Assessment of the components of sarcopenia and quality of life perceived of individuals on hemodialysis

Celoto, Bianca Raquel Bianchi; Marin, Flávia Andréia; Spexoto, Maria Claudia Bernardes

doi:10.1590/0034-7167-2022-0677

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 76 (6) • 2023 • https://doi.org/10.1590/0034-7167-2022-0677 copy

Assessment of the components of sarcopenia and quality of life perceived of individuals on hemodialysis

Evaluación de componentes de sarcopenia y calidad de vida percibida de individuos en hemodiálisis

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to evaluate the prevalence of sarcopenia in individuals aged 50 years or older on hemodialysis; to verify the association between sarcopenia and sociodemographic, clinical, anthropometric factors, components of sarcopenia and quality of life (QoL); and to correlate the components of sarcopenia with QoL.

Methods:

Participated 83 individuals on hemodialysis. Sarcopenia was established according to the current European consensus. Dynamometry to determine strength, calf circumference (CC) and appendicular skeletal muscle mass index (ASMMI) to obtain muscle mass and gait speed (GS) for physical performance. For QoL used the WHOQOL-bref.

Results:

the prevalence of sarcopenia was 32.6% (CC) and 18.1% (ASMMI). There was no association between sarcopenia and QoL. Both handgrip strength (r=0.25) and GS (r=0.36) showed a correlation with physical domain.

Conclusions:

sarcopenia was expressive, and the aspects of functionality determine the physical impairment in this population.

Descriptors:
Sarcopenia; Muscle Strength; Gait Speed; Quality of Life; Chronic Kidney Disease

Variables	n	%
Variables	M±SD
Sociodemographic
Age (years)	61.8±8.3
Age group
Adult	39	47.0
Elder	44	53.0
Sex
Male	60	72.3
Female	23	27.7
Race
White/Hispanic	44	53.0
Black/African-American	38	45.8
Asian	1	1.2
Marital status
Married	49	59.0
Single	8	9.6
Widowed	16	19.3
Divorced	10	12.0
Work activity
No	74	89.2
Yes	9	10.8
Economic level
A	-	-
B	20	24.1
C	43	51.8
D and E	20	24.1
Clinical
Comorbidities
None	6	7.2
1 to 2	61	73.5
3 or more	16	19.3
Functional capacity (KPS)
No signs or complaints; no evidence of disease (100%)	44	53.0
Stress
None	67	80.7
Low	7	8.4
Moderate	7	8.4
Elevated	2	2.4
Time in treatment (months)	34.0±32.8
Anthropometry
Weight (kg)	70.2±13.9
Height (m)	1.66±0.08
BMI (kg/m²)	25.6±4.5
APMT R (mm)	9.6±3.7
APMT L (mm)	9.4±4.1
Sarcopenia components
Calf circumference
CC (cm)	34.7±3.7
Adequate	46	55.4
Low muscle mass	37	44.6
ASMI
ASMI (kg/m²)	9.4±1.7
Adequate	66	79.5
Low muscle mass	17	20.5
Handgrip strength
HGS (kgf)	26.6±10.3
Adequate	27	32.5
Low muscle strength	56	67.5
Gait speed
GS (m/s)	0.91±0.26
Adequate	59	71.1
Low gait speed	24	28.9
Quality of life (QoL)
Physical Health (PH)	61.1±16.5
Psychological Health (PSH)	79.4±17.8
Social Relationships (SR)	75.6±24.0
Environment quality of life (EQL)	79.9±15.2
Global QoV	67.6±20.9

	Skeletal muscle mass
Sarcopenia	CC	ASMI
	n(%)	n(%)
4-Category Sarcopenia
Non-sarcopenia	27(32.5)	27(32.5)
Probable sarcopenia	29(34.9)	41(49.4)
Confirmed sarcopenia	17(20.5)	9(10.8)
Severe sarcopenia	10(12.1)	6(7.3)
3-Category Sarcopenia
Non-sarcopenia	27(32.5)	27(32.5)
Probable sarcopenia	29(34.9)	41(49.4)
Sarcopenia (confirmed and severe)	27(32.6)	15(18.1)

	Sarcopenia by CC				Sarcopenia by ASMI
Variables	Non-sarcopenia	Probable sarcopenia	Sarcopenia	p value^* * Pearson's chi-square (categorical) or ANOVA (means; continuous). Matching letters: statistical similarity.	Non-sarcopenia	Probable sarcopenia	Sarcopenia	p value^* * Pearson's chi-square (categorical) or ANOVA (means; continuous). Matching letters: statistical similarity.
	n(%)	n(%)	n(%)		n(%)	n(%)	n(%)
Sociodemographic
Age (years)	59.4±7.9 (56.7-62.2)	62.6±6.9 (60.1-65.6)	63.4±9.4 (59.8-66.9)	0.172	59.4±7.9 (56.2-62.8)	61.4±6.5 (59.4-63.4)	67.4±10.5 (61.0-73.9)	0.060
Age group				0.122				0.111
Adult	17(43.6)	12(30.8)	10(25.6)		17(43.6)	17(43.6)	5(12.8)
Elder	10(22.7)	17(38.6)	17(38.6)		10(22.7)	24(54.5)	10(22.7)
Sex				0.059				0.062
Male	24(40.0)	18(30.0)	18(30.0)		24(40.0)	26(43.3)	10(16.7)
Female	3(13.0)	11(47.8)	9(39.1)		3(13.0)	15(65.2)	5(21.7)
Race				0.660				0.401
White/Hispanic	14(31.8)	14(31.8)	16(36.4)		14(31.8)	19(43.2)	11(25.0)
Black/African-American	13(34.2)	14(36.8)	11(28.9)		13(34.2)	21(55.3)	4(10.5)
Asian	-	1(100.0)	-		-	1(100.0)	-
Marital status				0.548				0.575
Married	15(30.6)	19(38.8)	15(30.6)		15(30.6)	26(53.1)	8(16.3)
Single	4(50.0)	2(25.0)	2(25.0)		4(50.0)	4(50.0)	-
Widowed	4(25.0)	7(43.8)	5(31.3)		4(25.0)	7(43.8)	5(31.3)
Divorced	4(40.0)	1(10.0)	5(50.0)		4(40.0)	4(40.0)	2(20.0)
Work activity				0.678				0.546
No	25(33.8)	26(35.1)	23(31.1)		25(33.8)	35(47.3)	14(18.9)
Yes	2(22.2)	3(33.3)	4(44.4)		2(22.2)	6(66.7)	1(11.1)
Economic level				0.907				0.375
A	-	-	-		-	-	-
B	7(35.0)	7(35.0)	6(30.0)		7(35.0)	7(35.0)	6(30.0)
C	12(27.9)	16(37.2)	15(349)		12(27.9)	24(55.8)	7(16.3)
D and E	8(40.0)	6(30.0)	6(30.0)		8(40.0)	10(50.0)	2(10.0)
Clinical
Comorbidities				0.238				0.390
None	3(50.0)	3(50.0)	-		3(50.0)	2(33.3)	1(16.7)
1 to 2	20(32.8)	18(29.5)	23(37.7)		20(32.8)	28(45.9)	13(21.3)
3 or more	4(25.0)	8(50.0)	4(25.0)		4(25.0)	11(68.8)	1(6.3)
Metabolic stress				0.291				0.693
None	22(32.8)	26(38.8)	19(28.4)		22(32.8)	33(49.3)	12(17.9)
Low	3(42.9)	2(28.6)	2(28.6)		3(42.9)	4(57.1)	-
Moderate	2(28.6)	1(14.3)	4(57.1)		2(28.6)	3(42.9)	2(28.6)
Elevated	-	-	2(100.0)		-	1(50.0)	1(50.0)
Disease information
Treatment time (months)	33.5±27.8 (23.9-44.5)	35.6±35.3 (24.5-47.6)	36.9±37.6 (22.1-53.6)	0.930	33.5±27.8 (23.7-44.7)	38.0±37.7 (27.2-50.5)	31.4±32.8 (16.4-49.2)	0.789
Time of kidney disease (months)	34.5±27.2 (11.0-53.0)	38.4±34.8 (13.0-50.5)	33.3±33.0 (8.0-43.0)	0.667	34.5±7.5 (11.0-53.0)	37.6±33.7 (15.5-44.0)	31.4±34.4 (6.0-58.0)	0.641
TFGe (ml/min)	7.5±3.3 (4.9-6.9)	7.4±2.7 (5.2-9.5)	8.8±5.2 (5.8-9.3)	0.486	7.5±3.3 (4.9-9.4)	7.9±4.3 (5.3-9.5)	8.3±3.7 (6.2-9.3)	0.611
Anthropometry
Weight (kg)	75.4±15.8 (70.0-81.2)^a	74.1±8.9 (70.5-77.7)^a	58.9±7.8 (55.9-61.9)^b	<0.001	75.4±15.8 (69.8-81.6)^a	70.3±10.2 (66.8-73.5)^a	57.1±8.1 (53.1-61.7)^b	<0.001
Height (m)	1.70±0.08 (1.67-1.73)^a	1.65±0.08 (1.62-1.68)^a.b	1.62±0.08 (1.59-1.65)^b	0.004	1.70±0.08 (1.66-1.73)^a	1.63±0.08(1.60-1.66)^b	1.65±0.07(1.61-1.69)^a.b	0.006
BMI (kg/m²)	26.2±5.4 (24.3-28.4)^a	27.4±3.1 9 (26.1-28.7)^a	22.3±2.3 (21.5-23.2)^b	<0.001	26.2±5.4 (24.5-28.2)^a	26.4±3.1 (25.3-27.5)^a	20.9±2.0 (19.8-22.1)^b	<0.001
APMT R (mm)	9.8±3.3 (8.6-11.2)	9.7±3.8 (8.4-11.2)	9.4±4.2 (7.7-11.0)	0.910	9.8±3.3 (8.7-11.0)	9.3±3.7 (8.2-10.5)	10.3±4.7 (7.8-13.0)	0.699
APMT L (mm)	10.3±5.9 (8.7-12.5)	9.4±2.7 (8.4-10.5)	8.5±3.1 (7.2-9.6)	0.290	10.3±5.9 (8.5-12.4)	9.1±2.7 (8.3-10.0)	8.6±3.3 96.9-10.3)	0.483
Sarcopenia components
Calf circumference				<0.001				0.010
Adequate	17 (37.0)	29 (63.0)	-		17(37.0)	26(56.5)	3(6.5)
Low muscle mass	10 (27.0)	-	27 (73.0)		10(27.0)	15(40.5)	12(32.4)
CC (cm)	36.0±3.8 (34.5-37.5)^a	37.0±2.0 (36.1-37.7)^a	31.0±2.1 (30.2-31.8)^b	<0.001	36.0±3.8 (34.5-37.5)^a	35.1±3.0 (34.2-36.1)^a	31.0±3.5 (29.1-33.0)^b	<0.001
ASMI				0.001				<0.001
Adequate	25(37.9)	26(39.4)	15(22.7)		25(37.9)	41(62.1)	-
Low muscle mass	2(11.8)	3(17.6)	12(70.6)		2(11.8)	-	15(88.2)
ASMI (kg/m2)	10.1±1.8 (9.4-10.8) ^a	9.8±1.4 (9.2-10.3) ^a	8.4±1.4 (7.9-9.0) ^b	<0.001	10.1±1.8 (9.4-10.8)^a	9.6±1.4 (9.1-10.0)^a	7.9±1.1 (7.2-8.5)^b	<0.001
Handgrip strength				<0.001				<0.001
Adequate	27(100.0)	-	-		27(100.0)	-	-
Low muscle strength	-	29(51.8)	27(48.2)		-	41(73.2)	15(26.8)
HGS (kgf)	38.5±7.0 (35.7-41.2)^a	20.8±5.7 (18.6-22.9)^b	21.1±6.2 (18.7-23.5)^b	<0.001	38.5±7.0 (35.7-41.2)^a	21.6±5.7 (19.8-23.4)^b	19.3±6.2 (15.8-22.7)^b	<0.001
Gait speed				0.141				0.132
Adequate	23(39.0)	19(32.2)	17(28.8)		23(39.0)	27(45.8)	9(15.3)
Low gait speed	4(16.7)	10(41.7)	10(41.7)		4(16.7)	14(58.3)	6(25.0)
GS (m/s)	1.05±0.23 (0.95-1.14)^a	0.86±0.25 (0.77-0.96)^b	0.81±0.24 (0.72-0.91)^b	0.002	1.05±0.24 (0.95-1.14)^a	0.85±0.23 (0.78-0.92)^b	0.81±0.30 (0.64-0.97)^b	0.002
Quality of life (QoL)
Physical Health (PH)	65.7±14.0 (60.2-71.3)	60.5±17.5 (53.8-67.1)	57.3±17.2 (50.4-64.1)	0.165	65.7±14.0 (60.2-71.3)	60.0±16.6 (54.7-65.3)	55.9±19.3 (45.3-66.6)	0.153
Psychological Health (PSH)	83.3±16.4 (76.3-89.7)	77.1±19.3 (68.7-84.8)	80.7±15.3 (73.8-87.0)	0.458	83.3±16.4 (77.2-89.9)	79.7±18.5 (73.4-85.8)	76.5±14.6 (69.1-84.0)	0.399
Social Relationships (SR)	78.1±24.5 (68.1-87.5)	73.7±26.6 (62.9-83.4)	76.0±23.1 (66.2-85.0)	0.827	78.1±24.5 (69.2-85.9)	77.5±24.6 (67.9-85.9)	67.8±24.6 (54.2-81.3)	0.411
Environment quality of life (EQL)	84.7±13.1 (78.9-90.1)	77.5±15.7 (71.4-83.3)	76.5±16.3 (70.1-82.8)	0.086	84.7±13.1 (79.3-89.7)	77.5±15.4 (72.5-82.9)	75.7±17.2 (66.2-85.60	0.092
Global QoV	65.7±21.0 (57.8-73.8)	71.1±22.0 (62.4-80.0)	66.0±20.0 (57.5-74.8)	0.600	65.7±21.0 (58.4-72.9)	70.6±22.1 (63.6-77.8)	63.4±17.3 (54.5-72.0)	0.444

	HGS	CC	ASMI	GS	PH	PSH	SR	EQL	Global QoV
HGS	1	0.26^* * significance at the 0.05 level;	0.46^**	0.51^**	0.25^* * significance at the 0.05 level;	0.18(0.118)	0.18(0.115)	0.19(0.096)	-0.002(0.984)
CC		1	0.53^**	0.01(0.918)	0.06(0.624)	0.05(0.661)	0.03(0.789)	0.10(0.384)	0.08(0.470)
ASMI			1	0.06(0.579)	0.11(0.343)	0.15(0.194)	0.06(0.565)	0.14(0.219)	0.10(0.383)
GS				1	0.36^**	0.18(0.116)	0.13(0.242)	0.22^* * significance at the 0.05 level;	0.12(0.297)
PH					1	0.72^**	0.40^**	0.60^**	0.36^**
PSH						1	0.43^**	0.69^**	0.41^**
SR							1	0.38^**	0.15(0.172)
EQL								1	0.42^**
Global QoV									1

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[1] Corresponding author: Maria Claudia Bernardes Spexoto, E-mail: mariaspexoto@ufgd.edu.br