The Relationship Between Sarcopenia And Cardiovascular Disease In Elderly

Objective:The aim of the study was 1)to examine the association between sarcopenia and its components(muscle mass,grip strength and walking speed)and cardiovascular disease(CVD)or the three major risk factors for CVD risk factors(diabetes,hypertension and hyperlipidemia)in the cross-sectional study;2)to investigate the association between sarcopenia and its components and the risk of CVD or CVD risk factors in the cohort study;3)to determine whether sarcopenia and its components are modifiable predictors of CVD mortality during a five year follow-up or not.Methods:1)In the cross-sectional study,a total of 1014 older individuals(aged ≥ 60y)were recruited from Chadian,Tianjin from 2013 to 2015.All subjects were invited to participate in objective examinations and questionnaire survey.Objective examinations included routine physical measurements,body composition,grip strength,walking speed,and blood biochemical indicator detection.Questionnaires collected information included general population information,sociodemographic variables(marital status,living status,education level,occupation),lifestyle characteristics(smoking,drinking,daily activity levels,nutritional status),as well as past medical and medication history.Logistic regression model was used to analyze the association between sarcopenia and its components and CVD or CVD risk factors.2)In the cohort study,we collected the relative information again from 2014 to 2016.Logistic regression model was used to further investigate the association of sarcopenia and its components with the risk of CVD or CVD risk factors.3)All subjects in our cross-sectional study were prospectively followed up from 2003 to 2008.The relationship between sarcopenia and its components with CVD mortality was analyzed through the Kaplan–Meier analyses and multivariate Cox proportional hazard models.Results:1)First,in the cross-sectional study,there exsist correlation between CVD and sarcopenia.A linear increase in the prevalence of CVD was found to be associated with the severity of sarcopenia,and a linear increase in the prevalence of sarcopenia also was found to be associated with the number of CVD risk factors(P values for the trends < 0.05).Second,in the association analysis of the sarcopnia components with CVD,we found that muscle mass(OR = 2.64,95% CI = 1.49-4.68)were associated with prevalence of CVD in male;muscle mass(OR = 2.38,95% CI = 1.42-3.97),grip strength(OR = 1.82,95% CI = 1.20-2.77),while walking speed(OR = 1.77,95% CI = 1.03-3.02)was associated with prevalence of CVD in female.Third,in the association analysis between CVD risk factors(diabetes,hypertension,hyperlipidemia)and sarcopenia,we found diabetes(OR = 4.65,95% CI = 1.34-16.06)and high Blood pressure(OR = 3.41,95% CI = 1.14-10.13)were independent factors of sarcopenia in male;diabetes(OR = 5.73,95% CI = 1.03-3.02),hypertension(OR= 3.22,95% CI = 1.22-8.48)and hyperlipidemia(OR = 3.05,95% CI = 1.17-7.93)were independent factors of sarcopenia in female.Finally,in the analysis of CVD risk factors and the three components of sarcopnia,we found CVD risk factors(OR = 1.85,95% CI = 1.05-3.57,diabetes(OR = 2.81,95% CI = 1.10-7.15)and hypertension(OR =2.63,95% CI =1.38-5.01)was associated with the prevalence of low muscle mass in male,diabetes(OR = 3.62,95% CI =1.34-9.75)associated with the prevalence of low grip strength,and hypertension(OR = 2.15,95% CI = 1.12-4.98)was associated with prevalence of low walking speed;only CVD risk factors(OR = 2.75,95% CI = 1.20-6.30)were associated with the prevalence of muscle mass in the female.2)In the cohort study,in the risk relationship between sarcopenia and incidence of CVD and CVD risk factors,we found that sarcopenia is a risk factor for CVD(HR = 2.21,95% CI = 1.91),and was associated with increased risk of stroke(HR = 2.98,95% CI = 1.03-8.87)and coronary heart disease(HR = 2.22,95% CI = 1.02-4.84).In addition,in the relationship between sarcopenia and incident CVD risk factors(diabetes,hypertension and hyperlipidemia),the risk of developing CVD risk factors in sarcopniea group was 4.4 times higher than that in the nonsarcopenia group;sarcopenia was an independent risk factor of diabetes(HR= 5.27,95% CI = 1.81-15.34)and hypertension(HR = 2.71,95% CI = 1.23-5.97).Then,in the study of the relationship between the components of sarcopenia and incidence of CVD and CVD risk factors,we found that the muscle mass was associated with the incidence of CVD(HR = 1.89,95% CI = 1.94-4.81),coronary heart disease(HR = 2.23,95% CI = 1.12-4.42),CVD risk factors(HR = 2.39,95% CI = 1.06-5.40),and hypertension(HR = 2.08,95% CI = 1.16-3.72).3)After an 5 years follow-up,the study found that sarcopenia(male: HR = 5.83,95% CI = 1.98-17.22;female: HR = 3.94,95% CI = 1.21-12.78),muscle mass(male: HR = 3.80,95% CI = 1.97-8.06;female: HR = 3.51,95% CI = 1.13-10.93),grip strength(male: HR = 7.97,95% CI = 2.34-27.19;female: HR = 4.09,95% CI = 1.28-13.07),and walking speed(male: HR = 5.63,95% CI = 2.03-15.65;female: HR = 3.93,95% CI = 1.36-13.34)were associated with increased risk of CVD morality.Conclusions:Our study suggests that,sarcopenia is significantly associated with the prevalence and incidence CVD among the Chinese elderly.In regard to relationship between sarcopenia and CVD,the early prevention and treatment of sarcopnia may prevent and delay the occurrence and development of diabetes,hypertension and CVD disease.Maintaining and increasing muscle mass through nutrition and exercise therapy will play an important role in the intervention management of diabetes,hypertension and CVD disease.In addition,sarcopenia treatment by increasing muscle mass,muscle strength,and walking ability is benifical for protect against CVD death in the elderly.