Chen Xin, Zhu Mingyu, Cao Jie, Zuo Didi, Chen Zengai, Weng Yurong, Jiang Hua, Hu Yaomin
Department of Geriatrics, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of General Practice, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
Front Nutr. 2024 Sep 2;11:1431036. doi: 10.3389/fnut.2024.1431036. eCollection 2024.
While sarcopenia has been found to be associated with increased risks of cardiovascular diseases (CVDs), evidence exploring sex-related differences remains insufficient. This study aimed to investigate the differences in how often sarcopenia occurs in each sex, as determined by skeletal muscle area (SMA) in chest CT images, and its association with CVD common risk factors.
This cross-sectional study involved 1,340 inpatients from the Department of Geriatrics of Renji Hospital, affiliated to Shanghai Jiaotong University School of Medicine. Data on age, sex, body mass index (BMI), smoking status, disease history, and clinical parameters were collected. Sarcopenia was defined using chest CT images with a cut-off value of T12-SMA/height <25.75 cm/m in male patients and <20.16 cm/m in female patients. Cardiovascular risk was assessed using the Framingham risk score (FRS). The association between T12-SMA/height-defined sarcopenia and CVD risk factors by sex was evaluated using a multivariate logistic regression analysis.
The overall prevalence of T12-SMA/height-defined sarcopenia (<25.75 cm/m for male patients, <20.16 cm/m for female patients) was 54.03%, with 48.09% in male patients and 63.19% in female patients. The proportion of male patients with high CVD risk was greater than that of female patients. The multivariate analysis revealed that T12-SMA/height-defined sarcopenia was independently associated with age (in male patients only), systolic blood pressure (SBP), cholesterol, and high-density lipoprotein cholesterol (HDL-C) among the six FRS cardiovascular risk indices.
Our results suggest that T12-SMA/height-defined sarcopenia was more prevalent in male patients than in female patients. Sarcopenia was associated with higher levels of SBP and HDL-C and lower levels of cholesterol. Increasing age had a more significant effect on CVD risk in male patients.
虽然已发现肌肉减少症与心血管疾病（CVD）风险增加有关，但探索性别差异的证据仍然不足。本研究旨在调查根据胸部CT图像中的骨骼肌面积（SMA）确定的肌肉减少症在男女中发生频率的差异，及其与CVD常见危险因素的关联。
这项横断面研究纳入了上海交通大学医学院附属仁济医院老年科的1340名住院患者。收集了年龄、性别、体重指数（BMI）、吸烟状况、病史和临床参数等数据。使用胸部CT图像定义肌肉减少症，男性患者的截断值为T12-SMA/身高<25.75 cm/m，女性患者为<20.16 cm/m。使用弗雷明汉风险评分（FRS）评估心血管风险。采用多因素逻辑回归分析评估按性别划分的T12-SMA/身高定义的肌肉减少症与CVD危险因素之间的关联。
T12-SMA/身高定义的肌肉减少症（男性患者<25.75 cm/m，女性患者<20.16 cm/m）的总体患病率为54.03%，男性患者为48.09%，女性患者为63.19%。具有高CVD风险的男性患者比例高于女性患者。多因素分析显示，在六个FRS心血管风险指标中，T12-SMA/身高定义的肌肉减少症仅与男性患者的年龄、收缩压（SBP）、胆固醇和高密度脂蛋白胆固醇（HDL-C）独立相关。
我们的结果表明，T12-SMA/身高定义的肌肉减少症在男性患者中比在女性患者中更普遍。肌肉减少症与较高的SBP和HDL-C水平以及较低的胆固醇水平相关。年龄增加对男性患者的CVD风险影响更大。
