) and the non-sarcopenia group (n=25). The serum irisin level was detected by enzyme-linked immunosorbent assay. The muscle cross-sectional area at the third lumbar level was measured by CT. SPSS 21.0 software was used for inter-group comparison, correlation analysis, and regression analysis.Results The serum irisin concentration in the sarcopenia group was lower than that in the non-sarcopenia group [medium (lower quartile, upper quartile): 175.46 (126.00, 220.52) vs. 459.10 (233.83, 616.91) pg/mL; Z=−4.195, P<0.001]. The results of Spearman correlation analysis showed that serum irisin level was positively correlated with lean tissue index (r_s=0.265, P=0.048), however negatively correlated with serum creatinine level (r_s=−0.311, P=0.020). The results of logistic regression analysis showed that serum irisin level [odds ratio (OR)=0.957, 95% confidence interval (CI) (0.925, 0.990), P=0.012], walking speed [OR=0.000, 95%CI (0.000, 0.050), P=0.031], and grip strength [OR=0.658, 95%CI (0.434, 0.997), P=0.048] were protective factors of sarcopenia in MHD patients.Conclusions The level of circulating irisin in MHD patients with sarcopenia is lower than that in MHD patients without sarcopenia. Irisin is a protective factor of sarcopenia in MHD patients.

Citation： SHAO Wen, LI Rongshan, ZHOU Xiaoshuang. Changes of serum irisin in maintenance hemodialysis patients with sarcopenia. West China Medical Journal, 2020, 35(7): 788-793. doi: 10.7507/1002-0179.202005092 Copy

1.	Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet, 2013, 382(9888): 260-272.
2.	Zhang L, Wang F, Wang L, et al. Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet, 2012, 379(9818): 815-822.
3.	Pereira RA, Cordeiro AC, Avesani CM, et al. Sarcopenia in chronic kidney disease on conservative therapy: prevalence and association with mortality. Nephrol Dial Transplant, 2015, 30(10): 1718-1725.
4.	Souza VA, Oliveira D, Barbosa SR, et al. Sarcopenia in patients with chronic kidney disease not yet on dialysis: analysis of the prevalence and associated factors. PLoS One, 2017, 12(4): e0176230.
5.	Bostrom P, Wu J, Jedrychowski MP, et al. A pgc1-alpha-dependent myokine that drives brown-fat-like development of white fat and thermogenesis. Nature, 2012, 481(7382): 463-468.
6.	Reza MM, Subramaniyam N, Sim CM, et al. Irisin is a pro-myogenic factor that induces skeletal muscle hypertrophy and rescues denervation-induced atrophy. Nat Commun, 2017, 8(1): 1104-1104.
7.	Wen MS, Wang CY, Lin SL, et al. Decrease in irisin in patients with chronic kidney disease. PLoS One, 2013, 8(5): e64025.
8.	Ebert T, Focke D, Petroff D, et al. Serum levels of the myokine irisin in relation to metabolic and renal function. Eur J Endocrinol, 2014, 170(4): 501-506.
9.	Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing, 2019, 48(1): 16-31.
10.	Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia: consensus report of the Asian working group for sarcopenia. J Am Med Dir Assoc, 2014, 15(2): 95-101.
11.	Ali S, Garcia JM. Sarcopenia, cachexia and aging: diagnosis, mechanisms and therapeutic options-a mini-review. Gerontology, 2014, 60(4): 294-305.
12.	Kim JK, Choi SR, Choi MJ, et al. Prevalence of and factors associated with sarcopenia in elderly patients with end-stage renal disease. Clin Nutr, 2014, 33(1): 64-68.
13.	Fahal IH. Uraemic sarcopenia: aetiology and implications. Nephrol Dial Transplant, 2014, 29(9): 1655-1665.
14.	Walston JD. Sarcopenia in older adults. Curr Opin Rheumatol, 2012, 24(6): 623-627.
15.	Vettoretti S, Caldiroli L, Armelloni S, et al. Sarcopenia is associated with malnutrition but not with systemic inflammation in older persons with advanced CKD. Nutrients, 2019, 11(6): 1378.
16.	Pan YJ, Zhou SJ, Jin F, et al. Urotensin Ⅱ induces mice skeletal muscle atrophy associated with enhanced autophagy and inhibited irisin precursor (fibronectin type Ⅲ domain containing 5) expression in chronic renal failure. Kidney Blood Press Res, 2019, 44(4): 479-495.
17.	Jedrychowski M, Wrann C, Paulo J, et al. Detection and quantitation of circulating human irisin by tandem mass spectrometry. Cell Metab, 2015, 22(4): 734-740.
18.	Colaianni G, Mongelli T, Colucci S, et al. Crosstalk between muscle and bone via the muscle-myokine irisin. Curr Osteoporos Rep, 2016, 14(4): 132-137.
19.	Flakoll P, Sharp R, Baier S, et al. Effect of β-hydroxy-β-methylbutyrate, arginine, and lysine supplementation on strength, functionality, body composition, and protein metabolism in elderly women. Nutrition, 2004, 20(5): 445-451.
20.	Tieland M, van de Rest O, Dirks ML, et al. Protein supplementation improves physical performance in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc, 2012, 13(8): 720-726.
21.	Fielding RA, Vellas B, Evans WJ, et al. Sarcopenia: an undiagnosed condition in older adults. current consensus definition: prevalence, etiology, and consequences. International Working Group on Sarcopenia. J Am Med Dir Assoc, 2011, 12(4): 249-256.
22.	Torun D, Micozkadioglu H, Torun N, et al. Increased body mass index is not a reliable marker of good nutrition in hemodialysis patients. Ren Fail, 2007, 29(4): 487-493.

1. Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet, 2013, 382(9888): 260-272.
2. Zhang L, Wang F, Wang L, et al. Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet, 2012, 379(9818): 815-822.
3. Pereira RA, Cordeiro AC, Avesani CM, et al. Sarcopenia in chronic kidney disease on conservative therapy: prevalence and association with mortality. Nephrol Dial Transplant, 2015, 30(10): 1718-1725.
4. Souza VA, Oliveira D, Barbosa SR, et al. Sarcopenia in patients with chronic kidney disease not yet on dialysis: analysis of the prevalence and associated factors. PLoS One, 2017, 12(4): e0176230.
5. Bostrom P, Wu J, Jedrychowski MP, et al. A pgc1-alpha-dependent myokine that drives brown-fat-like development of white fat and thermogenesis. Nature, 2012, 481(7382): 463-468.
6. Reza MM, Subramaniyam N, Sim CM, et al. Irisin is a pro-myogenic factor that induces skeletal muscle hypertrophy and rescues denervation-induced atrophy. Nat Commun, 2017, 8(1): 1104-1104.
7. Wen MS, Wang CY, Lin SL, et al. Decrease in irisin in patients with chronic kidney disease. PLoS One, 2013, 8(5): e64025.
8. Ebert T, Focke D, Petroff D, et al. Serum levels of the myokine irisin in relation to metabolic and renal function. Eur J Endocrinol, 2014, 170(4): 501-506.
9. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing, 2019, 48(1): 16-31.
10. Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia: consensus report of the Asian working group for sarcopenia. J Am Med Dir Assoc, 2014, 15(2): 95-101.
11. Ali S, Garcia JM. Sarcopenia, cachexia and aging: diagnosis, mechanisms and therapeutic options-a mini-review. Gerontology, 2014, 60(4): 294-305.
12. Kim JK, Choi SR, Choi MJ, et al. Prevalence of and factors associated with sarcopenia in elderly patients with end-stage renal disease. Clin Nutr, 2014, 33(1): 64-68.
13. Fahal IH. Uraemic sarcopenia: aetiology and implications. Nephrol Dial Transplant, 2014, 29(9): 1655-1665.
14. Walston JD. Sarcopenia in older adults. Curr Opin Rheumatol, 2012, 24(6): 623-627.
15. Vettoretti S, Caldiroli L, Armelloni S, et al. Sarcopenia is associated with malnutrition but not with systemic inflammation in older persons with advanced CKD. Nutrients, 2019, 11(6): 1378.
16. Pan YJ, Zhou SJ, Jin F, et al. Urotensin Ⅱ induces mice skeletal muscle atrophy associated with enhanced autophagy and inhibited irisin precursor (fibronectin type Ⅲ domain containing 5) expression in chronic renal failure. Kidney Blood Press Res, 2019, 44(4): 479-495.
17. Jedrychowski M, Wrann C, Paulo J, et al. Detection and quantitation of circulating human irisin by tandem mass spectrometry. Cell Metab, 2015, 22(4): 734-740.
18. Colaianni G, Mongelli T, Colucci S, et al. Crosstalk between muscle and bone via the muscle-myokine irisin. Curr Osteoporos Rep, 2016, 14(4): 132-137.
19. Flakoll P, Sharp R, Baier S, et al. Effect of β-hydroxy-β-methylbutyrate, arginine, and lysine supplementation on strength, functionality, body composition, and protein metabolism in elderly women. Nutrition, 2004, 20(5): 445-451.
20. Tieland M, van de Rest O, Dirks ML, et al. Protein supplementation improves physical performance in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc, 2012, 13(8): 720-726.
21. Fielding RA, Vellas B, Evans WJ, et al. Sarcopenia: an undiagnosed condition in older adults. current consensus definition: prevalence, etiology, and consequences. International Working Group on Sarcopenia. J Am Med Dir Assoc, 2011, 12(4): 249-256.
22. Torun D, Micozkadioglu H, Torun N, et al. Increased body mass index is not a reliable marker of good nutrition in hemodialysis patients. Ren Fail, 2007, 29(4): 487-493.

West China Medical Journal

Changes of serum irisin in maintenance hemodialysis patients with sarcopenia

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