Association of Serum Urotensin II with Sarcopenia and Mortality in Patients on Hemodialysis

Background: Sarcopenia significantly impacts dialysis patients. Our prior research evaluated 6 muscle biomarkers for early sarcopenia detection and found that Urotensin II (UT II) had a strong correlation with sarcopenia. This study further investigates UT II's effectiveness in predicting cardiovascular (CV) mortality. Methods: A cross-sectional study was conducted on 175 stable HD patients at Tungs' Taichung Metroharbour Hospital. The associations of these biomarkers with CV mortality and sarcopenia were analyzed using multivariate Cox regression models, categorizing biomarkers into quartiles for statistical analysis. The predictive value of UT II against sarcopenia diagnosed by DEXA was also compared. Statistical analyses were performed using SAS software version 9.4. Results: In this cohort, Cox regression analysis revealed that elevated UT II levels were significantly associated with increased CV mortality (aHR = 5.209, p = 0.0146, Fig. 1). Further analysis, integrating UT II with DEXA measurements, confirmed the significant predictive value of UT II (aHR = 6.040, p = 0.0216, Fig. 1) for CV mortality, while sarcopenia and presarcopenia diagnosed via DEXA were non-significant (Fig. 2). Conclusion: UT II emerges as a better biomarker for predicting CV mortality in HD patients. This study emphasizes that serum UT II reflects not only muscle wasting but protein-energy wasting (PEW), which are related to CV diseases.