Myosteatosis is associated with adiposity, metabolic derangements and mortality in patients with chronic kidney disease

• Published in: European journal of clinical nutrition Vol. 79; no. 5; pp. 475 - 483
• Main Authors: Sabatino, Alice, Cordeiro, Antonio C., Prado, Carla M., Lindholm, Bengt, Stenvinkel, Peter, Avesani, Carla Maria
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.05.2025; Nature Publishing Group
• Subjects: 692/699/1585; 692/699/2743/2037; 692/700/1421/1846/2771; 692/700/2814; Abdomen; Adipose tissue; Adiposity; Aged; Attenuation; Body Composition; Body fat; Chronic illnesses; Clinical Nutrition; Computed tomography; Demographic variables; Demographics; Demography; Epidemiology; Female; Hand Strength; Health risks; Hemodialysis; Humans; Independent variables; Internal Medicine; Kidney diseases; Kidneys; Male; Medical imaging; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolic disorders; Metabolic syndrome; Metabolic Syndrome - complications; Metabolism; Middle Aged; Mortality; Mortality risk; Muscle strength; Muscle, Skeletal - diagnostic imaging; Obesity; Obesity, Abdominal - complications; Parameters; Public Health; Regression analysis; Regression models; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - mortality; Risk; Risk Factors; Sarcopenia; Skeletal muscle; Tomography; Tomography, X-Ray Computed; Vertebrae
• ISSN: 0954-3007; 1476-5640; 1476-5640
• DOI: 10.1038/s41430-024-01551-4

Background/Objectives Myosteatosis has been associated with sarcopenia, and increased mortality risk in patients on hemodialysis. We aimed to explore the associations between myosteatosis, as assessed by computed tomography (CT), with demographic parameters, body composition metrics, muscle strength, metabolic parameters and mortality in patients with chronic kidney disease (CKD). Subjects/Methods We enrolled 216 patients (age 60.3 ± 10.6 years, 63% men) with CKD stages 3–5. Abdominal CT scans at the third lumbar vertebra (L3) were used to assess body composition. Abdominal obesity was determined by abdominal adipose tissue (AT), sarcopenia by low skeletal muscle area (SMA) and low handgrip strength. Myosteatosis was evaluated by two parameters using CT scans at L3: mean muscle attenuation and percentage of intermuscular adipose tissue (%IMAT) within SMA. We evaluated the correlation between parameters of myosteatosis with demographic, clinical and metabolic variables. To determine independent predictors of myosteatosis, a multiple linear regression model was fitted. Mortality risk was evaluated with Cox-regression analysis. Results Both parameters of myosteatosis were independently associated with age, metabolic syndrome, abdominal AT and SMA in the multiple linear regression analysis (adjusted R 2 for multiple linear regression: muscle attenuation model 0.535, P  < 0.001; %IMAT model 0.462, P  < 0.001). Moreover, higher %IMAT and lower attenuation were associated with a higher mortality risk. Conclusion In patients with CKD, increased myosteatosis, as assessed by abdominal CT, was associated with old age, adiposity, metabolic dysfunction, and higher mortality risk.