Sarcopenia, sarcopenic obesity and mortality in older adults: results from the National Health and Nutrition Examination Survey III

Batsis, John A.; MacKenzie, Todd A.; Barre, Laura; López-Jiménez, Francisco; Bartels, Stephen J.

doi:10.1038/ejcn.2014.117

Cited by 384 publications

(284 citation statements)

References 44 publications

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“…Likewise, sarcopenia, defined as a loss of muscle mass and associated with frailty and overall decreased functionality and increased mortality, could have harmful effects in patients with CAD, as our results suggest 23, 24, 25…”

Section: Discussionmentioning

confidence: 61%

Association Between Adiposity and Lean Mass With Long‐Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox

Medina‐Inojosa

Somers

Thomas

et al. 2018

JAHA

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BackgroundPrognosis based on body fat percentage (BF%) in patients with coronary artery disease has not been extensively studied. We tested the hypothesis that patients with coronary artery disease and increased BF% have a higher risk for major adverse cardiovascular events (MACEs) and that fat‐free mass is associated with better prognosis.Methods and ResultsWe included 717 patients referred to cardiac rehabilitation after coronary artery disease events or procedures who underwent air displacement plethysmography to assess BF%; 75% were men, with a mean age 61.4±11.4 years and a mean body mass index of 30±5.4 kg/m2. Follow‐up was performed using a record linkage system. Patients were classified in sex‐specific quartiles of BF% and fat‐free mass index. The composite outcome of MACEs included acute coronary syndromes, coronary revascularization, stroke, or death from any cause. After a median follow‐up of 3.9 years, 201 patients had a MACE. After adjusting for covariates, body mass index was not associated with MACEs (P=0.12). However, the risk of MACEs for those in the highest BF% quartile was nearly double when compared with those in the lowest quartile (hazard ratio, 1.89; 95% confidence interval, 1.30–2.77; P=0.0008). In contrast, fat‐free mass was inversely associated with MACEs. The risk of MACEs for those in the fourth fat‐free mass quartile was lower (adjusted hazard ratio, 0.53; 95% confidence interval, 0.35–0.82; P=0.004), when compared with those in the first quartile.ConclusionsIn patients with coronary artery disease, there is no obesity paradox when measuring BF% instead of body mass index. BF% is associated with a higher risk of MACEs, whereas fat‐free mass is associated with a lower risk of MACEs. Body mass index was not associated with MACEs.

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Section: Discussionmentioning

confidence: 61%

Association Between Adiposity and Lean Mass With Long‐Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox

Medina‐Inojosa

Somers

Thomas

et al. 2018

JAHA

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“…Typically, people with sarcopenic obesity have visceral fat accumulation [58], a well-known risk factor for cardiovascular mortality [46]. The prevalence of sarcopenic obesity has been reported to be higher in type 2 diabetes compared with non-diabetes (15.7% vs 6.9% respectively in the Korean Sarcopenic Obesity Study) [59] and it has also been linked to an increased risk of falls [59], physical disability [60] and cardiovascular and all-cause mortality [61][62][63][64]. Another possible explanation could be reverse causation.…”

Section: Discussionmentioning

confidence: 99%

Nonlinear association of BMI with all-cause and cardiovascular mortality in type 2 diabetes mellitus: a systematic review and meta-analysis of 414,587 participants in prospective studies

et al. 2016

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Aims/hypothesis The relationship between BMI and mortality has been extensively investigated in the general population; however, it is less clear in people with type 2 diabetes. We aimed to assess the association of BMI with all-cause and cardiovascular mortality in individuals with type 2 diabetes mellitus. Methods We searched electronic databases up to 1 March 2016 for prospective studies reporting associations for three or more BMI groups with all-cause and cardiovascular mortality in individuals with type 2 diabetes mellitus. Study-specific associations between BMI and the most-adjusted RR were estimated using restricted cubic splines and a generalised least squares method before pooling study estimates with a multivariate random-effects meta-analysis. Results We included 21 studies including 24 cohorts, 414,587 participants, 61,889 all-cause and 4470 cardiovascular incident deaths; follow-up ranged from 2.7 to 15.9 years. There was a strong nonlinear relationship between BMI and all-cause mortality in both men and women, with the lowest estimated risk from 31-35 kg/m 2 and 28-31 kg/m 2 (p value for nonlinearity <0.001) respectively. The risk of mortality at higher BMI values increased significantly only in women, whilst lower values were associated with higher mortality in both sexes. Limited data for cardiovascular mortality were available, with a possible inverse linear association with BMI (higher risk for BMI <27 kg/m 2 ). Conclusions/interpretation In type 2 diabetes, BMI is nonlinearly associated with all-cause mortality with lowest risk in the overweight group in both men and women. Further research is needed to clarify the relationship with cardiovascular mortality and assess causality and sex differences.

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“…Several studies had suggested differential sexspecific rate of absolute muscle loss, being greater in men than in women, which could not be attributed merely to the larger initial muscle mass in men (Payette et al 2003). The need for improved insights into potential differential sex-specific mechanisms driving sarcopenia is further heightened by the recently observed higher mortality risk conferred by sarcopenia in older women despite its lower prevalence compared to their male counterparts (Batsis et al 2014). Indeed, data from the Framingham Heart Study had suggested that longitudinal decline in fat-free mass was consequent to a withdrawal of anabolic stimuli in men but reflecting an increase in catabolic stimuli represented by interleukin-6 (IL-6) in women (Payette et al 2003).…”

Section: Introductionmentioning

confidence: 99%

Sex-specific differences in risk factors for sarcopenia amongst community-dwelling older adults

Tay

Ding

Leung

et al. 2015

AGE

124

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With considerable variation including potential sex-specific differential rate of skeletal muscle loss, identifying modifiable factors for sarcopenia will be pivotal to guide targeted interventions. This study seeks to identify clinical and biological correlates of sarcopenia in community-dwelling older adults, with emphasis on the role of anabolic and catabolic stimuli, and special reference to gender specificity. In this crosssectional study involving 200 community-dwelling and functionally independent older adults aged ≥50 years, sarcopenia was defined using the Asian Working Group for Sarcopenia criteria. Comorbidities, cognitive and functional performance, physical activity and nutritional status were routinely assessed. Biochemical parameters included haematological indices, lipid panel, vitamin D level, anabolic hormones [insulin-like growth factor-1 (IGF-1), free testosterone (males only)] and catabolic markers [inflammatory markers (interleukin-6, Creactive protein) and myostatin]. Multiple logistic regression was performed to identify independent predictors for sarcopenia. Age was associated with sarcopenia in both genders. Malnutrition conferred significantly higher odds for sarcopenia in women (OR=5.71, 95 % CI 1.13-28.84.44, p=0.035) while higher but acceptable range serum triglyceride was protective in men (OR=0.05, 95 % CI 0.00-0.52, p=0.012). Higher serum myostatin independently associated with higher odds for sarcopenia in men (OR=1.11, 95 % CI 1.00-1.24, p=0.041). Serum IGF-1 was significantly lower amongst female sarcopenic subjects, with demonstrable trend for protective effect against sarcopenia in multiple regression models, such that each 1 ng/ml increase in IGF-1 was associated with 1 % decline in odds of sarcopenia in women (p=0.095). Our findings support differential pathophysiological mechanisms for sarcopenia that, if corroborated, may have clinical utility in guiding sex-specific targeted interventions for community-dwelling older adults.

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Sarcopenia, sarcopenic obesity and mortality in older adults: results from the National Health and Nutrition Examination Survey III

Abstract: Older women with sarcopenia have an increased all-cause mortality risk independent of obesity.

Cited by 384 publications

References 44 publications

Association Between Adiposity and Lean Mass With Long‐Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox

Association Between Adiposity and Lean Mass With Long‐Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox

Nonlinear association of BMI with all-cause and cardiovascular mortality in type 2 diabetes mellitus: a systematic review and meta-analysis of 414,587 participants in prospective studies

Sex-specific differences in risk factors for sarcopenia amongst community-dwelling older adults

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