Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate

BMC Geriatrics

Research

Haifeng Zhang¹  Qixin Guo²  Xu Zhu²  Shengen Liao²  Yanli Zhou²  Rongrong Gao²  Xinyi Lu²  Wenming Yao²  Iokfai Cheang²  Xinli Li²  Jinyu Sun²  Qiang Qu² 

[1] Department of Cardiology, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, 26 Daoqian Street, 215002, Suzhou, China;Department of Cardiology, Jiangsu Province Hospital, 300 Guangzhou Road, 210029, Nanjing, China;Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, China;

关键词: Prospective study;    Older adults;    Sarcopenia;    Low lean mass;    Appendicular lean mass index;    Obesity;    Sarcopenic obesity;    Low lean mass with obesity;    Prevalence;    All-cause mortality;   

DOI  :  10.1186/s12877-023-04326-x

 received in 2023-03-05, accepted in 2023-09-18,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe influence of sarcopenic obesity (SO) on overall survival in older adults with hypertension has not been addressed. The aim of this study was to investigate the prevalence and mortality predictive value of various body composition phenotypes, focusing mainly on SO, in older adults with hypertension.MethodsWe included 1105 hypertensive patients aged ≥ 60 years from the National Health and Nutrition Examination Survey 1999–2004. Sarcopenia was broadly defined based on low lean mass (LLM; as measured by dual-energy X-ray absorptiometry), and was defined using appendicular lean mass (ALM) divided by height squared (ALM/height2), weight (ALM/weight), and body mass index (BMI; ALM/BMI), respectively. Obesity was defined as BMI ≥ 30 kg/m2, body fat percentage ≥ 30/42%, or waist circumference ≥ 102/88 cm. The prevalence of LLM with obesity was estimated according to each ALM index (ALMI). Multivariable Cox regression analysis and sensitivity analysis were used to examine the association between various body composition phenotypes and all-cause mortality.ResultsIn older adults with hypertension, the prevalence of LLM with obesity by the ALM/height2 index (9.8%) was lower relative to the ALM/weight (11.7%) and ALM/BMI indexes (19.6%). After a median follow-up of 15.4 years, 642 deaths occurred. In the fully adjusted models, LLM with obesity was significantly associated with a higher risk of all-cause mortality (hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.14–2.49, P = 0.008; HR 1.48, 95% CI 1.04–2.10, P = 0.028; HR 1.30, 95% CI 1.02–1.66, P = 0.037; respectively) compared with the normal body phenotype, with no statistical differences found in individuals with LLM or obesity alone. Sensitivity analysis confirmed the robustness of the results.ConclusionsThe prevalence of LLM with obesity markedly differed in older adults with hypertension according to the 3 different ALMIs, varying from 9.8%, 11.7%, to 19.6%. Patients with both LLM and obesity had a higher risk of all-cause mortality. Further large, prospective, cohort studies are warranted to validate these findings and uncover underlying mechanisms.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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