Possible sarcopenia and risk of chronic kidney disease: a four-year follow-up study and Mendelian randomization analysis

ABSTRACT

Introduction

Chronic kidney disease (CKD) is a common risk factor for sarcopenia. However, whether sarcopenia increases the risk of CKD remains unclear. To investigate the longitudinal and causal associations between possible sarcopenia and CKD, this study was performed.

Methods

Possible sarcopenia was defined according to the Asian Working Group for Sarcopenia in 2019. Participants aged ≥ 40 years were recruited from the baseline survey of the China Health and Retirement Longitudinal Study and followed up for four years. Binary logistic regression was used to evaluate the cross-sectional and longitudinal associations between possible sarcopenia, low muscle strength, low physical performance and CKD. Propensity score matching was used to balance the intergroup differences. Subgroup and interactive analyses were adopted to identify potential interactive effects. Mendelian Randomization analysis was used to assess the causal association between appendicular lean mass (ALM) and CKD.

Results

After data cleansing, a total of 7296 participants were included in the baseline survey. In the cross-sectional analyses, the odds ratios (ORs) of prevalent CKD were 1.50 (95% CI = 1.23–1.84, p < 0.001) for possible sarcopenia, 1.37 (95% CI = 1.10–1.70, p < 0.01) for low muscle strength and 1.42 (95% CI = 1.16–1.74, p < 0.001) for low physical performance in the full models. No significant interaction effects of covariates were detected (all P for interaction > 0.05). After four years of follow-up, an increased risk of incident CKD was also observed in participants with possible sarcopenia (OR = 1.66, 95% CI = 1.13–2.44, p = 0.010) and low physical performance (OR = 1.69, 95% CI = 1.16–2.45, p = 0.006), but not in participants with low muscle strength (OR = 1.19, 95% CI = 0.75–1.88, p = 0.469). In the Mendelian Randomization analysis, the inverse variance weighted estimator showed that a 1-standard deviation increase of genetically predicted ALM was associated with a lower risk of CKD (OR = 0.92, 95% CI = 0.85–0.99, p = 0.035). All the sensitivity analyses supported the main findings.

Conclusions

Possible sarcopenia is an independent risk factor for CKD and may serve as a predictor of CKD for early identification and intervention.

KEYWORDS:

• Aging
• CHARLS
• chronic kidney disease
• Mendelian randomization
• sarcopenia

Acknowledgments

The authors sincerely thank the authors who shared the original dataset in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Authors’ contributions

Conceptualization: Y.X, X.J, Q.Z and XD.W. Data curation: Y.X, X.J and YC.Z. Formal analysis: Y.X, X.J, Q.Z, HW. Z and ZH. L; Writing-original draft: Y.X and X.J. Writing-review & editing: X.J, Q. Z, YC. Z, ZH. L, and XD. W. Supervision: ZH. L, and XD.W.

Ethnics approval and consent to participant

This study was reviewed and approved by the ethics committee of Peking University (IRB 00001052–11014; Beijing, China). The participants in the study were all well-read. Written and oral informed consent was obtained from all participants before their enrollment in this study.

Additional information

Funding

This work was supported by the 1.3.5 Project for Disciplines of Excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University No. 2021HXFH007, and Sichuan Science and Technology Program No. 2023YFS0256.