Abstract: Objective  To explore the factors enable us to predict the diagnosis of sarcopenia, and the effects of anti-resistance exercise combined with probiotics on quality of life in the maintenance hemodialysis (MHD) patients with sarcopenia.  Methods  The MHD patients admitted to Tongzhou District People's Hospital of Nantong City from July 2023 to December 2023 were enrolled in this study. They were divided into sarcopenia group (n=44) and non-sarcopenia group (n=89) according to the diagnostic criteria of sarcopenia. The baseline data were compared between the two groups, serum myostain (MSTN) and interleukin-6 (IL-6) were measured, and the risk factors for sarcopenia were analyzed. ROC curve was used to analyze the efficacy of myostain (MSTN), interleukin-6 (IL-6) and MSTN combined with IL-6 on the diagnosis of sarcopenia. The patients in sarcopenia group were further and randomly divided into control group and experimental group. The patients in control group were treated with anti-resistance exercise, high quality protein diet, control of blood pressure, maintenance of water and electrolyte balance, and other routine methods; the patients in experimental group were treated with anti-resistance exercise and probiotics for 3 months in addition to the measures given to the control group. The quality of life during follow-up study was compared between the two groups.  Results  A total of 133 patients were included in this study. Serum MSTN (OR=1.243, 95% CI: 1.105～1.399, P＜0.001) and IL-6 (OR=1.214, 95% CI: 1.107～1.331, P＜0.001) were the risk factors for sarcopenia in MHD patients. The AUC of MSTN combined with IL-6 for the diagnosis of sarcopenia was 0.741, with the sensitivity of 65.9%, the specificity of 70.8%, and 95% CI: 0.651～0.831. After the intervention, physiological functions and mental health were better in experiment group than in control group.  Conclusion  Serum MSTN combined with IL-6 can effectively predict the presence of sarcopenia in MHD patients. Anti-resistance exercise combined with probiotics can successfully and safely improve the quality of life in MHD patients with sarcopenia.

Key words: Maintenance hemodialysis, Sarcopenia, Probiotics, Myostatin, Quality of life