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Observational Study
. 2020 Oct 27;12(11):3293.
doi: 10.3390/nu12113293.

Predicted Skeletal Muscle Mass and 4-Year Cardiovascular Disease Incidence in Middle-Aged and Elderly Participants of IKARIA Prospective Epidemiological Study: The Mediating Effect of Sex and Cardiometabolic Factors

Christina Chrysohoou  1 , Matina Kouvari  1   2 , George Lazaros  1 , John Varlas  3 , Kyriakos Dimitriadis  1 , Marina Zaromytidou  1 , Constantina Masoura  1 , John Skoumas  1 , Manolis Kambaxis  1 , Nikos Galiatsatos  1 , Aggelos Papanikolaou  1 , Panagiotis Xydis  1 , Konstantinos Konstantinou  1 , Christos Pitsavos  1 , Konstantinos Tsioufis  1 , Christodoulos Stefanadis  1
Affiliations
Observational Study

Predicted Skeletal Muscle Mass and 4-Year Cardiovascular Disease Incidence in Middle-Aged and Elderly Participants of IKARIA Prospective Epidemiological Study: The Mediating Effect of Sex and Cardiometabolic Factors

Christina Chrysohoou et al. Nutrients. .

Abstract

The sex-specific effect of skeletal muscle mass (SMM) index (SMI) on 4-year first fatal/non-fatal cardiovascular disease (CVD) event in free-of-disease individuals was examined. In 2009, n = 1411 inhabitants (mean age = 64(12)) from Ikaria were selected. Follow-up was performed in 2013. SMI was created to reflect SMM through appendicular skeletal muscle mass (indirectly calculated through formulas) divided by body mass index (BMI). Fifteen and six tenths percent of participants exhibited CVD (19.8% in men/12% in women, p = 0.002). Significant U-shape trends were observed in participants >65 years old and women irrespective to age confirmed through multi-adjusted Cox regression analysis; in age >65 years, Hazard Ratio (HR)(2nd vs. 1st SMI tertile) = 0.80, 95% Confidence Interval (95%CI) (0.45, 0.96) and in women HR(2nd vs. 1st SMI tertile) = 0.71, 95% CI (0.33, 0.95), while, as for the 3rd SMI tertile, no significant trends were observed. Mediation analysis revealed that mediators of the aforementioned associations in men were the arterial distensibility and total testosterone, while, in women, inflammation, insulin resistance, and arterial distensibility. High SMM accompanied by obesity may not guarantee lower CVD risk. Specific cardiometabolic factors seem to explain this need for balance between lean and fat mass.

Keywords: aging; body composition; gender; heart disease; lean mass; obesity; primary prevention; women.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier survival curves for 4-year first fatal/non-fatal CVD event in apparently healthy men and women according to SMI tertiles and age status. Models were adjusted for (age), sex, current smoking, physical activity, diabetes mellitus, dyslipidemia, hypertension, and family history of CVD. Abbreviations: Cardiovascular disease (CVD); Skeletal muscle mass index (SMI).
Figure 2
Figure 2
Kaplan-Meier survival curves for 4-year first fatal/non-fatal CVD event in apparently healthy men according to SMI tertiles and age status. Models were adjusted for (age), current smoking, physical activity, diabetes mellitus, dyslipidemia, hypertension, and family history of CVD. Abbreviations: Cardiovascular disease (CVD); Skeletal muscle mass index (SMI).
Figure 3
Figure 3
Kaplan-Meier survival curves for 4-year first fatal/non-fatal CVD event in apparently healthy women according to SMI tertiles and age status. Models were adjusted for (age), current smoking, physical activity, diabetes mellitus, dyslipidemia, hypertension, and family history of CVD. Abbreviations: Cardiovascular disease (CVD); Skeletal muscle mass index (SMI).
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References

    1. De Carvalho F.G., Justice J.N., Freitas E.C., Kershaw E.E., Sparks L.M. Adipose Tissue Quality in Aging: How Structural and Functional Aspects of Adipose Tissue Impact Skeletal Muscle Quality. Nutrients. 2019;11:2553. doi: 10.3390/nu11112553. - DOI - PMC - PubMed
    1. Lavie C.J., Laddu D., Arena R., Ortega F.B., Alpert M.A., Kushner R.F. Healthy Weightand Obesity Prevention: JACC Health Promotion Series. J. Am. Coll. Cardiol. 2018;72:1506–1531. doi: 10.1016/j.jacc.2018.08.1037. - DOI - PubMed
    1. Srikanthan P., Horwich T.B., Tseng C.H. Relation of Muscle Mass and Fat Mass toCardiovascular Disease Mortality. Am. J. Cardiol. 2016;117:1355–1360. doi: 10.1016/j.amjcard.2016.01.033. - DOI - PubMed
    1. Leong D.P., Teo K.K., Rangarajan S., Lopez-Jaramillo P., Avezum A., Jr., Orlandini A., Seron P., Ahmed S.H., Rosengren A., Kelishadi R., et al. Prognostic value of grip strength: Findings from the ProspectiveUrban Rural Epidemiology (PURE) study. Lancet. 2015;386:266–273. doi: 10.1016/S0140-6736(14)62000-6. - DOI - PubMed
    1. Kim Y., Han B.D., Han K., Shin K.E., Lee H., Kim T.R., Cho K.H., Kim D.H., Kim Y.H., Kim H., et al. Optimal cutoffs for low skeletal muscle mass related to cardiovascularrisk in adults: The Korea National Health and Nutrition Examination Survey 2009–2010. Endocrine. 2015;50:424–433. doi: 10.1007/s12020-015-0577-y. - DOI - PubMed

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