Bing Shuang, Chen Zhanchao, Wu Di, Yu Bo, Qiu Hongbin, Zhang Yiying, Wang Shanjie
Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD); The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China.
Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China.
Eur J Prev Cardiol. 2025 Feb 27. doi: 10.1093/eurjpc/zwaf115.
Sarcopenia is an emerging risk factor for cardiovascular disease (CVD). However, previous studies did not take into consideration the cardiovascular impact of the changes in sarcopenia status. We investigated the relationship between changes in sarcopenia status and incident CVD.
Participants from two prospective cohorts: the China Health and Retirement Longitudinal Study (CHARLS) and the Health and Retirement Study (HRS) were included. Changes in sarcopenia status were assessed by sarcopenia status at the initial two surveys. CVD was ascertained by self-reported physician-diagnosed heart disease or stroke.
A total of 6,608 and 4,316 adults from CHARLS (mean age: 59.2 years, female: 53.6%) and HRS (mean age: 63.2 years, female: 60.2%) were analyzed, with a median follow-up of 5.0 years and 7.5 years, respectively. Meta-analysis showed a significant relationship between sarcopenia and CVD risk. Bidirectional MR analysis supported the robustness and causality, and no reverse association was found between CVD and sarcopenia. Compared with stable no sarcopenia participants, multivariable-adjusted incidence rate ratio (IRR) and 95% confidence interval (95% CI) for incident CVD in those who progressed from no sarcopenia to possible sarcopenia/sarcopenia were 1.29 (1.02-1.64) and 1.39 (1.11-1.74) in both cohorts. In contrast, sarcopenia participants who recovered to no sarcopenia/possible sarcopenia had lower incidence of CVD (CHARLS, IRR 0.61, 95% CI 0.43-0.87; HRS, IRR 0.20, 95% CI 0.11-0.39) than stable sarcopenia participants did.
The progression of sarcopenia status increases the risk of CVD, while the recovery of sarcopenia status reduces the risk of incident CVD.
肌肉减少症是心血管疾病（CVD）新出现的一个风险因素。然而，既往研究未考虑肌肉减少症状态变化对心血管的影响。我们调查了肌肉减少症状态变化与CVD发病之间的关系。
纳入了来自两个前瞻性队列的参与者：中国健康与养老追踪调查（CHARLS）和健康与退休研究（HRS）。通过最初两次调查时的肌肉减少症状态评估肌肉减少症状态的变化。CVD通过自我报告的医生诊断的心脏病或中风来确定。
对CHARLS（平均年龄：59.2岁，女性：53.6%）的6608名成年人和HRS（平均年龄：63.2岁，女性：60.2%）的4316名成年人进行了分析，中位随访时间分别为5.0年和7.5年。荟萃分析显示肌肉减少症与CVD风险之间存在显著关系。双向孟德尔随机化分析支持这种关系的稳健性和因果性，未发现CVD与肌肉减少症之间存在反向关联。与稳定的非肌肉减少症参与者相比，在两个队列中，从无肌肉减少症进展为可能的肌肉减少症/肌肉减少症的参与者发生CVD的多变量调整发病率比（IRR）和95%置信区间（CI）分别为1.29（1.02 - 1.64）和1.39（1.11 - 1.74）。相比之下，恢复为无肌肉减少症/可能的肌肉减少症的肌肉减少症参与者发生CVD的发生率（CHARLS，IRR 0.61，95% CI 0.43 - 0.87；HRS，IRR 0.20，95% CI 0.11 - 0.39）低于稳定的肌肉减少症参与者。
肌肉减少症状态的进展会增加CVD风险，而肌肉减少症状态的恢复会降低CVD发病风险。
