Associação da força e qualidade muscular com adiposidade corporal de pacientes em tratamento dialítico

Abstract

Introduction: The increase of body adiposity collaborates with the intramuscular fat accumulation, and may negatively affect muscle strength and quality. However, this association has not been tested in dialysis patients. Objective: To verify the association between strength and muscle quality with body adiposity in individuals on maintenance dialysis. Material and Methods: Cross-sectional study including patients on hemodialysis and peritoneal dialysis. Muscle strength was assessed by handgrip strength (HGS). Body adiposity parameters (total body fat, percent of body fat, and trunk fat) were quantified by dual-energy X-ray absorptiometry. Upper limb lean mass and appendicular lean mass (ALM) were considered for the calculation of muscle quality indices (MQI). To assess muscle quality, two IQM were used. MQIarm calculated through the HGS/sum of lean mass ratio of both upper limbs. MQIapp defined by HGS/ALM ratio. Linear regression models considered HGS or MQI as a dependent variable and adiposity parameters as independent variables. Results: 174 individuals were included. HGS showed an inverse association with trunk fat (𝛽= -0.502; 95% CI -0.880; -0.124; p=0.010) after adjusting for sex, age, diabetes, height and weight. Both IQM had an inverse association with total fat (MQIarm: 𝛽= -0.030; 95% CI -0.058; -0.002; p=0.034 and MQIapp 𝛽= -0.008; 95% CI -0.015; 0.001; p=0.035), after adjust for sex, age, diabetes and height. Conclusion: HGS was inversely associated with trunk fat and MQI was inversely associated with total fat.