0-3期成人心血管-肾脏代谢综合征患者的肌肉减少症和心血管疾病：一项前瞻性队列研究

IF 4.3 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology Pub Date : 2025-07-18 DOI:10.1016/j.ajpc.2025.101060

Yupeng Wei , Xiaopeng Hu

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引用次数: 0

摘要

大量证据表明，肌肉减少症与心血管疾病（CVD）之间存在相关性。然而，尚不确定这种相关性是否存在于心血管肾代谢综合征（CKM）患者中。方法本研究采用中国健康与退休纵向研究（CHARLS）的数据。骨骼肌减少症状态根据2019年亚洲骨骼肌减少症工作组标准确定。肌肉质量由身高调整后的肌肉质量估计。采用Cox比例风险模型计算风险比（HR）和95%置信区间（95% CI）。结果共7428例受试者，平均年龄59.0岁；男性：47.6%)纳入本研究。其中，非肌少症、可能肌少症和肌少症患者分别为4398例（59.2%）、2162例（29.1%）和869例（11.7%）。在中位9年的随访期间，与非肌肉减少症患者相比，可能患有肌肉减少症（HR: 1.32, 95% CI: 1.19-1.47）和肌肉减少症（HR: 1.45, 95% CI: 1.23-1.72）的患者发生心血管疾病的风险增加。肌肉质量高的五分位数比肌肉质量低的五分位数发生心血管疾病的风险显著增加(五分位数2:HR 1.34, 95% CI 1.15-1.56；五分位数3:HR 1.41, 95% CI 1.19-1.67；四分位数：危险度1.71,95%可信区间1.40-2.09；五分位数：HR 2.20, 95% CI 1.75-2.77)。剂量-反应曲线显示肌肉质量与CVD事件呈正线性关系（总体P = 0.001，非线性P = 0.795）。结论在CKM综合征0-3期患者中，可能的肌肉减少症和肌肉减少症都与CVD发生风险增加相关。

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Sarcopenia and cardiovascular disease among adults with cardiovascular-kidney-metabolic syndrome stages 0-3: A prospective cohort study

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Sarcopenia and cardiovascular disease among adults with cardiovascular-kidney-metabolic syndrome stages 0-3: A prospective cohort study

Background

Substantial evidence has demonstrated the correlation between sarcopenia and cardiovascular disease (CVD). However, it remains uncertain whether this correlation exists in individuals with cardiovascular-kidney-metabolic (CKM) syndrome.

Methods

This study used data from the China Health and Retirement Longitudinal Study (CHARLS). Sarcopenia state was determined according to the Asian Working Group for Sarcopenia 2019 criteria. Muscle mass was estimated by the height‐adjusted muscle mass. Cox proportional hazard models were employed to calculate the hazard ratio (HR) and 95 % confidence interval (95 % CI.

Results

A total of 7428 participants (mean age: 59.0 years; male: 47.6 %) were included in this study. Of these, non-sarcopenia, possible sarcopenia, and sarcopenia individuals were 4398 (59.2 %), 2162 (29.1 %), and 869 (11.7 %), respectively. During a median follow-up of 9.0 years, participants with possible sarcopenia (HR: 1.32, 95 % CI: 1.19–1.47) and sarcopenia (HR: 1.45, 95 % CI: 1.23–1.72) exhibited an increased risk of incident CVD compared to those with non-sarcopenia. Higher quintiles of muscle mass presented significantly increased risks of incident CVD than those with the lowest quintile (quintile 2: HR 1.34, 95 % CI 1.15–1.56; quintile 3: HR 1.41, 95 % CI 1.19–1.67; quintile 4: HR 1.71, 95 % CI 1.40–2.09; quintile 5: HR 2.20, 95 % CI 1.75–2.77). The dose-response curve indicated a positive linear association between muscle mass and incident CVD (P for overall <0.001, P for nonlinear = 0.795).