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Hyperhomocysteinemia Associated with Low Muscle Mass, Muscle Function in Elderly Hemodialysis Patients: An Analysis

Chi-Sin Wang¹, Te-Chih Wong², Tuyen Van Duong¹

¹School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.

Biomed Research International

|July 9, 2019

Insights

High homocysteine levels are common in elderly hemodialysis patients and linked to reduced muscle mass. Further research is needed on homocysteine-lowering therapies to address muscle decline in this population.

Area of Science:

Gerontology
Nephrology
Nutritional Science

Background:

Hyperhomocysteinemia is prevalent in hemodialysis patients, posing a cardiovascular disease risk.
Elderly hemodialysis patients face high risks of muscle wasting due to comorbidities, malnutrition, and inactivity.
This study examines the link between homocysteine levels and muscle mass/function in older hemodialysis patients.

Purpose of the Study:

To investigate the association between homocysteine levels and skeletal muscle mass (SMM) and muscle function in elderly hemodialysis patients.
To determine if hyperhomocysteinemia correlates with reduced muscle mass or impaired muscle function in this demographic.
To provide insights into potential therapeutic targets for mitigating muscle decline in hemodialysis patients.

Main Methods:

A cross-sectional study involving 138 hemodialysis patients aged 65+ in Taiwan.
Skeletal muscle mass (SMM) measured via bioelectrical impedance analysis (SMM_Ht2, SMM_Wt).
Muscle function assessed by handgrip strength (HGS); statistical analysis using regression models.

Main Results:

74.6% of patients exhibited hyperhomocysteinemia (≥ 15 μmol/L).
Higher homocysteine levels were significantly associated with lower SMM_Wt (B-coeff. = -0.03, p = 0.02).
No significant association was found between homocysteine levels and muscle function (handgrip strength).

Conclusions:

Hyperhomocysteinemia is common in elderly hemodialysis patients and linked to decreased muscle mass.
The findings suggest homocysteine may play a role in sarcopenia among this patient group.
Further research into homocysteine-lowering therapies is recommended to address muscle decline.

Read full analysis

Abstract

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 SMM_Ht2 (kg/m²) and SMM_Wt (%). 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 SMM_Ht2, SMM_Wt, 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 SMM_Wt (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.

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