Fatigue in Patients on Chronic Hemodialysis : The Role of Indoleamine 2,3-Dioxygenase (IDO) Activity, Interleukin-6, and Muscularity

Fatigue is a frequent symptom in hemodialysis (HD), and the indolamine-2,3-dioxygenase (IDO) metabolic trap has been hypothesized in the pathogenesis of fatigue. The association between IDO activity according to fatigue and its relationship with muscle mass and function in HD patients was verified. Chronic HD patients were considered, and fatigue was assessed. The plasma kynurenines and tryptophan ratio (Kyn/Trp), as surrogate of IDO activity, and interleukin (IL)-6 were measured. Muscularity was assessed by BIA and muscle strength by hand-grip dynamometer. 50 HD patients were enrolled, and fatigue was present in 24% of the cohort. Patients with fatigue showed higher Kyn/Trp (p = 0.005), were older (p = 0.007), and IL-6 levels resulted higher than in non-fatigue patients (p < 0.001). HD patients with fatigue showed lower intracellular water (surrogate of muscle mass) (p < 0.001), as well as lower hand grip strength (p = 0.02). The Kyn/Trp ratio positively correlated with IL-6 and ECW/ICW (p = 0.004 and p = 0.014). By logistic regression analysis, higher ICW/h2 was associated with lower odds of fatigue (OR, 0.10; 95% CI, 0.01 to 0.73). In conclusion, our cohort fatigue was associated with a higher Kyn/Trp ratio, indicating a modulation of IDO activity. The Kyn/Trp ratio correlated with IL-6, suggesting a potential role of IDO and inflammation in inducing fatigue and changes in muscularity.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:15

Enthalten in:

Nutrients - 15(2023), 4 vom: 09. Feb.

Sprache:

Englisch

Beteiligte Personen:

Molfino, Alessio [VerfasserIn]
Imbimbo, Giovanni [VerfasserIn]
Amabile, Maria Ida [VerfasserIn]
Ammann, Thomas [VerfasserIn]
Lionetto, Luana [VerfasserIn]
Salerno, Gerardo [VerfasserIn]
Simmaco, Maurizio [VerfasserIn]
Chiappini, Maria Grazia [VerfasserIn]
Muscaritoli, Maurizio [VerfasserIn]

Links:

Volltext

Themen:

343-65-7
8DUH1N11BX
Body composition
Dialysis
Fatigue
IDO
Indoleamine-Pyrrole 2,3,-Dioxygenase
Inflammation
Interleukin-6
Journal Article
Kyn/Trp ratio
Kynurenine
Muscle mass
Tryptophan

Anmerkungen:

Date Completed 28.02.2023

Date Revised 01.03.2023

published: Electronic

Citation Status MEDLINE

doi:

10.3390/nu15040876

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM353453633