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Factors Associated with the Serum Myostatin Level in Patients Undergoing Peritoneal Dialysis: Potential Effects of Skeletal Muscle Mass and Vitamin D Receptor Activator Use

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Abstract

Myostatin is a member of the transforming growth factor-β family, which regulates synthesis and degradation of skeletal muscle proteins and is associated with the development of sarcopenia. It is up-regulated in the skeletal muscle of chronic kidney disease patients and is considered to be involved in the development of uremic sarcopenia. However, serum myostatin levels have rarely been determined, and the relationship between serum myostatin levels with clinical and metabolic factors remains unknown. This cross-sectional study investigated the association between serum myostatin level and clinical factors in 69 outpatients undergoing peritoneal dialysis. Serum myostatin level was determined by commercially available enzyme-linked immunosorbent assay (ELISA). Univariable and multivariable analysis were conducted to determine factors associated with serum myostatin levels. The factors included age, sex, diabetes mellitus, dialysis history, body mass index, residual kidney function, peritoneal dialysate volume, serum biochemistries, and the use of vitamin D receptor activators (VDRAs). Mean serum myostatin level was 7.59 ± 3.37 ng/mL. There was no association between serum myostatin level and residual kidney function. Serum myostatin levels were significantly and positively associated with lean body mass measured by the creatinine kinetic method and negatively associated with the use of VDRAs after adjustment for potential confounding factors. Our study indicated that serum myostatin levels are associated with skeletal muscle mass and are lower in patients treated with VDRAs. Further studies are necessary to determine the significance of measuring serum myostatin level in patients undergoing peritoneal dialysis.

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Acknowledgments

We thank the investigators and the doctors of the participating dialysis centers. We thank Edanz Editing (http://www.edanzediting.co.jp/) for carefully reading and preparing our manuscript.

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Authors and Affiliations

  1. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Shunsuke Yamada, Kazuhiko Tsuruya, Kenji Ueki & Takanari Kitazono

  2. Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Kazuhiko Tsuruya & Hisako Yoshida

  3. Department of Internal Medicine, Fukuoka Dental College, Fukuoka, Japan

    Shunsuke Yamada, Masanori Tokumoto & Hiroaki Ooboshi

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  1. Shunsuke Yamada
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Correspondence to Kazuhiko Tsuruya.

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Shunsuke Yamada, Kazuhiko Tsuruya, Hisako Yoshida, Masanori Tokumoto, Kenji Ueki, Hiroaki Ooboshi, and Takanari Kitazono declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Yamada, S., Tsuruya, K., Yoshida, H. et al. Factors Associated with the Serum Myostatin Level in Patients Undergoing Peritoneal Dialysis: Potential Effects of Skeletal Muscle Mass and Vitamin D Receptor Activator Use. Calcif Tissue Int 99, 13–22 (2016). https://doi.org/10.1007/s00223-016-0118-6

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  • DOI: https://doi.org/10.1007/s00223-016-0118-6

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