Association between smoking status and sarcopenia among middle-aged and older adults: finding from the CHARLS study.

Abstract

Purpose: There is limited information on the association between smoking/smoking cessation and sarcopenia in Chinese populations. We conducted a retrospective cohort study to investigate the association between smoking/smoking cessation and its duration with the risk of sarcopenia.

Methods: This cohort included 6,719 adults over 45 from the CHARLS between 2011 and 2015. Smoking status was categorized into smokers (current smokers/quitters) and non-smokers. Duration of smoking was defined as < 20, 20-29, 30-39, and ≥ 40 years. Duration of smoking cessation was defined as ≤ 1, 2-4, and > 4 years. Sarcopenia was defined according to AWGS 2019. Cox proportional hazards regression models were used to estimate the hazard ratio for the risk of developing sarcopenia.

Results: The median age of the cohort was 57.0 years, and 47.0% were male. Over a 3.7-year follow-up period, 9.7% of participants developed sarcopenia. Compared to non-smokers, smokers had a higher risk of developing sarcopenia (HR: 1.27, 95% CI 1.02-1.59). Among individuals with a smoking duration exceeding 40 years, the likelihood of developing sarcopenia was 39.0% higher (HR: 1.39, 95% CI 1.08-1.79). The elevated risk persists regardless of alcohol consumption. Quitters had a lower risk of sarcopenia compared to current smokers (HR: 0.67, 95% CI 0.47-0.97). Individuals who had quit smoking for > 4 years had a lower risk of sarcopenia compared to current smokers (HR: 0.43, 95% CI 0.24-0.78).

Conclusion: Current smokers face a higher risk of sarcopenia, especially those with a prolonged smoking history. Promoting smoking cessation is an essential strategy for lowering the risk of sarcopenia and mitigating its burden among smokers.