Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate
Abstract Background The influence of sarcopenic obesity (SO) on overall survival in older adults with hypertension has not been addressed. The aim of this study was to investigate the prevalence and mortality predictive value of various body composition phenotypes, focusing mainly on SO, in older ad...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-023-04326-x |
| _version_ | 1827708470840786944 |
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| author | Qiang Qu Qixin Guo Jinyu Sun Xinyi Lu Iokfai Cheang Xu Zhu Wenming Yao Xinli Li Haifeng Zhang Yanli Zhou Shengen Liao Rongrong Gao |
| author_facet | Qiang Qu Qixin Guo Jinyu Sun Xinyi Lu Iokfai Cheang Xu Zhu Wenming Yao Xinli Li Haifeng Zhang Yanli Zhou Shengen Liao Rongrong Gao |
| author_sort | Qiang Qu |
| collection | DOAJ |
| description | Abstract Background The influence of sarcopenic obesity (SO) on overall survival in older adults with hypertension has not been addressed. The aim of this study was to investigate the prevalence and mortality predictive value of various body composition phenotypes, focusing mainly on SO, in older adults with hypertension. Methods We included 1105 hypertensive patients aged ≥ 60 years from the National Health and Nutrition Examination Survey 1999–2004. Sarcopenia was broadly defined based on low lean mass (LLM; as measured by dual-energy X-ray absorptiometry), and was defined using appendicular lean mass (ALM) divided by height squared (ALM/height2), weight (ALM/weight), and body mass index (BMI; ALM/BMI), respectively. Obesity was defined as BMI ≥ 30 kg/m2, body fat percentage ≥ 30/42%, or waist circumference ≥ 102/88 cm. The prevalence of LLM with obesity was estimated according to each ALM index (ALMI). Multivariable Cox regression analysis and sensitivity analysis were used to examine the association between various body composition phenotypes and all-cause mortality. Results In older adults with hypertension, the prevalence of LLM with obesity by the ALM/height2 index (9.8%) was lower relative to the ALM/weight (11.7%) and ALM/BMI indexes (19.6%). After a median follow-up of 15.4 years, 642 deaths occurred. In the fully adjusted models, LLM with obesity was significantly associated with a higher risk of all-cause mortality (hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.14–2.49, P = 0.008; HR 1.48, 95% CI 1.04–2.10, P = 0.028; HR 1.30, 95% CI 1.02–1.66, P = 0.037; respectively) compared with the normal body phenotype, with no statistical differences found in individuals with LLM or obesity alone. Sensitivity analysis confirmed the robustness of the results. Conclusions The prevalence of LLM with obesity markedly differed in older adults with hypertension according to the 3 different ALMIs, varying from 9.8%, 11.7%, to 19.6%. Patients with both LLM and obesity had a higher risk of all-cause mortality. Further large, prospective, cohort studies are warranted to validate these findings and uncover underlying mechanisms. |
| first_indexed | 2024-03-10T17:05:05Z |
| format | Article |
| id | doaj.art-9615ba62aa074023a30f467b2c894bb9 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-03-10T17:05:05Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-9615ba62aa074023a30f467b2c894bb92023-11-20T10:50:49ZengBMCBMC Geriatrics1471-23182023-10-0123111410.1186/s12877-023-04326-xLow lean mass with obesity in older adults with hypertension: prevalence and association with mortality rateQiang Qu0Qixin Guo1Jinyu Sun2Xinyi Lu3Iokfai Cheang4Xu Zhu5Wenming Yao6Xinli Li7Haifeng Zhang8Yanli Zhou9Shengen Liao10Rongrong Gao11Department of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Cardiology, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityAbstract Background The influence of sarcopenic obesity (SO) on overall survival in older adults with hypertension has not been addressed. The aim of this study was to investigate the prevalence and mortality predictive value of various body composition phenotypes, focusing mainly on SO, in older adults with hypertension. Methods We included 1105 hypertensive patients aged ≥ 60 years from the National Health and Nutrition Examination Survey 1999–2004. Sarcopenia was broadly defined based on low lean mass (LLM; as measured by dual-energy X-ray absorptiometry), and was defined using appendicular lean mass (ALM) divided by height squared (ALM/height2), weight (ALM/weight), and body mass index (BMI; ALM/BMI), respectively. Obesity was defined as BMI ≥ 30 kg/m2, body fat percentage ≥ 30/42%, or waist circumference ≥ 102/88 cm. The prevalence of LLM with obesity was estimated according to each ALM index (ALMI). Multivariable Cox regression analysis and sensitivity analysis were used to examine the association between various body composition phenotypes and all-cause mortality. Results In older adults with hypertension, the prevalence of LLM with obesity by the ALM/height2 index (9.8%) was lower relative to the ALM/weight (11.7%) and ALM/BMI indexes (19.6%). After a median follow-up of 15.4 years, 642 deaths occurred. In the fully adjusted models, LLM with obesity was significantly associated with a higher risk of all-cause mortality (hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.14–2.49, P = 0.008; HR 1.48, 95% CI 1.04–2.10, P = 0.028; HR 1.30, 95% CI 1.02–1.66, P = 0.037; respectively) compared with the normal body phenotype, with no statistical differences found in individuals with LLM or obesity alone. Sensitivity analysis confirmed the robustness of the results. Conclusions The prevalence of LLM with obesity markedly differed in older adults with hypertension according to the 3 different ALMIs, varying from 9.8%, 11.7%, to 19.6%. Patients with both LLM and obesity had a higher risk of all-cause mortality. Further large, prospective, cohort studies are warranted to validate these findings and uncover underlying mechanisms.https://doi.org/10.1186/s12877-023-04326-xProspective studyOlder adultsSarcopeniaLow lean massAppendicular lean mass indexObesity |
| spellingShingle | Qiang Qu Qixin Guo Jinyu Sun Xinyi Lu Iokfai Cheang Xu Zhu Wenming Yao Xinli Li Haifeng Zhang Yanli Zhou Shengen Liao Rongrong Gao Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate BMC Geriatrics Prospective study Older adults Sarcopenia Low lean mass Appendicular lean mass index Obesity |
| title | Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate |
| title_full | Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate |
| title_fullStr | Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate |
| title_full_unstemmed | Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate |
| title_short | Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate |
| title_sort | low lean mass with obesity in older adults with hypertension prevalence and association with mortality rate |
| topic | Prospective study Older adults Sarcopenia Low lean mass Appendicular lean mass index Obesity |
| url | https://doi.org/10.1186/s12877-023-04326-x |
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