Sarcopenic-obesity and cardiovascular disease risk in the elderly.
OBJECTIVE
To determine: 1) whether sarcopenic-obesity is a stronger predictor of cardiovascular disease (CVD) than either sarcopenia or obesity alone in the elderly, and 2) whether muscle mass or muscular strength is a stronger marker of CVD risk.


METHODS
Prospective cohort study.


METHODS
Participants included 3366 community-dwelling older (>or= 65 years) men and women who were free of CVD at baseline.


METHODS
Waist circumference (WC), bioimpedance analysis, and grip strength were used to measure abdominal obesity, whole-body muscle mass, and muscular strength, respectively. Subjects were classified as normal, sarcopenic, obese, or sarcopenic-obese based on measures of WC and either muscle mass or strength. Participants were followed for 8 years for CVD development and proportional hazard regression models were used to compare risk estimates for CVD in the four groups after adjusting for age, sex, race, income, smoking, alcohol, and cognitive status.


RESULTS
Compared with the normal group, CVD risk was not significantly elevated within the obese, sarcopenic, or sarcopenic-obese groups as determined by WC and muscle mass. When determined by WC and muscle strength, CVD risk was not significantly increased in the sarcopenic or obese groups, but was increased by 23% (95% confidence interval: 0.99-1.54, P=0.06) within the sarcopenic-obese group.


CONCLUSIONS
Sarcopenia and obesity alone were not sufficient to increase CVD risk. Sarcopenic-obesity, based on muscle strength but not muscle mass, was modestly associated with increased CVD risk. These findings imply that strength may be more important than muscle mass for CVD protection in old age.
Stephen
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WC
School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.
Janssen
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D000273:Adipose Tissue; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D017097:Electric Impedance; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D018737:Hand Strength; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D018908:Muscle Weakness / Q000453:epidemiology*; D018482:Muscle, Skeletal; D009133:Muscular Atrophy / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055105:Waist Circumference