Campos Alessandra M, Moura Filipe A, Santos Simone N, Freitas Wladimir M, Sposito Andrei C
Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil; Pharmaceutical Sciences Department, Faculty of Health Sciences, University of Brasilia (UnB), Brasília, DF, Brazil.
Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil.
Atherosclerosis. 2017 Mar;258:138-144. doi: 10.1016/j.atherosclerosis.2017.01.005. Epub 2017 Jan 18.
Excess weight is a widespread condition related to increased risk of coronary heart disease (CHD). Sarcopenia is a catabolic pathway common of the aging process and also associated with CHD. In the elderly, both changes occur concurrently and it remains unclear the relative contribution on CHD risk. We aimed to investigate whether sarcopenia, excess weight, or both are associated with subclinical atherosclerosis and/or endothelial dysfunction in very elderly individuals.
We performed a cross-sectional study of cohort enrolled individuals, aged 80 years or older (n = 208), who had never manifested cardiovascular diseases. Blood tests, medical and nutritional evaluations, cardiac computed tomography, flow-mediated dilation (FMD) and physical performance tests were obtained at the study admission. Odds ratio (OR) was calculated by multivariate regression models using coronary calcium score (CCS) categories and FMD as dependent variables. Adjustment for potential confounders was done.
Muscle mass, but not fatty mass, was inversely associated with CCS categories [OR:2.54(1.06-6.06); p = 0.018]. The lowering of gait speed was negatively related to CCS>100 [OR:2.36 (1.10-5.06); p = 0.028] and skeletal muscle index was directly associated with FMD [OR:5.44 (1.22-24.24); p = 0.026]. Total caloric intake was positively related to fatty mass [OR:2.71 (1.09-6.72); p = 0.031], but was not related to CCS.
This study reveals that sarcopenia - comprised by reduction of muscle mass and its strength - is associated with subclinical atherosclerosis and endothelial dysfunction. Surprisingly, the excess of fatty mass seems not to be related to atherosclerotic burden in very elderly individuals.
超重是一种普遍存在的状况，与冠心病（CHD）风险增加相关。肌肉减少症是衰老过程中常见的分解代谢途径，也与冠心病有关。在老年人中，这两种变化同时发生，目前尚不清楚它们对冠心病风险的相对影响。我们旨在研究肌肉减少症、超重或两者是否与高龄个体的亚临床动脉粥样硬化和/或内皮功能障碍有关。
我们对208名年龄在80岁及以上、从未患过心血管疾病的队列入选个体进行了横断面研究。在研究入组时进行了血液检测、医学和营养评估、心脏计算机断层扫描、血流介导的血管舒张（FMD）和身体机能测试。使用冠状动脉钙化评分（CCS）类别和FMD作为因变量，通过多变量回归模型计算比值比（OR）。对潜在混杂因素进行了调整。
肌肉量而非脂肪量与CCS类别呈负相关[OR：2.54（1.06 - 6.06）；p = 0.018]。步速降低与CCS>100呈负相关[OR：2.36（1.10 - 5.06）；p = 0.028]，骨骼肌指数与FMD呈正相关[OR：5.44（1.22 - 24.24）；p = 0.
