"The Lancet" Journal of China's 10,000 People Study: Pay Attention to Muscle Loss in Middle-aged and Older People!

▎Multiple research reports edited by WuXi AppTec content team show that the prevalence of sarcopenia in Asian elderly is about 6.
8%~25.
7%
.

Sarcopenia is a severe geriatric syndrome associated with decreased skeletal muscle mass, muscle strength, and/or poor physical function
.

Sarcopenia is also emerging as a major public health problem as the aging of the global population accelerates
.

There is increasing evidence that sarcopenia is closely associated with multiple adverse outcomes, such as falls, frailty, increased frequency of medical visits, and increased risk of death
.

At the same time, aging is also a strong risk factor associated with the development of cardiovascular disease, and cardiovascular disease is the leading cause of death in elderly patients
.

So, is sarcopenia in middle-aged and elderly people related to cardiovascular disease? Large-scale population-based longitudinal studies have historically been lacking
.

Recently, EClinicalMedicine, a journal of The Lancet, published a large-scale study in the Chinese population.
Long-term follow-up of nearly 15,000 Chinese middle-aged and elderly people showed that sarcopenia is associated with a significantly higher risk of cardiovascular disease, including cardiac Disease and stroke
.

The research was led by scholars from the Department of Gastroenterology of the First Affiliated Hospital of Xi'an Jiaotong University and the School of Basic Medicine of the Fourth Military Medical University
.

The paper states that this study extends our understanding of the cardiometabolic importance of sarcopenia
.

Screenshot source: How does EClinicalMedicine judge sarcopenia? In this study, sarcopenia was defined using the AWGS 2019 criteria
.

"Possible sarcopenia" found in community-based primary medical institutions: Potential cases found: calf circumference <34 cm in males and <33 cm in females; or SARC-F scale ≥4; or SARC-CalF scale ≥11
.

Risk assessment: Low muscle strength: Grip strength < 28 kg for men, < 18 kg for women or low physical function: 5 chair-ups test time ≥ 12 seconds Based on the judgment of community primary medical institutions, hospitals and clinical research can also pass Case detection for any of the following clinical conditions, including: functional decline or limitation; unintended weight loss; depressed mood; cognitive impairment; repeated falls; malnutrition; chronic diseases, including heart failure, COPD, diabetes , chronic kidney disease,
etc.

Further diagnosis of "sarcopenia" in a hospital setting: Low muscle strength: Grip strength <28 kg in males and <18 kg in females Low physical function: 6-meter walking speed <1.
0 m/s; or 5 chair-ups test time ≥12 seconds ; or recommended Physical Fitness Scale (SPPB) score ≤9
.

Limb skeletal muscle content: DAX male <7.
0 kg/m2, female <5.
4 kg/m2; or BIA male <7.
0 kg/m2, female <5.
7 kg/m2
.

Image source: 123RF Sarcopenia and Cardiovascular Disease This study is based on nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS)
.

CHARLS aims to collect a set of high-quality micro-data representing households and individuals of middle-aged and elderly people aged 45 and above in China to analyze the problem of China's population aging
.

The CHARLS National Baseline Survey was launched in 2011, covering 150 county-level units, 450 village-level units, and about 17,000 people in 10,000 households
.

These samples will be followed up every 2-3 years thereafter
.

The cross-sectional analysis portion of the study, which included 15,137 participants aged ≥45 years from CHARLS 2015, was the first to demonstrate that the group with sarcopenia was also more prevalent with cardiovascular disease
.

The prevalence of cardiovascular disease was 12.
6% (1905/15137), 10.
0% (1026/10280), 18.
1% (668) in the general population, in the population without sarcopenia, probable sarcopenia, and sarcopenia, respectively /3685), 18.
0% (211/1172)
.

After adjusting for sociodemographic characteristics and health-related factors, the risk of cardiovascular disease was significantly increased by 29% and 72% in probable sarcopenia and sarcopenia, respectively
.

This trend was consistent for both heart disease (17% and 55% increase, respectively) and stroke (1.
18-fold and 1.
7-fold increase, respectively)
.

The next longitudinal analysis screened 11,863 participants who were free of cardiovascular disease when they joined the study in 2015 and were followed through to 2018
.

Data from longitudinal analyses further showed that people with sarcopenia were also at higher risk for future cardiovascular disease events
.

During a mean follow-up of 3.
6 years, a total of 1273 (10.
7%) cardiovascular events were identified
.

After adjusting for other potential risk factors, compared with the same age group without sarcopenia: those diagnosed with probable sarcopenia had a 22% higher risk of cardiovascular disease; those diagnosed with sarcopenia had a 22% higher risk of cardiovascular disease increased by 33%
.

This risk is mainly reflected in stroke
.

Diagnosed with probable sarcopenia and sarcopenia, the risk of heart disease showed a trend toward a 6% and 21% increase, respectively, but not significantly; the risk of stroke was significantly increased by 59% and 67%, respectively
.

Regardless of cross-sectional or longitudinal analysis, the above associations did not change significantly after further metabolic biomarkers in nearly 10,000 participants
.

In addition, in the absence of low grip strength and poor physical function (both of which are definitions of "probable sarcopenia" in the AWGS 2019 criteria), the risk of cardiovascular disease was not significant in those with low muscle mass alone increase
.

This also confirms the risk of cardiovascular disease in people who may have sarcopenia
.

Image source: 123RF Small Conclusion As discussed in the text, the association between sarcopenia and cardiovascular disease involves multiple potential mechanisms
.

Patients with sarcopenia may experience several pathophysiological changes, including muscle mitochondrial dysfunction, oxidative stress, hyper-inflammatory states, microvascular endothelial dysfunction, and multiple metabolic disorders (insulin resistance and nonalcoholic fatty liver disease); in addition, Sarcopenia shares similar life>
.

These data suggest that assessment of underlying sarcopenia during physical examination and routine clinical practice can help identify those at risk for cardiovascular disease who are most likely to benefit from early intervention, the paper concludes
.

Prevention and improvement of possible sarcopenia and sarcopenia, including maintaining adequate muscle strength and physical function, may help reduce the risk of cardiovascular disease and promote healthy aging in the middle-aged and elderly population
.