ABSTRACT

Sarcopenia is a condition that can decrease a person’s quality of life and increase mortality in the elderly because it is often associated with cardiovascular complications. Insulin resistance is an important factor in the occurrence of sarcopenia. Old age and metabolic conditions such as chronic kidney disease on maintenance hemodialysis (MHD) can worsen insulin resistance, making sarcopenia prone to occur. There are few studies on the relationship between insulin resistance and the degree of sarcopenia in elderly patients on MHD. This study aimed at to analyze the relationship between insulin resistance and the degree of sarcopenia in elderly patients on MHD. Method: This study is an analytical observational study with a cross-sectional design in the elderly on MHD in Dr. Soetomo hospital Surabaya who met the inclusion criteria and did not meet the exclusion criteria. Examination of insulin resistance, using the HOMA IR formula and sarcopenia status adopting the 2019 AWGS standard. Data were analyzed using the Spearman correlation test. Results: From a total of 40 subjects, 70% severe sarcopenia, 12.5% sarcopenia, 5% presarcopenia, and 12.5% normal were found. The median value of HOMA IR is 2.29 (0.48-10.64). This study showed a positive correlation between insulin resistance and the degree of sarcopenia in elderly patients on MHD (p=0.001, r=0.496). In addition, there was also a significant relationship between HOMA IR and muscle mass (p<0.001) but not with muscle strength and physical performance (p=0,311; p=0,165). Conclusion: There is a relationship between insulin resistance and the degree of sarcopenia in elderly patients on MHD. The higher the HOMA IR, the more severe is the degree of sarcopenia. In addition, the relationship between insulin resistance and muscle mass was also found, but not on muscle strength and physical performance> <0.001) but not with muscle strength and physical performance (p=0,311; p=0,165). Conclusion: There is a relationship between insulin resistance and the degree of sarcopenia in elderly patients on MHD. The higher the HOMA IR, the more severe is the degree of sarcopenia. In addition, the relationship between insulin resistance and muscle mass was also found, but not on muscle strength and physical performance.