Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Department of Rehabilitation, Kameda Medical Center, Chiba, Japan.
BMC Geriatr. 2022 Jul 5;22(1):556. doi: 10.1186/s12877-022-03168-3.
The purpose of this study was to clarify the prevalence, association with frailty and exercise capacity, and prognostic implication of sarcopenic obesity in patients with heart failure.
The present study included 779 older adults hospitalized with heart failure (median age: 81 years; 57.4% men). Sarcopenia was diagnosed based on the guidelines by the Asian Working Group for Sarcopenia. Obesity was defined as the percentage of body fat mass (FM) obtained by bioelectrical impedance analysis. The FM cut-off points for obesity were 38% for women and 27% for men. The primary endpoint was 1-year all-cause death. We assessed the associations of sarcopenic obesity occurrence with the short physical performance battery (SPPB) score and 6-minute walk distance (6MWD).
The rates of sarcopenia and obesity were 19.3 and 26.2%, respectively. The patients were classified into the following groups: non-sarcopenia/non-obesity (58.5%), non-sarcopenia/obesity (22.2%), sarcopenia/non-obesity (15.3%), and sarcopenia/obesity (4.0%). The sarcopenia/obesity group had a lower SPPB score and shorter 6MWD, which was independent of age and sex (coefficient, - 0.120; t-value, - 3.74; P < 0.001 and coefficient, - 77.42; t-value, - 3.61; P < 0.001; respectively). Ninety-six patients died during the 1-year follow-up period. In a Cox proportional hazard analysis, sarcopenia and obesity together were an independent prognostic factor even after adjusting for a coexisting prognostic factor (non-sarcopenia/non-obesity vs. sarcopenia/obesity: hazard ratio, 2.48; 95% confidence interval, 1.22-5.04; P = 0.012).
Sarcopenic obesity is a risk factor for all-cause death and low physical function in older adults with heart failure.
University Hospital Information Network (UMIN-CTR: UMIN000023929 ).
本研究旨在阐明心力衰竭患者中肌肉减少性肥胖的患病率、与虚弱和运动能力的关系，以及对预后的影响。
本研究纳入了 779 名因心力衰竭住院的老年患者（中位年龄：81 岁；57.4%为男性）。根据亚洲肌肉减少症工作组的指南诊断肌肉减少症。肥胖定义为通过生物电阻抗分析获得的体脂肪量（FM）百分比。女性肥胖的 FM 切点为 38%，男性为 27%。主要终点为 1 年全因死亡。我们评估了肌肉减少性肥胖的发生与短体适能表现测验（SPPB）评分和 6 分钟步行距离（6MWD）之间的关系。
肌肉减少症和肥胖症的发生率分别为 19.3%和 26.2%。患者被分为以下几组：非肌肉减少/非肥胖（58.5%）、非肌肉减少/肥胖（22.2%）、肌肉减少/非肥胖（15.3%）和肌肉减少/肥胖（4.0%）。肌肉减少/肥胖组的 SPPB 评分较低，6MWD 较短，且与年龄和性别无关（系数：-0.120；t 值：-3.74；P<0.001 和系数：-77.42；t 值：-3.61；P<0.001）。96 例患者在 1 年随访期间死亡。在 Cox 比例风险分析中，即使在校正共存的预后因素后，肌肉减少症和肥胖症并存也是独立的预后因素（非肌肉减少/非肥胖与肌肉减少/肥胖：风险比，2.48；95%置信区间，1.22-5.04；P=0.012）。
肌肉减少性肥胖是老年心力衰竭患者全因死亡和低身体功能的危险因素。
大学医院信息网络（UMIN-CTR：UMIN000023929）。
