During a median follow-up of 13.1 years, 51,705 participants experienced at least one cardiometabolic disease (CMD).
Participants with confirmed or severe had a 1.42 times higher risk of moving from no CMD to a single CMD.
The risk of death for those with confirmed or severe sarcopenia was 2.08 times greater compared to those free of sarcopenia.
Sarcopenia is associated with increased risk of progression from single CMD to (CMM), with a hazard ratio of 1.69.
The transition from single CMD to death was also more likely for those with severe sarcopenia, showing a hazard ratio of 2.05.
All three components of sarcopenia—handgrip strength, muscle mass, and gait speed—are linked to increased risks of transitions, particularly low gait speed.
Lifestyle factors may modify the impact of sarcopenia on mortality-related transitions.
Simplified
BACKGROUND: Although has been linked to a range of cardiometabolic diseases (CMDs, including coronary heart disease [CHD], stroke, and diabetes here), its role in the temporal progression from healthy to single CMD, subsequently to (CMM, coexistence of ≥ 2 CMDs in an individual), and further to death remains unclear. In this study, we aimed to examine the associations of sarcopenia with the risk of CMDs, CMM, and mortality along the CMD progression trajectory.
METHODS: We used data from UK Biobank of 413,326 participants free of CMDs at baseline. Multi-state models were used to analyze the transition-specific associations of sarcopenia status measured by handgrip strength, muscle mass, and gait speed (according to the 2019 European Working Group of Sarcopenia in Older People 2) with the progression from no CMD to single CMD, CMM, and ultimately to death. The role of specific sarcopenia components was also assessed.
RESULTS: During a median follow-up of 13.1 years, 51,705 participants experienced ≥ 1 CMD, 6,003 had CMM, and 24,495 died. Compared with people free of sarcopenia, participants with confirmed/severe sarcopenia had higher risk experiencing transitions from no CMD to single CMD or death (hazard ratio [HR] 1.42 and 2.08) and also higher risk from single CMD to CMM progression or death (HR 1.69 and 2.05). Significant associations were observed for participants with probable sarcopenia with smaller effect sizes. All three sarcopenia components increased the risk of most transitions, and stronger associations were observed for low gait speed. In stratified analyses, the associations between sarcopenia and mortality-related transitions were modified by specific lifestyles.
CONCLUSIONS: Sarcopenia is an independent risk factor of CMD, CMM progression, and all-cause mortality among middle-aged and older people.
Key numbers
1.42
Increase in risk of CMD from no CMD
Hazard ratio for confirmed/severe transitioning from no CMD to single CMD
2.08
Increase in risk of death
Hazard ratio for confirmed/severe related to mortality
13.1 years
Median follow-up duration
Duration over which participants were monitored for CMD progression and mortality
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Declarations. Ethics approval and consent to participate: This research was conducted using UK Biobank Resource under project number 84443. The UK Biobank has been approved by the North West Multi-centre Research Ethics Committee as a Research Tissue Bank, and separate ethical clearance is not required for researchers under this approval (updated ref 21/NW/0157, 18 June 2021). All participants of UK Biobank have provided written informed consent. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
