Frailty, Sarcopenia, Selenium
Conditions
Keywords
frailty, sarcopenia, selenium, hemodialysis
Brief summary
Chronic kidney disease (CKD) is a significant public health issue with an increasing prevalence worldwide. In patients undergoing hemodialysis (HD) in particular, various factors-such as chronic inflammation, oxidative stress, nutritional disorders, and micronutrient deficiencies-can negatively affect muscle health and physical function. Selenium, an essential trace element with potent antioxidant properties, has been shown to be present at low levels in these patients and may be associated with muscle strength. Sarcopenia and frailty are critical clinical conditions in HD patients that diminish quality of life and increase the risk of hospitalization and mortality. This study aims to evaluate the relationship between serum selenium levels, sarcopenia, and frailty in patients undergoing chronic hemodialysis, and to investigate whether selenium levels might serve as a potential biomarker for these clinical conditions.
Detailed description
Sarcopenia is a significant muscular disorder characterized by a decline in muscle strength and muscle mass, which can lead to a loss of physical performance. Frailty, on the other hand, is a clinical condition arising from a reduction in physiological reserves, rendering an individual more vulnerable to stressors; it is associated with an increased risk of falls, functional dependence, hospitalization, and mortality. In patients undergoing chronic hemodialysis, common mechanisms-such as inflammation, oxidative stress, metabolic disturbances, malnutrition, and reduced physical activity-contribute to the development of both conditions. While previous studies have suggested that low selenium levels may be linked to a decline in muscle strength and mass, research simultaneously examining serum selenium levels in relation to both sarcopenia and frailty among chronic hemodialysis patients remains limited. This study aims to investigate the relationship between serum selenium levels and the presence of sarcopenia and frailty in patients receiving chronic hemodialysis, as well as to compare the clinical, laboratory, and physical performance characteristics of patients with and without selenium deficiency. It is anticipated that the findings will contribute to a better understanding of the factors associated with sarcopenia and frailty in this patient population and help evaluate the potential of serum selenium levels to serve as a biomarker.
Interventions
OTHERFRAIL scale
frailty
OTHERsarc-f
sarkopenia
OTHERtime up go test
functional performance
OTHERhand grip strength
hand grip strength using hand dynamometer
Sponsors
Ankara City Hospital Bilkent
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Receiving hemodialysis (HD) at least twice a week for a minimum of 3 months, * over 18 years of age, * agreeing to participate in the study.
Exclusion criteria
* Presence of signs of an acute infection or inflammatory disease, a history of musculoskeletal trauma or neurological disorder, * use of selenium supplements, * presence of a malignancy, * visual impairment, * heart failure or the presence of a cardiac pacemaker, * a diagnosis of depression or psychosis, * use of medication \[for these conditions\], * a history of corticosteroid use
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| frailty | 20 weeks | FRAIL scale: The FRAIL scale consists of 5 items, each scored on a scale of 0-1. The total score ranges from 0 to 5. Based on the total score, 0 is classified as robust/non-frail, 1-2 as prefrail, and 3 as frail. |
| sarcopenia sarc-f | 20 weeks | This is a questionnaire used for sarcopenia screening, which has been validated and tested for reliability in Turkish. Its components are defined as follows: Strength (S), Assistance with walking (A), Rising from a chair (R), Climbing stairs (C), and Falls (F). The questionnaire consists of 5 questions, each scored on a scale of 0-2 points. The recommended cut-off value for this scale is ≥4 points. A score of 4 or higher indicates a risk for sarcopenia. |
| time up go test | 20 weeks | Physical Performance: The "Timed Up and Go" (TUG) test was administered to assess the functional performance of the participants. The TUG test is a practical and rapidly applied assessment that measures walking speed, functional mobility, and dynamic balance. For the test, individuals were asked to sit on an armless chair with their feet touching the floor; upon the command "go," they were instructed to stand up, walk along a marked 3-meter path, turn around, and return to sit back down in the chair. During this process, the time taken by each individual to complete the activity was recorded. |
| hand grip strength | 20 weeks | Handgrip strength (HGS) was measured using a hydraulic hand dynamometer (Baseline). Measurements were performed three times on the hand without a fistula, and the highest value was recorded. |
| selenium | 20 weeks | Serum selenium concentrations were measured using inductively coupled plasma-mass spectrometry (ICP-MS) with an Agilent 7500 ICP-MS instrument (Agilent Technologies, USA), in accordance with the laboratory's analytical procedure (code: TIP-TÇT-52). Results were recorded in micrograms per liter (µg/L). Based on a previous study, a serum selenium level of \<70 µg/L was defined as selenium deficiency in our study. |
Countries
Turkey (Türkiye)
Outcome results
None listed