Mediating Role of 25-Hydroxy vitamin D Between Sedentary Time and Sarcopenia in Maintenance Hemodialysis Patients
CAO Ti
CHEN Hui
QIN Jinxue
GAO Honghua
Abstract：Objective To analyze the mediating role of 25-hydroxyvitamin D in the association between different sedentary time and sarcopenia in maintenance hemodialysis(MHD)patients.Methods A total of 325 MHD patients who received treatment in the Department of Nephrology in Central Hospital of Nanyang from January 2019 to December 2022 were included in this study.The patients were divided into a sarcopenia group(99 cases)and a non-sarcopenia group(226 cases)based on the presence or absence of sarcopenia.The basic data,blood biochemical indicators,skeletal muscle mass,strength,physical activity ability,and sedentary time were compared between the two groups.Logistic regression analysis was used to analyze the relationship between sedentary time and sarcopenia in MHD patients.Multiple linear regression analysis was used to analyze the relationship between sedentary time and serum 25-hydroxyvitamin D levels.The Process plugin was used to analyze the mediating effect of serum 25-hydroxyvitamin D on the impact of sedentary time on sarcopenia in MHD patients.Results A total of 325 MHD patients were included in the study,and the prevalence of sarcopenia was 30.46％(99/325).There were statistically significant differences in age,body mass index,sedentary time,C-reactive protein,albumin,beta-2 microglobulin,serum 25-hydroxyvitamin D levels,grip strength,chair stands,4-meter walking speed,and limb skeletal muscle mass index between the sarcopenia group and the non-sarcopenia group(P＜0.05).Logistic regression analysis showed that after adjusting for age,albumin,serum 25-hydroxyvitamin D,etc.,MHD patients with sedentary time of 4.60-7.00 hours(OR=3.705,95％CI:1.130-12.147)and＞7 hours(OR=9.803,95％CI:2.796-34.376)had a higher risk of developing sarcopenia compared to those with sedentary time≤2.5 hours(P＜0.05).There was a statistically significant increasing trend in the risk of sarcopenia with increasing sedentary time in the ≤2.5 hours,2.60-4.50 hours,4.60-7.00 hours,and＞7 hours groups(P＜0.05).Multiple linear regression analysis showed that after controlling for gender and age,sedentary time independently explained 37.70％of the variation in serum 25-hydroxyvitamin D levels in MHD patients(P＜0.05).Mediation analysis showed that serum 25-hydroxyvitamin D had a partial mediating effect(mediation effect value=0.050)between sedentary time and sarcopenia.Conclusion MHD patients with sarcopenia have longer sedentary time and lower levels of 25-hydroxyvitamin D.In MHD patients,sedentary time can have a direct impact on sarcopenia and can also have an indirect impact through serum 25-hydroxyvitamin D.
Keywords：sarcopeniamaintenance hemodialysissedentary time25-hydroxyvitamin D
Publication Date：2025-11-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 4119-4124 )