Association of Uremic Sarcopenia and Mitochondrial Copy Number and Its Clinical Correlates
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Sarcopenia is the decline of muscle mass and strength with age. Evidence suggests that oxidative stress and molecular inflammation play important roles in age-related muscle atrophy. The two factors may interfere with the balance between protein synthesis and breakdown, cause mitochondrial dysfunction, and induce apoptosis. Sarcopenia, inflammation and oxidative stress is highly prevalent in hemodialysis patients and may contribute to mortality. The copy number of mitochondrial DNA (mtDNA) is affected by oxidative stress in blood circulation. This study aimed to test whether mtDNA copy number correlates with oxidative stress and some uremic toxins in nondiabetic hemodialysis(HD) patients. 200 nondiabetic hemodialysis patients and 50 healthy subjects will be enrolled. This study will be performed to investigate quantitative changes in mtDNA occur in HD patients with and without sarcopenia. Copy number of mtDNA in leukocyte DNA is determined by real-time polymerase chain reaction in HD patients and 50 age- and sex-matched control subjects. In addition, correlation of the alterations of albumin redox status, 8-isoprostane, plasma IL-6 ,LBP and TNF-a and as well as various uremic toxins will be performed.
Determination of mtDNA/nDNA Ratio as a measure of mtDNA Content [ Time Frame: 1 years ]
The copy number of the mtDNA and the nDNA is calculated using the threshold cycle number (Ct) and intrapolating from the standard curve. The ratio of the copy number of mtDNA to the copy number of nDNA is measurement of mtDNA content.
Secondary Outcome Measures :
Plasma uremic toxins analysis [ Time Frame: 1 years ]
ndoxyl sulfate (IS) and para-cresol (p-cresol) belong to the group of protein-bound uremic toxins that are poorly cleared by dialysis and are associated with poor clinical outcomes.the group of protein-bound uremic toxins that are poorly cleared by dialysis and are associated with poor clinical outcomes.
Total of 8-iso-PGF2-alpha Analysis [ Time Frame: 1 years ]
Total 8-iso-PGF2-alpha concentrations in plasma were measured by a specific enzyme immunoassay (EIA) kit
Analysis of biomarkers of IL-6 [ Time Frame: 1 years ]
The IL-6 was determined from serum samples and controls using standardized enzymelinked immunosorbent assay (ELISA) methods
Analysis of biomarkers of TNF-α [ Time Frame: 1 years ]
The TNF-α was determined from serum samples and controls using standardized enzymelinked immunosorbent assay (ELISA) methods
Analysis of biomarkers of Liposaccharide-binding protein (LBP) [ Time Frame: 1 years ]
The LBP was determined from serum samples and controls using standardized enzymelinked immunosorbent assay (ELISA) methods
Measurement of the Albumin Redox State [ Time Frame: 1 years ]
the fractions of HMA, HNA-1, and HNA-2 to total HSA were measured using HPLC
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Layout table for eligibility information
Ages Eligible for Study:
20 Years to 90 Years (Adult, Older Adult)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
patients have to be at least 20-years-old and on outpatient hemodialysis (HD) for at least 3 months.
Both sexes aged between 20-90 years.
Received stable hemodialysis at least 3 months.
Written informed consent.
patients with severe infections, severe heart disease and liver disease, malignancy, autoimmune disorders, severe malnutrition, or clinical conditions requiring oral nutrition supplements;