title: Sarcopenic obesity and risk of cardiovascular disease and mortality: a population-based cohort study of older men.
abstract: OBJECTIVE
  To examine associations between sarcopenia, obesity, and sarcopenic obesity and risk of cardiovascular disease (CVD) and all-cause mortality in older men.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  British Regional Heart Study.
  
  
  METHODS
  Men aged 60-79 years (n = 4,252).
  
  
  METHODS
  Baseline waist circumference (WC) and midarm muscle circumference (MAMC) measurements were used to classify participants into four groups: sarcopenic, obese, sarcopenic obese, or optimal WC and MAMC. The cohort was followed for a mean of 11.3 years for CVD and all-cause mortality. Cox regression analyses assessed associations between sarcopenic obesity groups and all-cause mortality, CVD mortality, CVD events, and coronary heart disease (CHD) events.
  
  
  RESULTS
  There were 1,314 deaths, 518 CVD deaths, 852 CVD events, and 458 CHD events during follow-up. All-cause mortality risk was significantly greater in sarcopenic (HR = 1.41, 95% CI = 1.22-1.63) and obese (HR = 1.21, 95% CI = 1.03-1.42) men than in the optimal reference group, with the highest risk in sarcopenic obese (HR = 1.72, 95% CI = 1.35-2.18), after adjustment for lifestyle characteristics. Risk of CVD mortality was significantly greater in sarcopenic and obese but not sarcopenic obese men. No association was seen between sarcopenic obesity groups and CHD or CVD events.
  
  
  CONCLUSIONS
  Sarcopenia and central adiposity were associated with greater cardiovascular mortality and all-cause mortality. Sarcopenic obese men had the highest risk of all-cause mortality but not CVD mortality. Efforts to promote healthy aging should focus on preventing obesity and maintaining muscle mass.
authors.affiliation: Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: Janice L
authors.initials: JL
authors.lastname: Atkins
authors.forename: Peter H
authors.initials: PH
authors.lastname: Whincup
authors.forename: Richard W
authors.initials: RW
authors.lastname: Morris
authors.forename: Lucy T
authors.initials: LT
authors.lastname: Lennon
authors.forename: Olia
authors.initials: O
authors.lastname: Papacosta
authors.forename: S Goya
authors.initials: SG
authors.lastname: Wannamethee
mesh_terms: D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D002423:Cause of Death / Q000639:trends; D015331:Cohort Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011159:Population Surveillance / Q000379:methods*; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D055948:Sarcopenia / Q000150:complications*; D006113:United Kingdom / Q000453:epidemiology
keywords: cardiovascular disease; mortality; muscle mass; obesity; sarcopenia