scholarly journals Serum Sclerostin, Body Composition, and Sarcopenia in Hemodialysis Patients with Diabetes

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Maria Carolina Medeiros ◽  
Natalia Rocha ◽  
Elba Bandeira ◽  
Isabel Dantas ◽  
Conceição Chaves ◽  
...  
Keyword(s):  
Muscle Mass ◽  
Handgrip Strength ◽  
Bone Fragility ◽  
Hemodialysis Patients ◽  
High Serum ◽  
Diabetic Patients ◽  
Dialysis Session ◽  
Hormonal Changes ◽  
Patients With Diabetes ◽  
Skeletal Loading

Sclerostin (Scl) is an osteoblast-inhibiting glycoprotein that is secreted mainly by osteocytes and is regulated by hormonal changes and skeletal loading. Decreased physical function and high serum Scl concentrations have been reported in chronic renal failure patients but little is known to date about the differences between diabetic and non-diabetic patients on hemodialysis who are susceptible to both sarcopenia and bone fragility. Objective.To determine the prevalence of sarcopenia and its association with serum Scl concentrations and metabolic parameters in 92 patients on hemodialysis. Anthropometric data and physical performance were evaluated in this study. Blood samples were collected for Scl, glucose, cholesterol, triglycerides, calcium, phosphate, PTH, and 25 OH-vitamin D measurements. Lean mass was evaluated using multifrequency electro-bioimpedance after dialysis session. Results. Mean age was 63.3 ± 13.6 years, 63% of patients were male, and 44.6% had diabetes. Mean body mass index (BMI) was higher in diabetics (26.6 ± 5.2 vs. 24.1 ± 3.7; p=0.01) and there were no differences in gait speed and handgrip strength between diabetic and non-diabetic subjects. A low skeletal muscle mass index (SMI) was identified in 65.2% of the participants, and among them 76.7% were men and 36.7% were diabetics. Mean serum Scl was 86.9 ± 39.0 pmol/L, which was higher in men (94.6 ± 41.7; p=0.017), in those individuals with low SMI (94.9 ± 40.7; p<0.001), and in diabetics (97.2 ± 46.6; p<0.003). After multivariate analysis and adjustments for potential confounders, high serum Scl was independently associated with low SMI and with the presence of diabetes. The following variables correlated positively with diabetes: blood pressure; BMI; waist circumference; waist/hip ratio; plasma glucose; serum Scl; and fat mass. Conclusions. We found higher serum Scl concentrations in hemodialysis patients with diabetes and these were inversely related to muscle mass.

Higher Serum Bisphenol A Levels in Diabetic Hemodialysis Patients

2016 ◽  
Vol 42 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Faruk Turgut ◽  
Sana Sungur ◽  
Ramazan Okur ◽  
Mustafa Yaprak ◽  
Muge Ozsan ◽  
...  
Keyword(s):  
Bisphenol A ◽  
High Performance ◽  
Patient Characteristics ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Dialysis Session ◽  
Laboratory Parameters ◽  
Hemodialysis Session ◽  
Before And After ◽  
Patients With Diabetes

Background: Bisphenol A (BPA) has been implicated as an ‘endocrine disruptor'. We aimed at exploring the association between serum BPA levels and patient characteristics, particularly the presence of diabetes mellitus, and laboratory parameters in hemodialysis patients. Methods: This study included 47 chronic hemodialysis patients. Patient characteristics were recorded. Blood was drawn before and after hemodialysis session. Serum BPA levels were measured by the high-performance-liquid-chromatography and laboratory parameters were measured by using standard methods. Results: In hemodialysis patients, postdialysis serum BPA levels were significantly higher than predialysis after a single hemodialysis session (5.57 ± 1.2 vs. 4.06 ± 0.73, p < 0.0001). Predialysis serum BPA levels were significantly higher in patients with diabetes than non-diabetics (4.4 ± 0.6 vs. 3.9 ± 0.7, p = 0.025). No association was found between serum BPA levels and patient characteristics, and particularly laboratory parameters. Conclusion: Serum BPA levels were rising significantly after a single dialysis session. Diabetic hemodialysis patients had higher predialysis serum BPA levels.

scholarly journals High serum IgA concentrations in patients with diabetes mellitus: agewise distribution and relation to chronic complications

1996 ◽  
Vol 42 (7) ◽  
pp. 1064-1067 ◽  
Author(s):  
S Rodriguez-Segade ◽  
M F Camiña ◽  
A Carnero ◽  
M J Lorenzo ◽  
A Alban ◽  
...  
Keyword(s):  
Diabetic Complications ◽  
High Serum ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Chronic Complications ◽  
Serum Iga ◽  
Patients With Diabetes ◽  
Type 2 Diabetic

Abstract In this study we investigated the agewise distributions of serum IgA concentrations in 1251 type 1 and 2224 type 2 diabetic patients, and the association between serum IgA concentration and diabetic complications (retinopathy, neuropathy, nephropathy, macroangiopathy, and hypertension). The IgA concentrations of all groups of diabetic patients were significantly higher than those of the corresponding subgroups of 943 control subjects, except for type 1 patients &gt;60 years of age. High IgA concentrations were found in 23.1% of the whole diabetic group. The prevalence of high IgA was significantly greater in males than in females among type 1 patients (24.4% vs 18%). In conclusion, an increase in circulating IgA concentrations is a generalized phenomenon among diabetic patients; IgA concentrations above the reference range are more common among male than female diabetics; and diabetic complications are associated with a significant increase in serum IgA concentration.

Ratio of dietary ω-3 and ω-6 fatty acids—independent determinants of muscle mass—in hemodialysis patients with diabetes

Nutrition ◽  
2016 ◽  
Vol 32 (9) ◽  
pp. 989-994 ◽  
Author(s):  
Te-Chih Wong ◽  
Yu-Tong Chen ◽  
Pei-Yu Wu ◽  
Tzen-Wen Chen ◽  
Hsi-Hsien Chen ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Muscle Mass ◽  
Hemodialysis Patients ◽  
Patients With Diabetes

scholarly journals A SURVIVAL OF PATIENTS IN MAINTENCE HEMODIALYSIS DEPENDING ON EXPRESSED ANAEMIA AND CHARACTER OF DEFEAT OF KIDNEY

2017 ◽  
pp. 36-41
Author(s):  
V. Savchuk
Keyword(s):  
Diabetes Mellitus ◽  
Hemodialysis Patients ◽  
Mantel Test ◽  
Rank Test ◽  
Diabetic Patients ◽  
Group Iii ◽  
Hemoglobin Variability ◽  
Group I ◽  
Starting Point ◽  
Patients With Diabetes

The aim of the present research was to study the survival of hemodialysis (HD) patients depending on of anemia and character of kidney damage, «hemoglobin variability” Materials and methods: We have conducted a retrospective study of 183 hemodialysis patients who were treated from 2009. to 2012. The starting point of observation was defined the first hemodialysis session. The patients were divided in accordance of hemoglobin (Hb) levels for 4 groups: the level of Hb <70 g/l (n=32) – group I, Hb 70–89 g/l (n=68) - group II, Hb 90-110 g/l (n=65) – group III, Hb≥110g/l (n=28) - IV group. Results. The cumulative survival of patients was 55% at the moment of the end of the study. The cumulative proportion surviving of patients with diabetes mellitus was significantly lower compared to non-diabetic patients – 18% and 57%, respectively. The survival of patients I & II groups was significantly lower than the patients of  groups III & IV: 83.64% and 63.75% versus 31.7% and 29.28%, respectively (criteria Geha-Wilcoxon, Cox-Mantel test, Wilcoxon-Peto, F-criterion Cox log-rank test). The survival of patients with "stable hemoglobin" was significantly higher than in patients with "low of hemoglobin variability " and "high of hemoglobin variability"(р<0,005). Conclusions. Hb level and its variability had a significant effect on the survival of patients who are treated with hemodialysis. The survival of hemodialysis patients with diabetes mellitus was significantly lower than in non-diabetic kidney failure.

scholarly journals Association between the Cardio-Ankle Vascular Index and Diabetes Mellitus-Related Peripheral Arterial Disease in Chronic Hemodialysis Patients

2019 ◽  
Vol 47 (Suppl. 2) ◽  
pp. 25-30
Author(s):  
Fumihiko Furuya ◽  
Ai Motosugi ◽  
Kazutaka Haraguchi ◽  
Shunichiro Hanai ◽  
Toshihisa Ishii ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Diabetic Patients ◽  
Dialysis Patients ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
History Of ◽  
Peripheral Arterial

Background: Peripheral arterial disease (PAD) has increased in association with the increase in the numbers of patients with kidney disease or diabetes. The aim of this study was to assess the prevalence of PAD in hemodialysis patients with diabetes. Methods: To examine the usefulness of the cardio-ankle vascular index (CAVI) to screen for the presence of PAD, cross-sectional studies of 100 patients undergoing chronic hemodialysis were performed. The CAVI and other inflammatory markers were evaluated. Results: The CAVI was markedly elevated in patients with a history of PAD or cardiovascular disease. When dialysis patients were classified on the basis of CAVI quartiles, increased CAVI was associated with other risk factors for PAD. Conclusion: The prevalence of PAD is high in elderly diabetic patients on hemodialysis. The present findings suggest that the CAVI can be a useful index that predicts the occurrence of macrovascular complications in dialysis patients with diabetes.

scholarly journals Sarcopenic obesity and its association with frailty and protein-energy wasting in hemodialysis patients: preliminary data from a single center in Japan

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Masakazu Saitoh ◽  
Masumi Ogawa ◽  
Hisae Kondo ◽  
Kiichi Suga ◽  
Tetsuya Takahashi ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Physical Performance ◽  
Fat Mass ◽  
Handgrip Strength ◽  
Hemodialysis Patients ◽  
Normal Group ◽  
Sarcopenic Obesity ◽  
Dialysis Session ◽  
Protein Energy Wasting ◽  
Protein Energy

Abstract Background This study investigated the prevalence of sarcopenia or sarcopenic obesity and their association with frailty and protein-energy wasting (PEW) in hemodialysis patients. Methods The present study enrolled 117 adult hemodialysis patients (35% female, 64 ± 12 years old) from single units of a hemodialysis center. The patients were divided into four groups: normal, obese, sarcopenia, and sarcopenic obesity. Sarcopenia was diagnosed by Asian Working Group for Sarcopenia (AWGS) criteria, and obesity was defined as an extensive percent body fat mass greater than 40% in females and 30% in males. Skeletal muscle mass and percent fat mass were evaluated by multifrequency whole-body bioimpedance electrical analysis after a midweek dialysis session. Handgrip strength and a short physical performance battery (SPPB) were assessed before a dialysis session as indicators of muscle strength and physical performance. Moreover, participants completed the Kihon Checklist and the criteria proposed by the International Society of Renal Nutrition and Metabolism expert panel to classify frailty and PEW. We performed multivariate logistic regression analysis to identify the clinical risk of frailty and PEW in patients with sarcopenia or sarcopenic obesity. Results Forty-six (39.3%) patients were classified as normal; 18 (15.4%), as obese; 35 (29.9%), as having sarcopenia; and 18 (15.4%), as having sarcopenic obesity. The sarcopenia or sarcopenic obesity group had significantly lower handgrip strength than the normal or obesity group (all p < 0.05). In addition, the sarcopenia and sarcopenic obesity groups had significantly lower SPPB scores than the normal group (p < 0.05, respectively). In the multivariate analysis, the sarcopenic obesity group had a significantly higher risk of frailty than the normal group in the multivariate analysis after adjusting for age and gender (OR 4.518, 95%CI 1.218–16.752, p = 0.024). However, sarcopenic obesity was not associated with a higher likelihood of PEW, and sarcopenia imposed a significantly higher risk of PEW (OR 4.272, 95%CI 1.157–15.778, p = 0.029) than that in the normal group after adjusting for confounding factors. Conclusion Sarcopenic obesity was closely associated with frailty compared with the normal condition in HD patients. However, sarcopenic obesity was not associated with a higher likelihood of PEW.

scholarly journals Hyperhomocysteinemia Associated with Low Muscle Mass, Muscle Function in Elderly Hemodialysis Patients: An Analysis of Multiple Dialysis Centers

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Chi-Sin Wang ◽  
Te-Chih Wong ◽  
Tuyen Van Duong ◽  
Chien-Tien Su ◽  
Hsi-Hsien Chen ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Muscle Mass ◽  
Muscle Function ◽  
Stepwise Regression ◽  
Handgrip Strength ◽  
Hemodialysis Patients ◽  
Stepwise Regression Analysis ◽  
Muscle Quality ◽  
The Impact ◽  
Elderly Hemodialysis Patients

Background. The hyperhomocysteinemia was with high prevalence and has been considered as a risk factor for cardiovascular disease in hemodialysis patients. These patients also experienced a high risk of muscle wasting caused by the comorbidity, malnutrition, and low physical activity. We investigated the associations of homocysteinemia with muscle mass, muscle function in elderly hemodialysis patients. Methods. A clinical cross-sectional study was conducted on 138 hemodialysis patients aged 65 years and above in seven hospital-based hemodialysis centers in Taiwan. The data on anthropometry, laboratory, and 3-day dietary intake was examined. The skeletal muscle mass (SMM) was measured by the bioelectrical impedance analysis; the SMM was adjusted by height or weight as SMMHt2 (kg/m2) and SMMWt (%). Muscle function was defined as handgrip strength (HGS) (kg) measured by handgrip dynamometer. Statistical analyses were conducted using simple regression and multivariable stepwise regression analysis. Results. In the total sample, 74.6 % of hemodialysis patients were hyperhomocysteinemia (≥ 15 μmol/L). The means of SMMHt2, SMMWt, arm lean mass, hand grip strength, and muscle quality were 8.7 ± 1.2, 37.7 ± 5.6, 1.7 ± 0.5, 21.1 ± 7.4, and 10.0 ± 3.0, respectively. The multivariable stepwise regression analysis showed that homocysteinemia level was significantly inversely associated with SMMWt (B-coeff. = -0.03, p = 0.02) in hemodialysis patients above 65 years old, but not with muscle function. Conclusions. Hyperhomocysteinemia is common and associated with decreased muscle mass in the elderly hemodialysis patients. Future studies are suggested to explore the impact of the homocysteine-lowering therapy on muscle decline.

scholarly journals LEVELS ANTIINFAMMATORY CYTOKINES (ІL-4, ІL-10) IN MAINTENCE HEMODIALYSIS PATIENTS DEPENDING ON EXPRESSED ANAEMIA AND CHARACTER DEFEAT OF KIDNEY

2017 ◽  
pp. 31-36
Author(s):  
І. Dudar ◽  
V. Savchuk ◽  
I. Gonchar ◽  
V. Driyanska ◽  
E. Krasjuk ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Inflammatory Cytokines ◽  
Negative Correlation ◽  
Hemodialysis Patients ◽  
Average Level ◽  
Control Group ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
Anti Inflammatory

Aims: The purpose of the present study was to compare the levels of anti-inflammatory cytokines in patients with chronic kidney disease, prolonged sessions of hemodialysis, depending on the severity of anemia. Materials and methods: We investigated 155 patients with chronic kidney disease, prolonged sessions of hemodialysis and anemia (mean age 46.4±12.4). Patients were divided into 4 groups depending on expressed of anemia: in the I-st (n=22) group – patients with the level of hemoglobin over 110g/l, in the II (n=66) group hemoglobin 90 - 110g/l, in the III (n=44) group hemoglobin 70-89 g/l, in the IV (n=22) group hemoglobin <70 g/l. Results: We have defined that level of IL-4 was clinically significantly lower (p <0.001) in patients, who have getting hemodialysis by comparison to control group. Levels of IL-4 had a significant differences between all of group of patients and controls (p <0.05). IL-10 had a positive correlation with the level of Hb (r=0.2405; p=0.003). ІL-4 had a negative correlation with the level of Hb (r=-0.4842; p <0.001). The average level of IL-4 was significantly increased in diabetic patients compared with non-diabetic patients 92±17.7 vs 48.3±28.1 (p <0.05). Conclusions: All of studied patients have had an increased level of anti- inflammatory cytokines. Serum IL-4 was higher in patients with diabetes. The levels of anti-inflammatory cytokines (IL-4 and IL-10) have had a significant correlation with the severity of anemia.

Intramuscular Nerve and Neuromuscular Junction Alteration In Extraocular Muscles of Diabetic Mice

1985 ◽  
Vol 43 ◽  
pp. 682-683
Author(s):  
Bruce R. Pachter
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Nerves ◽  
Sudden Onset ◽  
Extraocular Muscles ◽  
Diabetic Patients ◽  
Oculomotor Palsy ◽  
Third Nerve Palsy ◽  
Patients With Diabetes ◽  
Intramuscular Nerve ◽  
Oculomotor Nerves

Diabetes mellitus is one of the commonest causes of neuropathy. Diabetic neuropathy is a heterogeneous group of neuropathic disorders to which patients with diabetes mellitus are susceptible; more than one kind of neuropathy can frequently occur in the same individual. Abnormalities are also known to occur in nearly every anatomic subdivision of the eye in diabetic patients. Oculomotor palsy appears to be common in diabetes mellitus for their occurrence in isolation to suggest diabetes. Nerves to the external ocular muscles are most commonly affected, particularly the oculomotor or third cranial nerve. The third nerve palsy of diabetes is characteristic, being of sudden onset, accompanied by orbital and retro-orbital pain, often associated with complete involvement of the external ocular muscles innervated by the nerve. While the human and experimental animal literature is replete with studies on the peripheral nerves in diabetes mellitus, there is but a paucity of reported studies dealing with the oculomotor nerves and their associated extraocular muscles (EOMs).

Management of the Asymptomatic Diabetic Patient with Evidence of Ischaemia

2010 ◽  
Vol 6 (1) ◽  
pp. 62
Author(s):  
Dimitrios Bliagos ◽  
Ajay J Kirtane ◽  
Jeffrey W Moses ◽  
◽  
◽  
...  
Keyword(s):  
Coronary Artery ◽  
Medical Therapy ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Ageing Population ◽  
Patients With Diabetes ◽  
Risk Patients ◽  
Asymptomatic Diabetic Patient ◽  
Artery Disease

In the US, a total of 23.6 million people have diabetes, representing 7.8% of the population, and the prevalence of diabetes is on the rise due to an increasingly sedentary lifestyle, increasing obesity and an ageing population. Coronary artery disease is the leading cause of death in patients with diabetes, despite a reduction in cardiovascular events over the last 50 years, due in part to better medical therapy. Asymptomatic diabetic patients with evidence of ischaemia on stress testing have higher cardiac mortality; increasing amounts of ischaemia are associated with higher mortality rates. Revascularisation of high-risk patients, or those with significant ischaemia, has the potential to improve outcomes in this patient population. The choice of which revascularisation strategy to choose – either percutaneous coronary intervention (PCI) or coronary artery bypass grafting – should be carefully individualised, and must always be implemented against the background of optimal medical therapy.

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