Sarcopenic-obesity and cardiovascular disease risk in the elderly

• Published in: The Journal of nutrition, health & aging Vol. 13; no. 5; pp. 460 - 466
• Main Authors: Stephen, W. C., Janssen, I.
• Format: Journal Article
• Language: English
• Published: Paris Springer-Verlag 01.05.2009; Springer; Springer Nature B.V
• Subjects: Adipose Tissue; Age Distribution; Aged; Aged, 80 and over; Aging; Biological and medical sciences; Body Composition; Cardiology. Vascular system; Cardiovascular Diseases - epidemiology; Cohort Studies; Comorbidity; Coronary heart disease; Electric Impedance; Feeding. Feeding behavior; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Geriatric Assessment - methods; Geriatric Assessment - statistics & numerical data; Geriatrics/Gerontology; Hand Strength; Heart; Humans; Longitudinal Studies; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic diseases; Muscle Weakness - epidemiology; Muscle, Skeletal; Muscular Atrophy - epidemiology; Neurosciences; Nutrition; Obesity; Obesity - epidemiology; Primary Care Medicine; Prospective Studies; Quality of Life Research; Risk Factors; Sarcopenic-Obesity and Cardiovascular Disease; United States - epidemiology; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Waist Circumference; United States; aged; Waist circumference; longitudinal study; skeletal muscle; Human; Obesity; Anthropometry; Nutrition disorder; Metabolic diseases; Cardiovascular disease; Corporal biometry; Striated muscle; Coronary heart disease; Follow up study; Risk factor; Cardiovascular risk; Waist hip ratio; Elderly; Nutritional status
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-009-0084-z

Objectives To determine: 1) whether sarcopenic-obesity is a stronger predictor of cardiovascular disease (CVD) than either sarcopenia or obesity alone in the elderly, and 2) whether muscle mass or muscular strength is a stronger marker of CVD risk. Design Prospective cohort study. Participants Participants included 3366 community-dwelling older (65 years) men and women who were free of CVD at baseline. Measurements Waist circumference (WC), bioimpedance analysis, and grip strength were used to measure abdominal obesity, whole-body muscle mass, and muscular strength, respectively. Subjects were classified as normal, sarcopenic, obese, or sarcopenic-obese based on measures of WC and either muscle mass or strength. Participants were followed for 8 years for CVD development and proportional hazard regression models were used to compare risk estimates for CVD in the four groups after adjusting for age, sex, race, income, smoking, alcohol, and cognitive status. Results Compared with the normal group, CVD risk was not significantly elevated within the obese, sarcopenic, or sarcopenic-obese groups as determined by WC and muscle mass. When determined by WC and muscle strength, CVD risk was not significantly increased in the sarcopenic or obese groups, but was increased by 23% (95% confidence interval: 0.99–1.54, P=0.06) within the sarcopenic-obese group. Conclusion Sarcopenia and obesity alone were not sufficient to increase CVD risk. Sarcopenic-obesity, based on muscle strength but not muscle mass, was modestly associated with increased CVD risk. These findings imply that strength may be more important than muscle mass for CVD protection in old age.