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Comparative Study
. 2014 Feb;62(2):253-60.
doi: 10.1111/jgs.12652. Epub 2014 Jan 15.

Sarcopenic obesity and risk of cardiovascular disease and mortality: a population-based cohort study of older men

Janice L Atkins  1 , Peter H Whincup, Richard W Morris, Lucy T Lennon, Olia Papacosta, S Goya Wannamethee
Affiliations
Comparative Study

Sarcopenic obesity and risk of cardiovascular disease and mortality: a population-based cohort study of older men

Janice L Atkins et al. J Am Geriatr Soc. 2014 Feb.

Abstract

Objectives: To examine associations between sarcopenia, obesity, and sarcopenic obesity and risk of cardiovascular disease (CVD) and all-cause mortality in older men.

Design: Prospective cohort study.

Setting: British Regional Heart Study.

Participants: Men aged 60-79 years (n = 4,252).

Measurements: Baseline waist circumference (WC) and midarm muscle circumference (MAMC) measurements were used to classify participants into four groups: sarcopenic, obese, sarcopenic obese, or optimal WC and MAMC. The cohort was followed for a mean of 11.3 years for CVD and all-cause mortality. Cox regression analyses assessed associations between sarcopenic obesity groups and all-cause mortality, CVD mortality, CVD events, and coronary heart disease (CHD) events.

Results: There were 1,314 deaths, 518 CVD deaths, 852 CVD events, and 458 CHD events during follow-up. All-cause mortality risk was significantly greater in sarcopenic (HR = 1.41, 95% CI = 1.22-1.63) and obese (HR = 1.21, 95% CI = 1.03-1.42) men than in the optimal reference group, with the highest risk in sarcopenic obese (HR = 1.72, 95% CI = 1.35-2.18), after adjustment for lifestyle characteristics. Risk of CVD mortality was significantly greater in sarcopenic and obese but not sarcopenic obese men. No association was seen between sarcopenic obesity groups and CHD or CVD events.

Conclusion: Sarcopenia and central adiposity were associated with greater cardiovascular mortality and all-cause mortality. Sarcopenic obese men had the highest risk of all-cause mortality but not CVD mortality. Efforts to promote healthy aging should focus on preventing obesity and maintaining muscle mass.

Keywords: cardiovascular disease; mortality; muscle mass; obesity; sarcopenia.

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Figures

Figure 1
Figure 1
Unadjusted rates of coronary heart disease (CHD) events, cardiovascular disease (CVD) events, CVD mortality, and all-cause mortality (per 1,000 person-years; 95% confidence interval) according to sarcopenic obesity groups (defined according to waist circumference (WC) and midarm muscle circumference (MAMC)). Optimal (WC ≤ 102 cm, MAMC > 25.9 cm), sarcopenic (WC ≤ 102 cm, MAMC ≤ 25.9 cm), obese (WC > 102 cm, MAMC > 25.9 cm), sarcopenic obese (WC > 102 cm, MAMC ≤ 25.9 cm).
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