J Ren Nutr. 2026 Oct 31:S1051-2276(26)00204-9. doi: 10.1053/j.jrn.2026.10.009. Online ahead of print.
ABSTRACT
BACKGROUND: Left ventricular hypertrophy (LVH) is common and prognostically important in dialysis patients, and may be linked to abnormal body composition. We investigated the associations of skeletal muscle radiodensity (SMD) and skeletal muscle index (SMI) with LVH risk in this population.
METHODS: We enrolled 2,119 dialysis patients from four tertiary hospitals (2020-2023). Muscle parameters were quantified via L1-level CT scans. LVH was defined as a left ventricular mass index (LVMI) >95 g/m2 in women and >115 g/m2 in men, based on echocardiography. Ordinal logistic regression and restricted cubic splines (RCS) assessed associations and dose-response relationships.
RESULTS: The mean (SD) age was 54.8 (13.9) years, 60.7% were male, and 67.5% had LVH. After adjustment, compared with Q4, the ORs (95% CIs) for LVH in Q1, Q2, and Q3 were 1.55 (1.17-2.05; P=0.002; E-value 2.47 [upper CI: 1.62]), 1.45 (1.14-1.86; P=0.003; E-value 2.26 [upper CI: 1.54]), and 1.20 (0.95-1.51; P=0.123), respectively (P for trend=0.001). Each 1-SD decrease in SMD was associated with 1.23-fold higher odds of LVH (95% CI: 1.11-1.37; P<0.001). For SMI, compared with the highest quartile, the lowest quartile was associated with a 43% lower risk of LVH (OR=0.57; 95% CI: 0.43-0.75; P<0.001), and a 1-SD decrease in SMI was associated with an OR of 0.76 (95% CI: 0.68-0.85; P<0.001) for LVH. RCS analyses showed linear relationships of SMD and SMI with LVH (P for nonlinear>0.05).
CONCLUSIONS: SMD was inversely associated with LVH, whereas SMI showed a positive association in dialysis patients. These findings highlight the need to consider both muscle quality and muscle quantity when evaluating LVH risk in this population.
PMID:42966479 | DOI:10.1053/j.jrn.2026.10.009