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. 2019 Dec 11;20(1):462.
doi: 10.1186/s12882-019-1647-9.

Significance of serum Myostatin in hemodialysis patients

Pasquale Esposito  1   2 , Yuri Battaglia  3 , Edoardo La Porta  1 , Maria Antonietta Grignano  1 , Elena Caramella  1 , Alessando Avella  1 , Sabrina Peressini  4 , Nicodemo Sessa  4 , Riccardo Albertini  4 , Giuseppe Di Natali  5 , Claudio Lisi  5 , Marilena Gregorini  1 , Teresa Rampino  1
Affiliations

Significance of serum Myostatin in hemodialysis patients

Pasquale Esposito et al. BMC Nephrol. .

Abstract

Background: Malnutrition and muscle wasting are common in haemodialysis (HD) patients. Their pathogenesis is complex and involves many molecules including Myostatin (Mstn), which acts as a negative regulator of skeletal muscle. The characterisation of Mstn as a biomarker of malnutrition could be useful in the prevention and management of this condition. Previous studies have reported no conclusive results on the actual relationship between serum Mstn and wasting and malnutrition. So, in this study, we evaluated Mstn profile in a cohort of regular HD patients.

Methods: We performed a cross-sectional study, enrolling 37 patients undergoing bicarbonate-HD (BHD) or haemodiafiltration (HDF) at least for six months. 20 sex-matched healthy subjects comprised the control group. Mstn serum levels were evaluated by ELISA before and after HD. We collected clinical and biochemical data, evaluated insulin resistance, body composition, malnutrition [by Malnutrition Inflammation Score (MIS)] and tested muscle function (by hand-grip strength, six-minute walking test and a questionnaire on fatigue).

Results: Mstn levels were not significantly different between HD patients and controls (4.7 ± 2.8 vs 4.5 ± 1.3 ng/ml). In addition, while a decrease in Mstn was observed after HD treatment, there were no differences between BHD and HDF. In whole group of HD patients Mstn was positively correlated with muscle mass (r = 0.82, p < 0.001) and inversely correlated with age (r = - 0.63, p < 0.01) and MIS (r = - 0.39, p = 0.01). No correlations were found between Mstn and insulin resistance, such as between Mstn levels and parameters of muscle strength and fatigue. In multivariate analysis, Mstn resulted inversely correlated with fat body content (β = - 1.055, p = 0.002).

Conclusions: Circulating Mstn is related to muscle mass and nutritional status in HD patients, suggesting that it may have a role in the regulation of skeletal muscle and metabolic processes. However, also considering the lack of difference of serum Mstn between healthy controls and HD patients and the absence of correlations with muscle function tests, our findings do not support the use of circulating Mstn as a biomarker of muscle wasting and malnutrition in HD.

Keywords: Bioimpedance analysis; Hemodialysis; Malnutrition; Muscle wasting; Myostatin.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Serum Myostatin levels in HD patients. There were not significant differences in serum myostatin levels between healthy control subjects (C) and patients undergoing hemodialysis. Post-dialysis there was a significant decrease in Myostatin levels compared with pre-dialysis values. * p < 0.05
Fig. 2
Fig. 2
Correlation between serum Myostatin and muscle mass in HD patients. There was a direct correlation between serum Mstn and muscle mass (expressed as Lean Tissue Index-LTI). Linear regression analysis, r = 0.67, p < 0.0001
See this image and copyright information in PMC

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