대한신장학회

논문분류	춘계학술대회 초록집
제목	1,25-Dihydroxyvitamin D is Independently Associated with Sarcopenia in Patients with Pre-dialysis Chronic Kidney Disease
저자	Kyu Won Jang
출판정보	2024; 2024(1):
키워드
초록	Objectives: Sarcopenia is characterized by progressive and widespread loss of skeletal muscle, resulting in muscle weakness and frailty. While there are reports linking vitamin D deficiency, prevalent in chronic kidney disease (CKD), to sarcopenia in the general population, limited information exists regarding the specific relationship between vitamin D and sarcopenia in CKD patients. This study aims to explore the association between vitamin D deficiency and sarcopenia in patients with pre-dialysis CKD. Methods: This cross-sectional study enrolled 569 patients with pre-dialysis CKD. Sarcopenia was assessed using computed tomography (CT)-derived skeletal muscle index (SMI), calculated based on the cross-sectional area of skeletal muscles at the 3rd lumbar vertebra. Patients were categorized into sarcopenic and non-sarcopenic groups using Korean-specific SMI cutoffs. Logistic regression analyses were employed to explore associations between sarcopenia and baseline variables, including 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] levels. Results: The prevalence of sarcopenia increased with advancing CKD stage. Univariate logistic regression analysis revealed that serum 1,25(OH)2D levels, but not serum 25(OH)D levels, are associated with sarcopenia. In multivariable logistic regression analysis, 1,25(OH)2D levels remained independently associated with sarcopenia (per 1 pg/dl increase, odds ratio: 0.84; 95% confidence interval: 0.80–0.87, P < 0.001). Additionally, age, diabetes, serum albumin, and high-sensitive C-reactive protein were also independently associated with sarcopenia. Receiver operating characteristic curve analysis showed that 1,25(OH)2D levels had good diagnostic potential for predicting the presence of sarcopenia in study participants (area under curve: 0.844, P < 0.001, best cutoff value: 12.2 pg/dl with sensitivity of 75.2% and specificity of 82.3%). Conclusions: This study revealed an independent association between serum 1,25(OH)2D levels and sarcopenia derived from CT scans in pre-dialysis CKD patients. Including serum 1,25(OH)2D assessment could serve as a valuable tool for physicians in effectively stratifying the risk of sarcopenia in these patients.
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