Abstract
Background: An association between sarcopenic obesity and cardiovascular disease has been suggested. We investigated the relationship between sarcopenia and coronary atherosclerosis, taking into account the presence or absence of obesity in a health check-up population.Methods: Data were reviewed for subjects who underwent bioelectrical impedance analysis (BIA) and coronary calcium scoring (CAC) computed tomography between January 2017 and December 2018. Appendicular skeletal muscle mass (ASM) was assessed using BIA. Sarcopenia was defined as reduction of muscle mass and calculated as ASM% (ASM/body weight) more than two standard deviations below the sex-specific mean for healthy young adults. CAC scores were dichotomized as low (<100) or high (≥100).Results: Among 1,282 subjects (mean age, 58.1 years; 75.5% male), the prevalence of high CAC was 21%. When the study population was divided into four groups according to their obesity and sarcopenia status, the prevalence of high CAC in the sarcopenic-obesity (SO) group was significantly higher than in the other groups (40.7%, P < 0.001). After adjusting for age, sex, hypertension, diabetes, dyslipidemia, and creatinine, subjects with SO exhibited a significantly higher odds of a high CAC score, compared with the non-sarcopenic, non-obese group (odds ratio, 1.92; 95% confidence interval, 1.16–3.18, P = 0.011).Conclusion: SO was significantly associated with CAC, independent of known risk factors for coronary artery disease. These findings suggest that sarcopenia and obesity may potentiate each other to increase atherosclerotic burden in coronary arteries, which may eventually lead to adverse cardiovascular events.
Highlights
Sarcopenia refers to an age-related decline in skeletal muscle mass and strength, with or without a reduction in physical performance [1]
Sarcopenic obesity (SO) was significantly associated with calcium scoring (CAC), independent of known risk factors for coronary artery disease
These findings suggest that sarcopenia and obesity may potentiate each other to increase atherosclerotic burden in coronary arteries, which may eventually lead to adverse cardiovascular events
Summary
Sarcopenia refers to an age-related decline in skeletal muscle mass and strength, with or without a reduction in physical performance [1]. Stephen and Janssen followed 3,366 community-dwelling elderly individuals with no baseline cardiovascular disease for 8 years They reported that sarcopenia (defined as reduced muscle strength or mass) and obesity alone did not affect the risk of cardiovascular disease, but SO (defined by reduced muscle strength) was associated with a 23% increased risk of cardiovascular disease [6]. Farmer et al investigated the association of sarcopenia (assessed by grip strength) and obesity with cardiovascular disease and showed that obesity alone, sarcopenia alone, and SO were all associated with increased cardiovascular and all-cause mortality, as well as cardiovascular disease events (except sarcopenia alone) [7] These results show that SO is associated with cardiovascular disease. We investigated the relationship between sarcopenia and coronary atherosclerosis, taking into account the presence or absence of obesity in a health check-up population
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