Sarcopenic Obesity and Risk of Cardiovascular Disease and Mortality: A Population‐Based Cohort Study of Older Men

TLDR

Healthy aging requires preventing obesity and preserving muscle mass. The study examined how sarcopenia, obesity, and sarcopenic obesity influence cardiovascular disease and mortality risk in older men. A prospective cohort of 4,252 men aged 60–79 was followed for 11.3 years, with baseline waist circumference and midarm muscle circumference used to classify participants into sarcopenic, obese, sarcopenic‑obese, or optimal groups, and Cox regression assessed outcomes. Sarcopenic and obese men had higher all‑cause mortality (HR 1.41 and 1.21, respectively) and sarcopenic‑obese men had the greatest risk (HR 1.72), while CVD mortality was elevated in sarcopenic and obese but not sarcopenic‑obese men, and no differences were seen for CHD or CVD events.

Abstract

To examine associations between sarcopenia, obesity, and sarcopenic obesity and risk of cardiovascular disease (CVD) and all-cause mortality in older men.Prospective cohort study.Men aged 60-79 years (n = 4,252).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.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.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.