Wei Yupeng, Hu Xiaopeng
University of Pittsburgh, United States.
Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China.
Am J Prev Cardiol. 2025 Jul 18;23:101060. doi: 10.1016/j.ajpc.2025.101060. eCollection 2025 Sep.
Substantial evidence has demonstrated the correlation between sarcopenia and cardiovascular disease (CVD). However, it remains uncertain whether this correlation exists in individuals with cardiovascular-kidney-metabolic (CKM) syndrome.
This study used data from the China Health and Retirement Longitudinal Study (CHARLS). Sarcopenia state was determined according to the Asian Working Group for Sarcopenia 2019 criteria. Muscle mass was estimated by the height-adjusted muscle mass. Cox proportional hazard models were employed to calculate the hazard ratio (HR) and 95 % confidence interval (95 % CI.
A total of 7428 participants (mean age: 59.0 years; male: 47.6 %) were included in this study. Of these, non-sarcopenia, possible sarcopenia, and sarcopenia individuals were 4398 (59.2 %), 2162 (29.1 %), and 869 (11.7 %), respectively. During a median follow-up of 9.0 years, participants with possible sarcopenia (HR: 1.32, 95 % CI: 1.19-1.47) and sarcopenia (HR: 1.45, 95 % CI: 1.23-1.72) exhibited an increased risk of incident CVD compared to those with non-sarcopenia. Higher quintiles of muscle mass presented significantly increased risks of incident CVD than those with the lowest quintile (quintile 2: HR 1.34, 95 % CI 1.15-1.56; quintile 3: HR 1.41, 95 % CI 1.19-1.67; quintile 4: HR 1.71, 95 % CI 1.40-2.09; quintile 5: HR 2.20, 95 % CI 1.75-2.77). The dose-response curve indicated a positive linear association between muscle mass and incident CVD (P for overall <0.001, P for nonlinear = 0.795).
Both possible sarcopenia and sarcopenia were associated with an increased risk of incident CVD among individuals with CKM syndrome stages 0-3.
大量证据表明肌肉减少症与心血管疾病（CVD）之间存在关联。然而，这种关联在患有心血管 - 肾脏 - 代谢（CKM）综合征的个体中是否存在仍不确定。
本研究使用了中国健康与养老追踪调查（CHARLS）的数据。根据2019年亚洲肌肉减少症工作组标准确定肌肉减少症状态。通过身高调整后的肌肉量估算肌肉质量。采用Cox比例风险模型计算风险比（HR）和95%置信区间（95%CI）。
结果：本研究共纳入7428名参与者（平均年龄：59.0岁；男性：47.6%）。其中，非肌肉减少症、可能肌肉减少症和肌肉减少症个体分别为4398名（59.2%）、2162名（29.1%）和869名（11.7%）。在中位随访9.0年期间，与非肌肉减少症参与者相比，可能肌肉减少症（HR：1.32，95%CI：1.19 - 1.47）和肌肉减少症（HR：1.45，95%CI：1.23 - 1.72）参与者发生CVD的风险增加。肌肉质量较高的五分位数组发生CVD的风险显著高于最低五分位数组（五分位数2：HR 1.34，95%CI 1.15 - 1.56；五分位数3：HR 1.41，95%CI 1.19 - 1.67；五分位数4：HR 1.71，95%CI 1.40 - 2.09；五分位数5：HR 2.20，95%CI 1.75 - 2.77）。剂量反应曲线表明肌肉质量与发生CVD之间存在正线性关联（总体P<0.001，非线性P = 0.795）。
在0 - 3期CKM综合征个体中，可能肌肉减少症和肌肉减少症均与发生CVD的风险增加相关。
