Patients with chronic kidney disease (CKD) frequently develop sarcopenia, which worsens their prognosis. Oxidative stress contributes to the pathogenesis of sarcopenia, and advanced glycation end products (AGEs), which are associated with oxidative stress, may promote muscle loss. This study examined the association between serum carboxymethyl-lysine (CML), a major AGE, and sarcopenia in patients with non-dialysis CKD. In this single-center cross-sectional study, 132 patients with non-dialysis CKD were enrolled based on inclusion/exclusion criteria. Clinical, anthropometric, and body composition data were obtained using bioelectrical impedance analysis. Sarcopenia was diagnosed based on the 2019 Asian Working Group for Sarcopenia criteria. Correlations between CML and sarcopenia indices were assessed using Spearman’s/Pearson’s correlation and linear regression. The predictive performance of CML for sarcopenia was assessed using the receiver operating characteristic (ROC) curve and area under the curve (AUC). Among patients with non-dialysis CKD, the overall sarcopenia prevalence was 25.76%, and the mean serum CML concentration was 46.2 ± 7.1 µg/L. Multivariate linear regression analysis revealed a significant negative association between CML levels and appendicular skeletal muscle index (ASMI) (β = −0.27, p = 0.01), particularly among females (β = −0.40, p = 0.01). However, ROC curve analysis showed an AUC of 0.65 (p = 0.33) for serum CML in diagnosing sarcopenia in females, indicating that CML does not demonstrate statistically significant discriminative ability beyond chance for predicting sarcopenia. Elevated serum CML levels were associated with increased sarcopenia prevalence in patients with non-dialysis CKD. CML levels were independently inversely correlated with ASMI, especially in females. The cross-sectional design and limited sample size, however, warrant cautious interpretation and validation in larger cohorts.
Yang et al. (Thu,) studied this question.