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Peer-reviewedCC BY 4.0Biomolecules

The Association Between Circulating Myostatin and Skeletal Muscle Mass Varies by Nutritional–Inflammatory Status in Hemodialysis Patients

  • Xuan Tan1
  • Changsong Ma2
  • Abdullah Md Sheikh1
  • Atsushi Nagai3
  • Shozo Yano1,4
4 affiliations
  1. 1Department of Laboratory Medicine, Faculty of Medicine, Shimane University, 89-1 Enya-Cho, Izumo 693-8501, Japan
  2. 2Department of Pediatrics, Faculty of Medicine, Shimane University, 89-1 Enya-Cho, Izumo 693-8501, Japan
  3. 3Department of Internal Medicine 3, Faculty of Medicine, Shimane University, 89-1 Enya-Cho, Izumo 693-8501, Japan
  4. 4The Center for Integrated Kidney Research and Advance (IKRA), Faculty of Medicine, Shimane University, 89-1 Enya-Cho, Izumo 693-8501, Japan
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Abstract

Myostatin (MSTN) is a negative regulator of skeletal muscle growth. However, previous studies in hemodialysis patients have reported inconsistent associations between circulating MSTN and muscle-related parameters, and the reasons for these discrepancies remain unclear. This cross-sectional study aimed to investigate whether these associations varied across nutritional and inflammatory contexts. We enrolled 138 maintenance hemodialysis patients. Serum MSTN levels were measured by ELISA, and skeletal muscle index (SMI), handgrip strength (HGS), and sarcopenia were assessed according to AWGS 2025 criteria. Nutritional and inflammatory status were evaluated using the Nutritional Risk Index for Japanese hemodialysis patients (NRI-JH) and C-reactive protein (CRP), respectively. In the overall cohort, higher serum MSTN levels were associated with greater SMI and HGS. In exploratory analyses, a significant negative three-way interaction among MSTN, NRI-JH, and CRP was observed for SMI (B = −0.445, p = 0.018). Above the model-derived Johnson–Neyman boundary of CRP (0.22 mg/dL), the positive association between MSTN and SMI was progressively weaker with increasing NRI-JH scores. These findings suggest statistical heterogeneity in the association between circulating MSTN and skeletal muscle mass across nutritional–inflammatory backgrounds in hemodialysis patients. However, the results are exploratory and require validation in larger independent cohorts.

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Cite

BibTeXRIS
BibTeX
@article{tan2026association,
  title = {{The Association Between Circulating Myostatin and Skeletal Muscle Mass Varies by Nutritional–Inflammatory Status in Hemodialysis Patients}},
  author = {Xuan Tan and Changsong Ma and Abdullah Md Sheikh and Atsushi Nagai and Shozo Yano},
  journal = {Biomolecules},
  year = {2026},
  month = oct,
  doi = {10.3390/biom16101469},
  url = {https://www.mdpi.com/2218-273X/16/10/1469},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - The Association Between Circulating Myostatin and Skeletal Muscle Mass Varies by Nutritional–Inflammatory Status in Hemodialysis Patients
AU  - Xuan Tan
AU  - Changsong Ma
AU  - Abdullah Md Sheikh
AU  - Atsushi Nagai
AU  - Shozo Yano
PY  - 2026
DA  - 2026/10/01
JO  - Biomolecules
DO  - 10.3390/biom16101469
UR  - https://www.mdpi.com/2218-273X/16/10/1469
AB  - Myostatin (MSTN) is a negative regulator of skeletal muscle growth. However, previous studies in hemodialysis patients have reported inconsistent associations between circulating MSTN and muscle-related parameters, and the reasons for these discrepancies remain unclear. This cross-sectional study aimed to investigate whether these associations varied across nutritional and inflammatory contexts. We enrolled 138 maintenance hemodialysis patients. Serum MSTN levels were measured by ELISA, and skeletal muscle index (SMI), handgrip strength (HGS), and sarcopenia were assessed according to AWGS 2025 criteria. Nutritional and inflammatory status were evaluated using the Nutritional Risk Index for Japanese hemodialysis patients (NRI-JH) and C-reactive protein (CRP), respectively. In the overall cohort, higher serum MSTN levels were associated with greater SMI and HGS. In exploratory analyses, a significant negative three-way interaction among MSTN, NRI-JH, and CRP was observed for SMI (B = −0.445, p = 0.018). Above the model-derived Johnson–Neyman boundary of CRP (0.22 mg/dL), the positive association between MSTN and SMI was progressively weaker with increasing NRI-JH scores. These findings suggest statistical heterogeneity in the association between circulating MSTN and skeletal muscle mass across nutritional–inflammatory backgrounds in hemodialysis patients. However, the results are exploratory and require validation in larger independent cohorts.
SN  - 2218-273X
ER  -