The Value Of Serum Irisin Level To Predict Sarcopenia Among Peritoneal Dialysis Patients

Object: To explore the incidence and influencing factors of sarcopenia in peritoneal dialysis(PD)patients and evaluate the early predictive value of serum Irisin level to PD sarcopenia.Methods: Patients who received regular peritoneal dialysis at Shaoxing People’s Hospital from December 2020 to August 2021 were enrolled and general data of subjects were collected.The skeletal muscle mass index of limbs was measured by Bioelectric Impedance Analyzer(BIA),muscle strength was evaluated by grip strength,and physical function was evaluated by the 5-time chair stand time test.According to the latest consensus of Asian Working Group for Sarcopenia(AWGS2019 consensus),PD patients were divided into sarcopenia group and non-sarcopenia group and baseline differences between the two groups were compared.Binary logistic regression was used to analyze the risk factors of PD sarcopenia.Receiver operating characteristic(ROC)curves and their respective areas under the curve(AUCs)were used to analyze the early predictive value of serum Irisin level to PD sarcopenia.Results: Among 105 patients undergoing PD,43(41.0%)were male,with an age of(59.2±8.9)years and the median dialysis age was 24.43(8.65,50.17)months.33 patients(31.4%)were diagnosed with PD sarcopenia,8 patients(7.6%)were diagnosed with severe PD sarcopenia,and 9 patients(8.6%)were diagnosed with obesity sarcopenia.Binary Logistic regression analysis showed that low serum Irisin level(OR=0.984,95% CI:0.974～0.994,P=0.002),low phase angel(Ph A)(OR=0.432,95%CI: 0.208～0.899,P=0.025)and low BMI(OR=0.636,95%CI: 0.486～0.831,P=0.001)were independent risk factors for PD sarcopenia.ROC analysis showed that the AUC of serum Irisin level in predicting PD sarcopenia was 0.793(95% CI: 0.691～0.873,P<0.001)with an optimal cut-off of 235.3ng/m L,a sensitivity of 90.9%,and a specificity of 63.5%.In male,the AUC in predicting PD sarcopenia was 0.835(95% CI:0.665～0.941,P<0.001)and the best cutoff value of serum Irisin concentrations was 233.7 ng/m L with a sensitivity of 100% and specificity of 76.0%;In female,the AUC in predicting PD sarcopenia was 0.776(95% CI:0.639～0.880,P<0.001)and the best cutoff value of serum Irisin concentrations was 176.7 ng/m L with a sensitivity of68.0% and specificity of 77.7%.Furthermore,we found that the AUC of the combination of serum Irisin level and Ph A was 0.886(95% CI: 0.799～0.945,P<0.001),with a sensitivity of90.9% and a specificity of 84.6% in predicting PD sarcopenia.Conclusions: The prevalence of PD sarcopenia is not low.Low serum Irisin level,low Ph A and low BMI are the independent risk factors of PD sarcopenia.Serum Irisin level can be used to early predict PD sarcopenia,and is more effective when serum Irisin level is combined with PhA.