The association of plasma TMAO and body composition with the occurrence of PEW in maintenance hemodialysis patients.

INTRODUCTION

This study aims to explore the relationship between trimethylamine N-oxide (TMAO), body composition, and protein-energy wasting (PEW) in patients undergoing maintenance hemodialysis (MHD).

METHODS

A total of 127 MHD patients participated in this study. Body composition was measured using the InBody770 multi-frequency body composition analyzer. Plasma TMAO concentrations were assessed by ELISA. Cross-sectional analysis was performed after collecting demographic data, dialysis-related data, laboratory parameters, and body composition data from MHD patients.

RESULTS

In MHD patients, the PEW group exhibited lower levels of hemoglobin (Hb), albumin (ALB), transferrin (TF), creatinine (Cr), triglycerides (TG), prealbumin (PALB), soft lean mass (SLM), body mass index (BMI), percent of body fat (PBF), arm muscle circumference (AMC), and phase angle (PHA) compared to the non-PEW group, while C-reactive protein (CRP) and trimethylamine-N-oxide (TMAO) levels, as well as Extracellular Water/Total Body Water (ECW/TBW) ratio, were higher in the PEW group than in the non-PEW group. After full adjustment, TMAO and ECW/TBW ratio were independent risk factors for PEW in MHD patients. Further, plasma TMAO levels correlated negatively with Cr, ALB, Hb, BMI, and PHA, and positively with ECW/TBW in MHD patients with PEW. The ROC curve analysis indicated that the area under the curve (AUC) for plasma TMAO in predicting PEW in MHD patients was 0.788.

CONCLUSIONS

Plasma TMAO levels and certain body composition are associated with the occurrence of PEW in MHD patients. Plasma TMAO levels appear to serve as a potential predictive marker for the onset of PEW.