Jun Ji Eun, Choi Min Sun, Park Sung Woon, Kim Gyuri, Jin Sang-Man, Kim Kyunga, Hwang You-Cheol, Ahn Kyu Jeung, Chung Ho Yeon, Jeong In-Kyung, Kang Mira, Kim Jae Hyeon
Department of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Can J Cardiol. 2021 Sep;37(9):1480-1488. doi: 10.1016/j.cjca.2021.04.002. Epub 2021 Sep 4.
Low skeletal muscle mass (SMM) is an emerging risk factor of cardiovascular disease (CVD). We investigated the association between SMM and coronary artery calcification (CAC).
We enrolled 19,728 adults free of CVD who underwent computed tomographic estimation of Agatston CAC scores for cross-sectional analysis. Among them, 5,401 subjects who had at least 2 follow-up CAC scores were included in longitudinal analysis. Relative SMM is presented as the skeletal muscle mass index [SMI (%) = total appendicular muscle mass (kg)/body weight (kg) × 100]. CAC presence and incidence were defined as CAC score > 0, and CAC progression was defined as √CAC score (follow-up) - √CAC score (baseline) > 2.5.
Among all of the subjects (mean age 53.4 years, 80.8% male), the prevalence of CAC was 36.7%. The incidence of CAC was 17.4% during a mean of 3.6 years, and the progression of CAC was 49.9% during a mean of 2.3 years. The lowest SMI quartile was significantly associated with an increased risk of CAC presence (adjusted odds ratio 2.75, 95% confidence interval [CI] 2.45-3.05; P < 0.001), incidence (adjusted hazard ratio [AHR] 1.99, 95% CI 1.36-2.91; P < 0.001), and progression (AHR 1.48, 95% CI 1.25-1.77; P < 0.001) compared with the highest quartile. SMI as a continuous value was also significantly inversely associated with CAC. SMI was the best parameter to be related to CAC among other quantitative indices such as height or body mass index adjusted.
Low SMM is significantly associated with an elevated risk of CAC, independently of other cardiometabolic parameters.
低骨骼肌质量（SMM）是心血管疾病（CVD）新出现的一个危险因素。我们研究了SMM与冠状动脉钙化（CAC）之间的关联。
我们纳入了19728名无CVD的成年人，他们接受了计算机断层扫描以估算阿加斯顿CAC评分用于横断面分析。其中，5401名至少有2次随访CAC评分的受试者被纳入纵向分析。相对SMM以骨骼肌质量指数表示[SMI（%）=四肢肌肉总质量（kg）/体重（kg）×100]。CAC的存在和发生率定义为CAC评分>0，CAC进展定义为√CAC评分（随访）-√CAC评分（基线）>2.5。
在所有受试者（平均年龄53.4岁，80.8%为男性）中，CAC的患病率为36.7%。在平均3.6年期间，CAC的发生率为17.4%，在平均2.3年期间，CAC的进展率为49.9%。与最高四分位数相比，最低SMI四分位数与CAC存在风险增加（校正比值比2.75，95%置信区间[CI]2.45 - 3.05；P < 0.001）、发生率（校正风险比[AHR]1.99，95%CI 1.36 - 2.91；P < 0.001）和进展（AHR 1.48，95%CI 1.25 - 1.77；P < 0.001）显著相关。作为连续变量的SMI也与CAC显著负相关。在调整身高或体重指数等其他定量指标后，SMI是与CAC相关的最佳参数。
低SMM与CAC风险升高显著相关，独立于其他心脏代谢参数。
