Changes in sarcopenia and incident cardiovascular disease in prospective cohorts

Abstract

Background: Previous studies have identified sarcopenia as a significant risk factor for cardiovascular disease (CVD). However, these studies primarily focused on sarcopenia status at baseline, without considering changes in sarcopenia status during follow-up. The aim of this study is to investigate the association between changes in sarcopenia status and the incidence of new-onset cardiovascular disease.

Methods: This study utilized prospective cohort data from the China Health and Retirement Longitudinal Study (CHARLS). Sarcopenia status was assessed using the 2019 Asian Working Group for Sarcopenia (AWGS) algorithm and categorized as non-sarcopenia, possible sarcopenia, or sarcopenia. Changes in sarcopenia status were evaluated based on assessments at baseline and at the second follow-up survey 2 years later. CVD was identified through self-reported physician diagnoses of heart disease, including angina, myocardial infarction, congestive heart failure, and other heart problems, or stroke. Cox proportional hazards models were employed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounding factors.

Results: Based on the inclusion and exclusion criteria, a total of 7499 CHARLS participants were included in the analysis, with 50.8% being female and an average age of 58.5 years. Compared to participants with stable non-sarcopenia status, those who progressed from non-sarcopenia to possible sarcopenia or sarcopenia exhibited a significantly increased risk of new-onset CVD (HR 1.30, 95% CI 1.06-1.59). Conversely, participants who recovered from sarcopenia to non-sarcopenia or possible sarcopenia had a significantly reduced risk of new-onset CVD compared to those with stable sarcopenia status (HR 0.61, 95% CI 0.37-0.99). Among participants with baseline possible sarcopenia, those who recovered to non-sarcopenia had a significantly lower risk of new-onset CVD compared to those with stable possible sarcopenia status (HR 0.67, 95% CI 0.52-0.86).

Conclusions: Changes in sarcopenia status are associated with varying risks of new-onset CVD. Progression in sarcopenia status increases the risk, while recovery from sarcopenia reduces the risk of developing cardiovascular disease.

Keywords: Cardiovascular disease; Dynamic nature; Epidemiology; Sarcopenia.

Fig. 1

Selection process of the study population. CVD, cardiovascular disease