Abstract
Background and Aims
Walking speed test is a usefulness tool for cardiovascular risk stratification in older adults. The inhibition of myostatin in adult significantly increases muscle mass and confers benefits upon measures of performance and metabolism. The present study evaluated the relationship between walking speed test and serum myostatin levels in renal transplant recipients.
Method
Fasting blood samples were collected from 84 renal transplant recipients. Handgrip strength (HGS) was measured using a Jamar Plus Digital Hand Dynamometer for assessment of muscle strength. Gait speed was measured by walking 6 meters at the usual speed. Gait speed < 1 m/s was defined as low gait speed group according to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria. Serum myostatin levels were measured using a commercial enzyme-linked immunosorbent assay.
Results
Thirty-one renal transplant recipients (36.9%) had low gait speed, and they included a lower percentage of use of mycophenolate mofetil (p = 0.003), higher percentage of use of steroid (p = 0.037), older age (p = 0.0090, higher body weight (p = 0.044), body mass index (p = 0.017), skeletal muscle index (p = 0.027), serum triglyceride (p = 0.029), glucose (p = 0.007), blood urea nitrogen (p = 0.041), cystatin C (p = 0.015), while lower estimated glomerular filtration rate from serum creatinine (eGFRcre, p = 0.047) and estimated glomerular filtration rate from serum cystatin C (eGFRcys, p = 0.006) compared with renal transplant recipients with normal gait speed. After adjusting for cofounders associated with low gait speed in these patients by multivariable logistic regression analysis, serum myostatin levels (Odds ratio (OR): 0.943, 95% confidence interval (CI): 0.898–0.990, p = 0.018), and mycophenolate mofetil used (OR: 0.199, 95% CI: 0.050–0.795, p = 0.022) were independently associated with low gait speed in renal transplant recipients. The area under the receiver-operating characteristic (ROC) curve indicates the diagnostic power of serum myostatin levels at predicting low gait speed of renal transplant recipients was 0.769 (95% CI: 0.664-0.854, p < 0.001). Multivariable forward stepwise linear regression analysis also showed that serum myostatin levels (β = 0.353, adjusted R2 change: 0.245, p = 0.001) was positively associated with gait speed values in renal transplant recipients.
Conclusion
In this study, serum myostatin levels is found to be positively correlated with gait speed values and is identified as serum low myostatin levels is associated with low gait speed in renal transplant patients.
Conversion to Combined Therapy with Sirolimus and Mycophenolate Mofetil Improved Renal Function in Stable Renal Transplant Recipients
