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Kim J, Lee I, Kang H. The association between physical activity and neck circumference with cardiovascular disease risk in older wheelchair users. J Rehabil Med 2024; 56:jrm35279. [PMID: 38898678 PMCID: PMC11218756 DOI: 10.2340/jrm.v56.35279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVE To examine the association between physical activity, neck circumference, and cardiovascular disease risk in older wheelchair users. DESIGN A cross-sectional study. SUBJECTS/PATIENTS Sixty-one Korean wheelchair users aged 50 years and older. METHODS Physical activity was assessed using a self-administered questionnaire. Neck circumference was measured with a tape ruler. Cardiovascular disease risk was evaluated by calculating the Framingham risk score (FRS) for estimating 10-year cardiovascular disease risk, which was classified as low-moderate (19% or less) or high risk (20% or more). RESULTS The FRS for 10-year cardiovascular disease risk was inversely related to physical activity (beta [SE] = -0.213 (0.103), p = 0.043) and positively related to neck circumference (beta [SE] = 1.331 ± 0.419, p = 0.003). Binary logistic regression showed that those with low physical activity (odds ratio [95% confidence interval] = 4.256 (1.188~15.243), p = 0.026) or a large neck circumference (odds ratio [95% confidence interval] = 3.645 (1.172~11.338), p = 0.025) had a higher risk for high cardiovascular disease risk compared with those with high physical activity or normal neck circumference. CONCLUSION The current study findings suggest that an intervention targeting physical inactivity and upper-body obesity should be implemented to reduce cardiovascular disease risk in older wheelchair users.
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Affiliation(s)
- Jeonghyeon Kim
- College of Sport Science, Sungkyunkwan University, Seoul, Republic of Korea
| | - Inhwan Lee
- Department of Antiaging and Health Care, College of Future Convergence, Changwon National University, Changwon, Republic of Korea
| | - Hyunsik Kang
- College of Sport Science, Sungkyunkwan University, Suwon, Republic of Korea.
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Li G, Yan H, Jing L, Tian Y, Li Y, Sun Q, Sun J, Yue L, Xing L, Liu S. Neck circumference as an additional predictor of cardiovascular disease mortality: A multi-center prospective population-based study in northeastern China. Prev Med 2024; 180:107859. [PMID: 38228252 DOI: 10.1016/j.ypmed.2024.107859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 01/18/2024]
Abstract
BACKGROUND AND AIMS This study aimed to assess the potential of neck circumference (NC) and neck-to-height ratio (NHR) as predictors of future cardiovascular disease (CVD) mortality in a general population from Northeastern China. METHODS A multi-center prospective study was conducted in Northeastern China, involving 18, 796 participants. The associations between NC or NHR and the incidence of overall CVD mortality, stroke mortality, and coronary heart disease (CHD) mortality were examined using multivariate Cox regression models. Hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were calculated. Reclassification analyses were conducted to determine the incremental predictive value of NC or NHR. RESULTS NC was significantly associated with the risk of CVD mortality, independent of other anthropometric measurements for obesity. Individuals in the highest quartile of NC had a 1.83-fold (95% CI 1.29 to 2.61) and a 2.40-fold (95% CI 1.45 to 4.00) higher risk of overall CVD mortality and CHD mortality, respectively. Larger NC was significantly related to a heightened risk of ischemic stroke mortality, although no such association was observed with hemorrhagic stroke mortality. Furthermore, the risk of overall CVD mortality, stroke mortality, and CHD mortality increased by approximately 1.21 to 1.25 times per 1-SD change in NC. Similar findings were observed for NHR. The percentages of correct classification of overall CVD mortality improved by 12.1% and 16.3% after the addition of NC or NHR into established models, respectively. CONCLUSIONS NC and NHR might be promising predictors of CVD mortality, with higher values indicating greater risk.
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Affiliation(s)
- Guangxiao Li
- Department of Medical Record Management Center, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Han Yan
- Institute of Preventive Medicine, China Medical University, Shenyang, Liaoning 110001, China; Department of Chronic Disease Preventive and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, People's Republic of China
| | - Li Jing
- Institute of Preventive Medicine, China Medical University, Shenyang, Liaoning 110001, China; Department of Chronic Disease Preventive and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, People's Republic of China
| | - Yuanmeng Tian
- Institute of Preventive Medicine, China Medical University, Shenyang, Liaoning 110001, China; Department of Chronic Disease Preventive and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, People's Republic of China
| | - Ying Li
- Office of Scientific Research Management, School of Public Health, China Medical University, Shenyang 110122, China
| | - Qun Sun
- Department of Chronic Disease, Disease Control and Prevention of Chao Yang City, Chaoyang, Liaoning, China
| | - Jixu Sun
- Department of Chronic Disease Prevention and Control, Disease Control and Prevention of Dan Dong City, Dandong, China
| | - Ling Yue
- Department of Ultrasound, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110033, China
| | - Liying Xing
- Institute of Preventive Medicine, China Medical University, Shenyang, Liaoning 110001, China; Department of Chronic Disease Preventive and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, People's Republic of China.
| | - Shuang Liu
- Department of Ultrasound, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110033, China.
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Fotouhi F, Shahidi A, Hashemi H, Saffarpour M, Yekta A, Esmaieli R, Esteki T, Derakhshan HB, Khabazkhoob M. Hypertension prevalence in Iran's elderly according to new criteria: the Tehran Geriatric Eye Study. J Diabetes Metab Disord 2023; 22:1489-1498. [PMID: 37975137 PMCID: PMC10638178 DOI: 10.1007/s40200-023-01272-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 07/27/2023] [Indexed: 11/19/2023]
Abstract
Purpose To determine the prevalence of hypertension in a population above 60 years of age and its relationship with demographic and anthropometric factors. Methods A cross-sectional population-based study was conducted in 2019. Using a multistage random cluster sampling, 160 clusters were selected from 22 districts of Tehran. All participants were interviewed to collect demographic, anthropometric, and socioeconomic information. Then, systolic (SBP) and diastolic (DBP) blood pressures were measured under standard conditions twice, 10 min apart. A third measurement was performed if the two measurements showed a difference of ≥ 10 mmHg in SBP or ≥ 5 mmHg in DBP. Hypertension was defined as a SBP > 130 mmHg or a DBP > 80 mmHg (new criteria), being a known case of hypertension, or use of blood pressure lowering medications. Results Of 3791 invitees, 3310 participated in the study (87.3%). The mean age of the participants was 68.25 ± 6.54 years (60-97 years). The prevalence of hypertension was 81.08% (95% CI: 79.57-82.59) in the whole sample; 82.96% (95% CI: 81.02-84.91) in females, and 79.15% (95% CI: 76.6 -81.69) in males. The prevalence of hypertension ranged from 75.47% (95% CI: 72.65-78.29) in the age group 60-64 years to 88.40% (95% CI: 83.71-93.08) in the age group ≥ 80 years. The prevalence of hypertension unawareness was 32.84% (95% CI: 30.82-34.86). The highest and lowest prevalence of hypertension was seen in illiterate subjects (89.41%) and those with a university education (77.14%), respectively. According to the multiple logistic regression analysis, older age, lower education level, obesity and overweight, neck circumference, and diabetes were significantly associated with the prevalence of hypertension. Conclusion A significant percentage of Iranian elderly have hypertension and one of every 3 affected individuals is unaware of their disease. Considering the population aging in Iran, urgent and special attention should be paid to the elderly population. Caring for the elderly, informing families, and using non-traditional screening methods are recommended by families at the first level and policymakers at the macro level.
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Affiliation(s)
- Farid Fotouhi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aida Shahidi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mahshid Saffarpour
- Department of Restorative Dentistry, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Abbasali Yekta
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roghayeh Esmaieli
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Taraneh Esteki
- Department of Anesthesiology and Operating Room, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homayoon Bana Derakhshan
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Anesthesiology and Operating Room, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hu T, Shen Y, Xu Y, Wang Y, Bao Y, Ma X. Low total osteocalcin levels are associated with the risk of cardiovascular events among women with hyperglycaemia: a 7.6-year prospective study. Endocrine 2023; 82:47-56. [PMID: 37341923 DOI: 10.1007/s12020-023-03428-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 06/12/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE To investigate the association between circulating osteocalcin and incident cardiovascular diseases in a community-based cohort, and further assess whether the association differs by different glycemic stages. METHODS This cohort study included 1428 participants (626 men and 802 women) aged 50-80 years, without baseline cardiovascular diseases, and with osteocalcin data available. Circulating total osteocalcin levels were measured by electrochemiluminescence immunoassay. Multivariate Cox proportional hazards models were used to assess the relationship between osteocalcin levels and different glycemic stages with cardiovascular events. RESULTS At baseline, 437 participants were normoglycaemia and 991 participants were hyperglycaemia. Median circulating osteocalcin levels were 16.43 (13.34-20.19) and 21.66 (17.95-26.11) ng/mL in men and women, respectively. During a mean follow-up of 7.6 years, 144 cases of cardiovascular diseases occurred (10.1%). The risk of incident cardiovascular diseases linearly increased with a decrease in baseline osteocalcin quartiles (quartile 1 versus quartile 4: hazard ratio 2.44, 95% confidence interval 1.07-5.55) in women, while not in men (Pinteraction on sex = 0.028). Subgroup analyses showed that the association was more predominant in participants with baseline hyperglycaemia. Besides, the joint effect of baseline decreased osteocalcin levels and hyperglycaemia resulted in higher risks of future cardiovascular diseases. CONCLUSIONS Low baseline osteocalcin levels were associated with high risks of cardiovascular diseases in middle-aged and elderly women, which were more predominant among those with baseline hyperglycaemia.
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Affiliation(s)
- Tingting Hu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, 200233, China
| | - Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, 200233, China
| | - Yiting Xu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, 200233, China
| | - Yufei Wang
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, 200233, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, 200233, China.
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, 200233, China.
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Shen Y, Hu T, Tan H, Xu Y, Wang Y, Ma X, Bao Y. Insight to the association among fibroblast growth factor 21, non-alcoholic fatty liver disease and cardiovascular outcomes: A population-based study. Cytokine 2023; 170:156318. [PMID: 37549489 DOI: 10.1016/j.cyto.2023.156318] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/01/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE We aimed to investigate whether there was a joint effect of fibroblast growth factor 21 (FGF21) and non-alcoholic fatty liver disease (NAFLD) or interaction on the incidence of cardiovascular diseases based on a community-dwelling population. METHODS Serum FGF21 levels were determined using an enzyme-linked immunosorbent method. NAFLD was diagnosed via ultrasonography. Multivariable-adjusted cox proportional hazards models were used to assess the joint effects of FGF21 and NAFLD on the major adverse cardiovascular events (MACE). RESULTS A total of 1194 participants were enrolled in the final analysis. The multivariable-adjusted hazard ratio (HR) of MACE was 1.84 (95% confidence interval (CI) 1.18-2.86) in participants with diagnosed NAFLD at baseline, compared with those without NAFLD at baseline. The multivariable-adjusted HRs of MACE across quintiles of serum FGF21 levels at baseline were 1.00, 1.48 (95%CI 0.68-3.21), 2.01 (95%CI 0.98-4.13), 1.94 (95%CI 0.94-4.02) and 2.14 (95%CI 1.03-4.44) respectively. Participants with high FGF21 levels and NAFLD at baseline showed the highest risk of MACE with a significant interaction between the presence of NAFLD and serum FGF21 levels. CONCLUSIONS Both FGF21 and NAFLD were associated with MACE, while the association between FGF21 and MACE may be interacted by the presence of NAFLD at baseline.
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Affiliation(s)
- Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Tingting Hu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Hongyu Tan
- Jinzhou Medical University, Linghe District, Jinzhou, 121004, China
| | - Yiting Xu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Yufei Wang
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
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Hu T, Shen Y, Cao W, Xu Y, Wang Y, Bao Y, Ma X. The Association and Joint Effect of Adipocyte Fatty Acid Binding Protein and Obesity Phenotype With Cardiovascular Events. J Clin Endocrinol Metab 2023; 108:2353-2362. [PMID: 36848145 PMCID: PMC10438874 DOI: 10.1210/clinem/dgad110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/10/2023] [Accepted: 02/23/2023] [Indexed: 03/01/2023]
Abstract
CONTEXT There is little evidence regarding the joint effect of serum adipocyte fatty acid binding protein (A-FABP) levels and obesity phenotype on the risk of cardiovascular events. OBJECTIVE To explore the association between serum A-FABP levels and obesity phenotype defined by fat percentage (fat%) and visceral fat area (VFA), and their joint impact on incident cardiovascular events. METHODS A total of 1345 residents (579 men and 766 women) without previous cardiovascular diseases at baseline, with body composition and serum A-FABP data available, were included. A bioelectrical impedance analyzer and magnetic resonance imaging were used to assess fat% and VFA, respectively. RESULTS During a mean follow-up of 7.6 years, 136 cases of cardiovascular events (13.9 per 1000 person-years) occurred. Per 1-unit increase in loge-transformed A-FABP levels was associated with an increase in cardiovascular events risk (hazard ratio [HR] 1.87, 95% CI 1.33-2.63). The highest tertiles of fat% and VFA levels were related to higher risks of cardiovascular events (fat%: HR 2.38, 95% CI 1.49-3.81; VFA: HR 1.79, 95% CI 1.09-2.93). The association between A-FABP levels and cardiovascular events was more pronounced in participants with low fat%, regardless of VFA levels. The joint effect of high A-FABP levels and obesity resulted in a greater risk of cardiovascular events. CONCLUSION Serum A-FABP levels were significantly associated with the risk of cardiovascular events, and this pattern of association was more prominent among the population with low fat%, which was independent of VFA.
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Affiliation(s)
- Tingting Hu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Weijie Cao
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yiting Xu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yufei Wang
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
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Xu Y, Hu T, Shen Y, Wang Y, Bao Y, Ma X. Contribution of low skeletal muscle mass in predicting cardiovascular events: A prospective cohort study. Eur J Intern Med 2023; 114:113-119. [PMID: 37164887 DOI: 10.1016/j.ejim.2023.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/26/2023] [Accepted: 05/04/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND We aimed to explore the association between skeletal muscle mass and cardiovascular events, and its additional value on the assessment of cardiovascular diseases (CVD) over traditional risk scores. METHODS The study included 1365 community-based participants aged over 50 years and free of CVDs at baseline. Participants completed detailed assessments at baseline and received a follow-up assessment in 2021-2022 via phone calls or electronic medical records. Skeletal muscle mass was measured using an automatic bioelectric analyzer. Predicted probabilities of 10-year atherosclerotic cardiovascular disease (ASCVD) risk were estimated individually with the China-PAR equation. RESULTS After a mean follow-up of 7.6 years, 144 cardiovascular events were identified. The fully-adjusted hazard ratios (HRs) of cardiovascular events were 0.93 (0.88-0.98) and 1.08 (1.04-1.12) for skeletal muscle mass and predicted 10-year risk, respectively. Among participants over 60 years and with two or more risk factors, cardiovascular events risk increased progressively with each decreasing skeletal muscle tertile. Receiver operating characteristic curves showed that the C-statistic of predicting cardiovascular events for a 10-year risk assessment was slightly increased after adding skeletal muscle mass. The categorical net reclassification improvement (NRI) showed a 56.7% increase in the reclassification. The continuous NRI and integrated discrimination improvement increased as well. CONCLUSION Participants with low skeletal muscle mass were more likely to have cardiovascular events. Low muscle mass improved the predictive power of CVD incidence over the original risk score, indicating that muscle mass could be a valuable parameter and a declining value needed early detection in the population.
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Affiliation(s)
- Yiting Xu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Tingting Hu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yufei Wang
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China.
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Two-year changes in body composition and future cardiovascular events: a longitudinal community-based study. Nutr Metab (Lond) 2023; 20:4. [PMID: 36721154 PMCID: PMC9890690 DOI: 10.1186/s12986-023-00727-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/21/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The risk of cardiovascular diseases has rapidly increased among middle-aged and elderly. However, little is known about the relationship of body composition changes with the risk of cardiovascular events among this population in China. We explored the associations of 2-year changes in fat percentage (fat%) and fat-free mass percentage (FFM%) with subsequent cardiovascular events in a middle-aged and elderly community-based cohort. METHODS This study included 1048 participants (456 men [43.51%], aged 50-80 years) without overt cardiovascular disease, who underwent two examinations during 2013-2014 and 2015-2016. All participants were followed up until 2022 for cardiovascular events. A bioelectrical impedance analyzer was used to calculate fat% and FFM% change. RESULTS At baseline, the median body mass index (BMI), fat%, and FFM% were 23.9 (22.1-25.9) kg/m2, 27.2 (20.8-33.6)%, and 72.8 (66.4-79.2)%, respectively. Two-year changes in fat% and FFM% were 0.31 (- 5.53 to 6.87)% and - 0.12 (- 2.36 to 2.06)%. During an average follow-up of 5.5 years, 86 cardiovascular events (8.21%) occurred. Cox regression models showed that hazard ratios (HRs) of every 2% change in fat% and FFM% for cardiovascular events were 1.04 (95% confidence interval [CI] 1.01-1.07) and 0.84 (95% CI 0.74-0.95), respectively. Compared with participants with stable fat% (-2% ≤ ⊿fat% < 2%), those with fat% gain ≥ 2% had an increased risk of cardiovascular events (HR 2.07, 95% CI 1.08-3.97). FFM% loss > 8% was associated with a higher risk of cardiovascular events (HR 3.83, 95% CI 1.29-11.4). CONCLUSIONS In a middle-aged and elderly community-based Chinese population, fat% gain or FFM% loss was associated with an increased risk of cardiovascular events.
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