Chung Goh Eun, Park Hyo Eun, Lee Heesun, Kim Min Joo, Choi Su-Yeon, Yim Jeong Yoon, Yoon Ji Won
Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea.
Front Med (Lausanne). 2021 Mar 29;8:651961. doi: 10.3389/fmed.2021.651961. eCollection 2021.
An association between sarcopenic obesity and cardiovascular disease has been suggested. We investigated the relationship between sarcopenia and coronary atherosclerosis, taking into account the presence or absence of obesity in a health check-up population. Data were reviewed for subjects who underwent bioelectrical impedance analysis (BIA) and coronary calcium scoring (CAC) computed tomography between January 2017 and December 2018. Appendicular skeletal muscle mass (ASM) was assessed using BIA. Sarcopenia was defined as reduction of muscle mass and calculated as ASM% (ASM/body weight) more than two standard deviations below the sex-specific mean for healthy young adults. CAC scores were dichotomized as low (<100) or high (≥100). Among 1,282 subjects (mean age, 58.1 years; 75.5% male), the prevalence of high CAC was 21%. When the study population was divided into four groups according to their obesity and sarcopenia status, the prevalence of high CAC in the sarcopenic-obesity (SO) group was significantly higher than in the other groups (40.7%, < 0.001). After adjusting for age, sex, hypertension, diabetes, dyslipidemia, and creatinine, subjects with SO exhibited a significantly higher odds of a high CAC score, compared with the non-sarcopenic, non-obese group (odds ratio, 1.92; 95% confidence interval, 1.16-3.18, = 0.011). SO was significantly associated with CAC, independent of known risk factors for coronary artery disease. These findings suggest that sarcopenia and obesity may potentiate each other to increase atherosclerotic burden in coronary arteries, which may eventually lead to adverse cardiovascular events.
已有研究表明肌肉减少性肥胖与心血管疾病之间存在关联。我们在一个健康体检人群中，考虑了肥胖的存在与否，研究了肌肉减少症与冠状动脉粥样硬化之间的关系。回顾了2017年1月至2018年12月期间接受生物电阻抗分析（BIA）和冠状动脉钙化评分（CAC）计算机断层扫描的受试者的数据。使用BIA评估四肢骨骼肌质量（ASM）。肌肉减少症定义为肌肉质量减少，计算方法为ASM%（ASM/体重）比健康年轻成年人的性别特异性平均值低两个标准差以上。CAC评分分为低（<100）或高（≥100）。在1282名受试者（平均年龄58.1岁；75.5%为男性）中，高CAC的患病率为21%。当根据肥胖和肌肉减少症状态将研究人群分为四组时，肌肉减少性肥胖（SO）组中高CAC的患病率显著高于其他组（40.7%，<0.001）。在调整年龄、性别、高血压、糖尿病、血脂异常和肌酐后，与非肌肉减少、非肥胖组相比，SO受试者的高CAC评分几率显著更高（优势比，1.92；95%置信区间，1.16 - 3.18，P = 0.011）。SO与CAC显著相关，独立于已知的冠状动脉疾病危险因素。这些发现表明，肌肉减少症和肥胖可能相互作用，增加冠状动脉的动脉粥样硬化负担，最终可能导致不良心血管事件。
