Effects of Low Muscle Mass on Albuminuria and Chronic Kidney Disease in Patients with Type 2 Diabetes: The Korean Sarcopenic Obesity Study (KSOS)

Hye Soo Chung, Soon Young Hwang, Ju Hee Choi, Hyun Jung Lee, Hye-Jin Yoo, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Dong Seop Choi, Sei-Hyun Baik, Kyung Mook Choi

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Abstract

Background Previous studies have shown that chronic kidney disease (CKD) is associated with accelerated loss of skeletal muscle in patients on dialysis. However, the relationships of sarcopenia with albuminuria and early-stage CKD in patients with type 2 diabetes have not been examined. Methods We analyzed diabetic subgroup data from 409 patients with type 2 diabetes from the Korean Sarcopenic Obesity Study (KSOS). Sarcopenia was defined as a skeletal muscle mass index (SMI; SMI [%] = total skeletal muscle mass [kg]/weight [kg] × 100) less than 2 SD below the sex-specific mean for a younger reference group. The estimated glomerular filtration rates and urinary albumin-to-creatinine ratios were used to assess renal function and albuminuria. Results The prevalence of sarcopenia was significantly increased in the albuminuria group compared with the normo-albuminuria group (26.7% vs 12.6%, p =.001), as well as in CKD 3 group compared with the CKD 1-2 group (46.7% vs 15.1%, p =.005). After adjusting for age, SMI was negatively correlated with urinary albumin-to-creatinine ratios and positively correlated with aspartate aminotransferase, alanine aminotransferase, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels. Multiple logistic regression analysis revealed that the odds ratio for albuminuria association was 3.02 (95% CI 1.37-6.67) in the lowest tertile of SMI compared with the highest tertile after adjusting for various confounding factors. Conclusions Sarcopenia is more prevalent in individuals with albuminuria than in those without albuminuria. Furthermore, increased albuminuria is independently associated with low muscle mass in patients with type 2 diabetes.

Original languageEnglish
Pages (from-to)386-392
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume73
Issue number3
DOIs
Publication statusPublished - 2018 Mar 2

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Albuminuria
Chronic Renal Insufficiency
Type 2 Diabetes Mellitus
Obesity
Sarcopenia
Muscles
Skeletal Muscle
Albumins
Creatinine
Aspartate Aminotransferases
Alanine Transaminase
Glomerular Filtration Rate
LDL Cholesterol
HDL Cholesterol
Dialysis
Logistic Models
Odds Ratio
Cholesterol
Regression Analysis
Kidney

Keywords

  • Albuminuria
  • Chronic kidney disease
  • Sarcopenia
  • Skeletal muscle mass index
  • Type 2 diabetes

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology

Cite this

@article{0bbb914ec43f4463ada7b1e6a94714ed,
title = "Effects of Low Muscle Mass on Albuminuria and Chronic Kidney Disease in Patients with Type 2 Diabetes: The Korean Sarcopenic Obesity Study (KSOS)",
abstract = "Background Previous studies have shown that chronic kidney disease (CKD) is associated with accelerated loss of skeletal muscle in patients on dialysis. However, the relationships of sarcopenia with albuminuria and early-stage CKD in patients with type 2 diabetes have not been examined. Methods We analyzed diabetic subgroup data from 409 patients with type 2 diabetes from the Korean Sarcopenic Obesity Study (KSOS). Sarcopenia was defined as a skeletal muscle mass index (SMI; SMI [{\%}] = total skeletal muscle mass [kg]/weight [kg] × 100) less than 2 SD below the sex-specific mean for a younger reference group. The estimated glomerular filtration rates and urinary albumin-to-creatinine ratios were used to assess renal function and albuminuria. Results The prevalence of sarcopenia was significantly increased in the albuminuria group compared with the normo-albuminuria group (26.7{\%} vs 12.6{\%}, p =.001), as well as in CKD 3 group compared with the CKD 1-2 group (46.7{\%} vs 15.1{\%}, p =.005). After adjusting for age, SMI was negatively correlated with urinary albumin-to-creatinine ratios and positively correlated with aspartate aminotransferase, alanine aminotransferase, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels. Multiple logistic regression analysis revealed that the odds ratio for albuminuria association was 3.02 (95{\%} CI 1.37-6.67) in the lowest tertile of SMI compared with the highest tertile after adjusting for various confounding factors. Conclusions Sarcopenia is more prevalent in individuals with albuminuria than in those without albuminuria. Furthermore, increased albuminuria is independently associated with low muscle mass in patients with type 2 diabetes.",
keywords = "Albuminuria, Chronic kidney disease, Sarcopenia, Skeletal muscle mass index, Type 2 diabetes",
author = "Chung, {Hye Soo} and Hwang, {Soon Young} and Choi, {Ju Hee} and Lee, {Hyun Jung} and Hye-Jin Yoo and Seo, {Ji A} and Kim, {Sin Gon} and Kim, {Nan Hee} and Choi, {Dong Seop} and Sei-Hyun Baik and Choi, {Kyung Mook}",
year = "2018",
month = "3",
day = "2",
doi = "10.1093/gerona/glx055",
language = "English",
volume = "73",
pages = "386--392",
journal = "Journals of Gerontology - Series A Biological Sciences and Medical Sciences",
issn = "1079-5006",
publisher = "Oxford University Press",
number = "3",

}

TY - JOUR

T1 - Effects of Low Muscle Mass on Albuminuria and Chronic Kidney Disease in Patients with Type 2 Diabetes

T2 - The Korean Sarcopenic Obesity Study (KSOS)

AU - Chung, Hye Soo

AU - Hwang, Soon Young

AU - Choi, Ju Hee

AU - Lee, Hyun Jung

AU - Yoo, Hye-Jin

AU - Seo, Ji A

AU - Kim, Sin Gon

AU - Kim, Nan Hee

AU - Choi, Dong Seop

AU - Baik, Sei-Hyun

AU - Choi, Kyung Mook

PY - 2018/3/2

Y1 - 2018/3/2

N2 - Background Previous studies have shown that chronic kidney disease (CKD) is associated with accelerated loss of skeletal muscle in patients on dialysis. However, the relationships of sarcopenia with albuminuria and early-stage CKD in patients with type 2 diabetes have not been examined. Methods We analyzed diabetic subgroup data from 409 patients with type 2 diabetes from the Korean Sarcopenic Obesity Study (KSOS). Sarcopenia was defined as a skeletal muscle mass index (SMI; SMI [%] = total skeletal muscle mass [kg]/weight [kg] × 100) less than 2 SD below the sex-specific mean for a younger reference group. The estimated glomerular filtration rates and urinary albumin-to-creatinine ratios were used to assess renal function and albuminuria. Results The prevalence of sarcopenia was significantly increased in the albuminuria group compared with the normo-albuminuria group (26.7% vs 12.6%, p =.001), as well as in CKD 3 group compared with the CKD 1-2 group (46.7% vs 15.1%, p =.005). After adjusting for age, SMI was negatively correlated with urinary albumin-to-creatinine ratios and positively correlated with aspartate aminotransferase, alanine aminotransferase, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels. Multiple logistic regression analysis revealed that the odds ratio for albuminuria association was 3.02 (95% CI 1.37-6.67) in the lowest tertile of SMI compared with the highest tertile after adjusting for various confounding factors. Conclusions Sarcopenia is more prevalent in individuals with albuminuria than in those without albuminuria. Furthermore, increased albuminuria is independently associated with low muscle mass in patients with type 2 diabetes.

AB - Background Previous studies have shown that chronic kidney disease (CKD) is associated with accelerated loss of skeletal muscle in patients on dialysis. However, the relationships of sarcopenia with albuminuria and early-stage CKD in patients with type 2 diabetes have not been examined. Methods We analyzed diabetic subgroup data from 409 patients with type 2 diabetes from the Korean Sarcopenic Obesity Study (KSOS). Sarcopenia was defined as a skeletal muscle mass index (SMI; SMI [%] = total skeletal muscle mass [kg]/weight [kg] × 100) less than 2 SD below the sex-specific mean for a younger reference group. The estimated glomerular filtration rates and urinary albumin-to-creatinine ratios were used to assess renal function and albuminuria. Results The prevalence of sarcopenia was significantly increased in the albuminuria group compared with the normo-albuminuria group (26.7% vs 12.6%, p =.001), as well as in CKD 3 group compared with the CKD 1-2 group (46.7% vs 15.1%, p =.005). After adjusting for age, SMI was negatively correlated with urinary albumin-to-creatinine ratios and positively correlated with aspartate aminotransferase, alanine aminotransferase, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels. Multiple logistic regression analysis revealed that the odds ratio for albuminuria association was 3.02 (95% CI 1.37-6.67) in the lowest tertile of SMI compared with the highest tertile after adjusting for various confounding factors. Conclusions Sarcopenia is more prevalent in individuals with albuminuria than in those without albuminuria. Furthermore, increased albuminuria is independently associated with low muscle mass in patients with type 2 diabetes.

KW - Albuminuria

KW - Chronic kidney disease

KW - Sarcopenia

KW - Skeletal muscle mass index

KW - Type 2 diabetes

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U2 - 10.1093/gerona/glx055

DO - 10.1093/gerona/glx055

M3 - Article

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VL - 73

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EP - 392

JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

SN - 1079-5006

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