Muscle mass and plasma myostatin after exercise training: a substudy of Renal Exercise (RENEXC)-a randomized controlled trial

Yunan Zhou, Matthias Hellberg, Thomas Hellmark, Peter Höglund, Naomi Clyne, Yunan Zhou, Matthias Hellberg, Thomas Hellmark, Peter Höglund, Naomi Clyne

Abstract

Background: Sarcopenia increases as renal function declines and is associated with higher morbidity and mortality. Myostatin is a negative regulator of muscle growth. Its expression in response to exercise is unclear. In this prespecified substudy of the Renal Exercise (RENEXC) trial, we investigated the effects of 12 months of exercise training on sarcopenia, muscle mass and plasma myostatin and the relationships between physical performance, muscle mass and plasma myostatin.

Methods: A total of 151 non-dialysis-dependent patients (average measured glomerular filtration rate 23 ± 8 mL/min/1.73 m2), irrespective of age or comorbidity, were randomly assigned to either strength or balance in combination with endurance training. Body composition was measured with dual-energy X-ray absorptiometry. Plasma myostatin was analysed using enzyme-linked immunosorbent assay kits.

Results: After 12 months, the prevalence of sarcopenia was unchanged, leg and whole-body lean mass increased significantly in the balance group and was unchanged in the strength group. Whole fat mass decreased significantly in both groups. There were no significant between-group differences in sarcopenia or body composition. Plasma myostatin levels increased significantly in both groups, with a significant difference in favour of the strength group. Plasma myostatin was significantly positively related to muscle mass and physical performance at baseline, but these relationships were attenuated after 12 months.

Conclusions: Exercise training seems to be effective in preventing sarcopenia and maintaining muscle mass in non-dialysis-dependent patients with chronic kidney disease (CKD). However, the role of plasma myostatin on muscle mass and physical performance in patients with CKD warrants further study.

Trial registration: ClinicalTrials.gov NCT02041156.

Keywords: body composition; chronic kidney disease; exercise training; myostatin; sarcopenia.

© The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA.

Figures

Graphical abstract
Graphical abstract
FIGURE 1
FIGURE 1
CONSORT flow over 12 months.
FIGURE 2
FIGURE 2
Body composition at baseline and after 12 months. Data are presented as mean ± SD. *P 

FIGURE 3

Plasma myostatin at baseline and…

FIGURE 3

Plasma myostatin at baseline and after 12 months. Data are presented as median…

FIGURE 3
Plasma myostatin at baseline and after 12 months. Data are presented as median ± interquartile range. *P 
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FIGURE 3
FIGURE 3
Plasma myostatin at baseline and after 12 months. Data are presented as median ± interquartile range. *P 

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