Angiotensin-Converting Enzyme Inhibitors and Parameters of Sarcopenia: Relation to Muscle Mass, Strength and Function: Data from the Berlin Aging Study-II (BASE-II)

Abstract

Background: Pharmacological options for the treatment of sarcopenia currently do not exist. However, off-label treatment options of some established drugs have been suggested.

Objectives: The aim of this study was to assess differences in various muscle and physical performance parameters in relation to the intake of angiotensin-converting enzyme (ACE) inhibitors in a cohort of community-dwelling older people.

Methods: Eight hundred and thirty-eight participants from the Berlin Aging Study-II (BASE-II) were included. Appendicular lean mass was assessed with dual-energy X-ray absorptiometry and related to height and body mass index. Muscle strength was measured by grip strength and related to muscle mass (arm muscle quality) and functional status was assessed via the timed "Up and Go" test.

Results: Users of ACE inhibitors had higher lean mass related to height but significantly lower lean mass related to body mass index (p = 0.001 for women and p < 0.0001 for men). Moreover, they exhibited lower arm muscle quality (p = 0.032 for women and p = 0.031 for men) and reported difficulties in climbing stairs more often than non-users (p = 0.014 for women and p = 0.004 for men). After adjustment for confounders, there were no significant differences regarding lean mass, arm muscle quality and the timed "Up and Go" test according to the use of ACE inhibitors.

Conclusions: In BASE-II, no positive relationship was found between the intake of ACE inhibitors and lean mass, strength, muscle quality or function. Moreover, remarkable differences between parameters of absolute and relative lean mass in relation to the use of ACE inhibitors became evident. Fat mass proved to be an important confounder and therefore muscle mass cannot be viewed irrespectively of whole body composition.