Serum myostatin levels and grip strength in normal subjects and patients on maintenance haemodialysis

• Published in: Clinical endocrinology (Oxford) Vol. 75; no. 6; pp. 857 - 863
• Main Authors: Han, Der-Sheng, Chen, Yung-Ming, Lin, Sen-Yung, Chang, Hao-Hsiang, Huang, Tao-Min, Chi, Yu-Chiao, Yang, Wei-Shiung
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.12.2011; Blackwell; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Aged, 80 and over; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Body Composition - physiology; Case-Control Studies; Cross-Sectional Studies; Emergency and intensive care: renal failure. Dialysis management; Endocrinopathies; Female; Fundamental and applied biological sciences. Psychology; Hand Strength - physiology; Humans; Intensive care medicine; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - pathology; Kidney Failure, Chronic - therapy; Male; Medical sciences; Middle Aged; Muscle Weakness - blood; Muscle Weakness - diagnosis; Muscle, Skeletal - anatomy & histology; Muscle, Skeletal - pathology; Myostatin - blood; Organ Size; Renal Dialysis - adverse effects; Renal Dialysis - methods; Renal Dialysis - statistics & numerical data; Vertebrates: endocrinology; Human; Extrarenal dialysis; Gripping; Hemodialysis; Clinical biology; Patient; Maintenance; Normal; Endocrinology; Strength
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1111/j.1365-2265.2011.04120.x

Summary Objective  Myostatin, a negative regulator of skeletal muscle growth, may modulate grip strength, an indicator of muscle function. Its serum levels could be modulated by maintenance haemodialysis (MHD). Design  A descriptive cross‐sectional study. Patients  Forty‐one normal controls and 60 MHD patients using different dialyzers at a medical centre. Measurements  The grip strength of the dominant hand, body composition, and the predialysis and postdialysis serum myostatin and IGF‐1 levels were measured. Results  The MHD patients had lower body mass index, IGF‐1 level, and grip strength than the normal controls. The patients using the high‐flux dialyzer had better grip strength than those using the low‐flux dialyzer (25·5 vs 19·2 kg). The predialysis myostatin level was higher in low‐flux dialyzer than high‐flux dialyzer (31·0 vs 18·5 μg/ml). Interestingly, the high‐flux dialyzer reduced the serum myostatin by 36%, whereas low‐flux dialyzer increased it by 25%. The myostatin was inversely related to age and the use of high‐flux dialyzer. Furthermore, the grip strength was negatively related to age, female gender, muscle mass, myostatin levels and haemodialysis, but positively to the use of high‐flux dialyzer in linear regression. The risk of low grip strength was 7·6 times higher in those with higher serum myostatin with the adjustment of age, gender, muscle mass, haemodialysis and mode of dialysis in a logistic regression. Conclusions  The mode of dialyzer modulates the blood levels of myostatin. Higher myostatin is associated with lower muscle function. The use of myostatin assay in various clinical settings merits further investigation.