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. 2025 Feb 12;61(2):322.
doi: 10.3390/medicina61020322.

MOTS-c Levels and Sarcopenia Risk in Chronic Peritoneal Dialysis Patients: A Pilot Study

Mariateresa Zicarelli  1 , Marta Greco  1   2 , Stefanos Roumeliotis  3 , Maria Elisa Lo Vasco  4 , Francesco Dragone  2 , Christodoula Kourtidou  3 , Ioannis Alekos  5 , Roberta Misiti  2 , Daniela Patrizia Foti  2   6 , Giuseppe Coppolino  1 , Vassilios Liakopoulos  3 , Evangelia Dounousi  5 , Davide Bolignano  7
Affiliations

MOTS-c Levels and Sarcopenia Risk in Chronic Peritoneal Dialysis Patients: A Pilot Study

Mariateresa Zicarelli et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Sarcopenia is exceedingly frequent in end-stage kidney disease (ESKD) patients on dialysis, including those undergoing peritoneal dialysis (PD), and is of multifactorial origin. MOTS-c is a mitochondrial-derived peptide that promotes muscle growth whose levels are unbalanced in ESKD. In this study, we evaluated MOTS-c balance and its relationship with sarcopenia risk in an ESKD-PD cohort. Materials and Methods: MOTS-c was measured in serum, urine, and dialysate samples of 32 chronic PD patients. Patients were thus screened for sarcopenia risk by the SARC-F tool, anthropometric measurements, and physical performance tests. Results: PD patients with a very high sarcopenia risk (SARC-F ≥ 2) had significantly lower serum (sMOTS-c) and higher dialysate (dMOTS-c) levels, suggesting an increased peritoneal clearance of this substance (d/s MOTS-c). sMOTS-c levels were directly correlated with muscle performance in physical tests, while an opposite relationship was found with dMOTS-c and d/sMOTS-c. ROC analyses demonstrated the diagnostic potential of MOTS-c, particularly in combination with physical and anthropometric assessments, to identify PD patients at very high risk of sarcopenia. Conclusions: Chronic PD may negatively affect MOTS-c balance, which, in turn, may contribute to enhanced sarcopenia risk. Larger studies are needed to confirm these observations and to validate the potential utility of this substance as a biomarker for improving sarcopenia risk stratification in PD patients.

Keywords: ESKD; MOTS-c; SARC-F; peritoneal dialysis; sarcopenia.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Linear correlations between (log-transformed) serum and dialysate MOTS-c levels.
Figure 2
Figure 2
Difference in peritoneal MOTS-c clearance (d/sMOTS-c) among PD patients categorized for membrane transport performance at PET (peritoneal equilibration test). * p = 0.006; ** p = 0.03.
Figure 3
Figure 3
Frequency distribution of SARC-F scores in the study population.
Figure 4
Figure 4
Differences in serum, dialysate, and peritoneal MOTS-C clearance between patients at very high risk of Sarcopenia (SARC-F ≥ 2) compared to others. * p = 0.003; ** p = 0.04; and *** p = 0.003.
Figure 5
Figure 5
Significant relationships between sarcopenia risk correlates and MOTS-C.
Figure 6
Figure 6
Diagnostic performance (area under the curve; AUC) of serum, dialysate, and peritoneal MOTS-C clearance for identifying PD patients at very high risk of sarcopenia (SARC-F ≥ 2).
See this image and copyright information in PMC

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