Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Respir Res. 2022 Jul 13;23(1):185. doi: 10.1186/s12931-022-02109-3.
Sarcopenia is a well-established risk factor for atherosclerotic cardiovascular disease (ASCVD), but its relationship with chronic obstructive pulmonary disease (COPD) has not been fully determined. This study is aimed to investigate the association between sarcopenia and risk for ASCVD in patients with COPD, independent of central obesity and fat mass.
Data regarding 704 men with COPD (mean age: 63.4 years) were extracted from the 2008 to 2011 Korean National Health and Nutrition Examination Surveys. Sarcopenia index and fat mass were assessed using dual-energy X-ray absorptiometry. Sarcopenia was defined according to the presence of sarcopenia index values < 1 standard deviation from the cutoff (0.774) among the study participants. ASCVD risk was evaluated using American College of Cardiology/American Heart Association guidelines. High probability of ASCVD was defined as ASCVD risk > 20%.
The quartile-stratified sarcopenia index was negatively associated with ASCVD risk (P < 0.001). ASCVD risk and prevalence of high ASCVD risk were significantly greater in sarcopenic participants than in non-sarcopenic participants, regardless of central obesity and fat mass (all P < 0.001). Multivariate regression analyses demonstrated an independent association between sarcopenia and ASCVD risk (estimated ± standard error = 3.63 ± 0.77%, P < 0.001) and high ASCVD risk (odds ratio [OR] = 2.32, 95% confidence interval [CI] 1.05-5.15, P = 0.039). Furthermore, sarcopenia was an independent factor for high ASCVD risk in participants with moderate to very severe airflow limitation (OR = 2.97, 95% CI 1.06-8.36, P < 0.001).
Sarcopenia was significantly associated with an increased risk for ASCVD in men with COPD, independent of central obesity and fat mass. High ASCVD risk was significantly associated with sarcopenia, particularly in participants with moderate to very severe airflow limitation.
肌少症是动脉粥样硬化性心血管疾病（ASCVD）的一个既定危险因素，但它与慢性阻塞性肺疾病（COPD）的关系尚未完全确定。本研究旨在探讨 COPD 患者中肌少症与 ASCVD 风险的关系，这种关系独立于中心性肥胖和脂肪量。
从 2008 年至 2011 年韩国国家健康和营养检查调查中提取了 704 名男性 COPD 患者的数据（平均年龄：63.4 岁）。使用双能 X 射线吸收法评估肌少症指数和脂肪量。根据研究参与者中肌少症指数值低于截距（0.774）的标准偏差（1 个标准差）<1，定义肌少症。使用美国心脏病学会/美国心脏协会指南评估 ASCVD 风险。高 ASCVD 风险定义为 ASCVD 风险>20%。
按四分位分层的肌少症指数与 ASCVD 风险呈负相关（P<0.001）。无论中心性肥胖和脂肪量如何，肌少症患者的 ASCVD 风险和高 ASCVD 风险的患病率均明显高于非肌少症患者（均 P<0.001）。多变量回归分析表明，肌少症与 ASCVD 风险（估计值±标准误差=3.63±0.77%，P<0.001）和高 ASCVD 风险（比值比[OR] = 2.32，95%置信区间[CI] 1.05-5.15，P=0.039）独立相关。此外，在中至重度气流受限的参与者中，肌少症是高 ASCVD 风险的独立因素（OR=2.97，95%CI 1.06-8.36，P<0.001）。
肌少症与 COPD 男性 ASCVD 风险增加显著相关，这种相关性独立于中心性肥胖和脂肪量。高 ASCVD 风险与肌少症显著相关，尤其是在中至重度气流受限的患者中。
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