Zeng Qingyue, Zhao Lijun, Zhong Qian, An Zhenmei, Li Shuangqing
General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
BMC Med. 2024 Dec 31;22(1):607. doi: 10.1186/s12916-024-03841-x.
Previous studies have identified sarcopenia as a significant risk factor for cardiovascular disease (CVD). However, these studies primarily focused on sarcopenia status at baseline, without considering changes in sarcopenia status during follow-up. The aim of this study is to investigate the association between changes in sarcopenia status and the incidence of new-onset cardiovascular disease.
This study utilized prospective cohort data from the China Health and Retirement Longitudinal Study (CHARLS). Sarcopenia status was assessed using the 2019 Asian Working Group for Sarcopenia (AWGS) algorithm and categorized as non-sarcopenia, possible sarcopenia, or sarcopenia. Changes in sarcopenia status were evaluated based on assessments at baseline and at the second follow-up survey 2 years later. CVD was identified through self-reported physician diagnoses of heart disease, including angina, myocardial infarction, congestive heart failure, and other heart problems, or stroke. Cox proportional hazards models were employed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounding factors.
Based on the inclusion and exclusion criteria, a total of 7499 CHARLS participants were included in the analysis, with 50.8% being female and an average age of 58.5 years. Compared to participants with stable non-sarcopenia status, those who progressed from non-sarcopenia to possible sarcopenia or sarcopenia exhibited a significantly increased risk of new-onset CVD (HR 1.30, 95% CI 1.06-1.59). Conversely, participants who recovered from sarcopenia to non-sarcopenia or possible sarcopenia had a significantly reduced risk of new-onset CVD compared to those with stable sarcopenia status (HR 0.61, 95% CI 0.37-0.99). Among participants with baseline possible sarcopenia, those who recovered to non-sarcopenia had a significantly lower risk of new-onset CVD compared to those with stable possible sarcopenia status (HR 0.67, 95% CI 0.52-0.86).
Changes in sarcopenia status are associated with varying risks of new-onset CVD. Progression in sarcopenia status increases the risk, while recovery from sarcopenia reduces the risk of developing cardiovascular disease.
既往研究已将肌肉减少症确定为心血管疾病（CVD）的一个重要危险因素。然而，这些研究主要关注基线时的肌肉减少症状态，未考虑随访期间肌肉减少症状态的变化。本研究的目的是调查肌肉减少症状态的变化与新发心血管疾病发病率之间的关联。
本研究利用了中国健康与养老追踪调查（CHARLS）的前瞻性队列数据。采用2019年亚洲肌肉减少症工作组（AWGS）算法评估肌肉减少症状态，并将其分为非肌肉减少症、可能的肌肉减少症或肌肉减少症。根据基线评估和2年后第二次随访调查的评估结果来评估肌肉减少症状态的变化。通过自我报告的医生诊断的心脏病（包括心绞痛、心肌梗死、充血性心力衰竭和其他心脏问题）或中风来确定CVD。采用Cox比例风险模型计算风险比（HRs）和95%置信区间（CIs），并对潜在混杂因素进行调整。
根据纳入和排除标准，共有7499名CHARLS参与者纳入分析，其中50.8%为女性，平均年龄为58.5岁。与非肌肉减少症状态稳定的参与者相比，从非肌肉减少症进展为可能的肌肉减少症或肌肉减少症的参与者新发CVD的风险显著增加（HR 1.30，95% CI 1.06 - 1.59）。相反，与肌肉减少症状态稳定的参与者相比，从肌肉减少症恢复为非肌肉减少症或可能的肌肉减少症的参与者新发CVD的风险显著降低（HR 0.61，95% CI 0.37 - 0.99）。在基线时可能患有肌肉减少症的参与者中，恢复为非肌肉减少症的参与者新发CVD的风险显著低于可能的肌肉减少症状态稳定的参与者（HR 0.67，95% CI 0.52 - 0.86）。
肌肉减少症状态的变化与新发CVD的不同风险相关。肌肉减少症状态的进展会增加风险，而从肌肉减少症恢复则会降低患心血管疾病的风险。
