DOI QR코드

DOI QR Code

Sarcopenia and Sarcopenic Obesity and Their Association with Cardiovascular Disease Risk in Postmenopausal Women : Results for the 2008-2011 Korea National Health and Nutrition Examination Survey

폐경 여성의 근감소증 및 근감소성비만과 심혈관질환 위험도와의 관련성 연구: 국민건강영양조사(2008-2011) 자료를 활용하여

  • Kim, Misung (Department of Food and Nutrition, Wonkwang University) ;
  • Sohn, Cheongmin (Department of Food and Nutrition, Wonkwang University)
  • 김미성 (원광대학교 식품영양학과) ;
  • 손정민 (원광대학교 식품영양학과)
  • Received : 2016.08.01
  • Accepted : 2016.08.25
  • Published : 2016.08.30

Abstract

Objectives: This study was conducted to investigate the association between sarcopenia and sarcopenic obesity and cardiovascular disease risk in Korean postmenopausal women. Methods: We analyzed data of 2,019 postmenopausal women aged 50-64 years who participated in the Korea National Health and Nutrition Examination Survey in 2008-2011 and were free of cardiovascular disease history. Blood pressure, height, and weight were measured. We analyzed the serum concentrations of glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglyceride levels. Waist circumference was used to measure obesity. Appendicular skeletal muscle mass was measured by dual-energy X-ray absorptiometry. Sarcopenia was defined as the appendicular skeletal muscle mass/body weight<1 standard deviation below the gender-specific means for healthy young adults. The estimated 10-year risk of cardiovascular disease risk was calculated by Pooled Cohort Equation. Subjects were classified as non-sarcopenia, sarcopenia, or sarcopenic obesity based on status of waist circumference and appendicular skeletal muscle mass. Results: The prevalence of sarcopenia and sarcopenic obesity was 16.3% (n=317) and 18.3% (n=369), respectively. The 10-year risk of cardiovascular disease risk in the sarcopenic obesity group was higher ($3.82{\pm}0.22%$) than the normal group ($2.73{\pm}0.09%$) and sarcopenia group ($3.17{\pm}0.22%$) (p < 0.000). The odd ratios (ORs) for the ${\geq}7.5%$ 10-year risk of cardiovascular disease risk were significantly higher in the sarcopenic obesity group (OR 3.609, 95% CI: 2.030-6.417) compared to the sarcopenia group (OR 2.799, 95% CI: 1.463-5.352) (p for trend < 0.000) after adjusting for independent variables (i.e., exercise, period of menopausal, alcohol use disorders identification test (AUDIT) score, income, education level, calorie intake, %fat intake and hormonal replacement therapy). Conclusions: Sarcopenia and sarcopenic obesity appear to be associated with higher risk factors predicting the 10-year risks of cardiovascular disease risk in postmenopausal women. These findings imply that maintaining normal weight and muscle mass may be important for cardiovascular disease risk prevention in postmenopausal women.

Keywords

References

  1. Sipila S, Narici M, Kjaer M, Pollanen E, Atkinson RA, Hansen M et al. Sex hormones and skeletal muscle weakness. Biogerontology 2013; 14(3): 231-245. https://doi.org/10.1007/s10522-013-9425-8
  2. Zamboni M, Mazzali G, Zoico E, Harris TB, Meigs JB, Di Francesco V et al. Health consequences of obesity in the elderly: a review of four unresolved questions. Int J Obes (Lond) 2005; 29(9): 1011-1029. https://doi.org/10.1038/sj.ijo.0803005
  3. Czarkowska-Paczek B, Milczarczyk S. Age-related muscle mass loss. Przegl Lek 2006; 63(8): 658-661.
  4. Rosenberg IH. Sarcopenia: origins and clinical relevance. J Nutr 1997; 127(5 Suppl): 990s-991s. https://doi.org/10.1093/jn/127.5.990S
  5. Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 1998; 147(8): 755-763. https://doi.org/10.1093/oxfordjournals.aje.a009520
  6. Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 2002; 50(5): 889- 896. https://doi.org/10.1046/j.1532-5415.2002.50216.x
  7. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European working group on sarcopenia in older people. Age Ageing 2010; 39(4): 412-423. https://doi.org/10.1093/ageing/afq034
  8. Zamboni M, Mazzali G, Fantin F, Rossi A, Di Francesco V. Sarcopenic obesity: a new category of obesity in the elderly. Nutr Metab Cardiovasc Dis 2008;18(5): 388-395. https://doi.org/10.1016/j.numecd.2007.10.002
  9. Visser M, Pahor M, Taaffe DR, Goodpaster BH, Simonsick EM, Newman AB et al. Relationship of interleukin-6 and tumor necrosis factor-alpha with muscle mass and muscle strength in elderly men and women: the Health ABC Study. J Gerontol A Biol Sci Med Sci 2002; 57(5): M326-M332. https://doi.org/10.1093/gerona/57.5.M326
  10. Schaap LA, Pluijm SM, Deeg DJ, Visser M. Inflammatory markers and loss of muscle mass (sarcopenia) and strength. Am J Med. 2006; 119(6): 526.e9-17. https://doi.org/10.1016/j.amjmed.2005.10.049
  11. Stone NJ, Robinson JG, Lichtenstein AH, Merz CNB, Blum CB, Eckel RH et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American college of cardiology/American heart association task force on practice guidelines. Circulation. 2014; 129(25 Suppl 2): S1-45. https://doi.org/10.1161/01.cir.0000437738.63853.7a
  12. Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ et al. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract 2007; 75(1): 72-80. https://doi.org/10.1016/j.diabres.2006.04.013
  13. Andrus B, Lacaille D. 2013 ACC/AHA guideline on the assessment of cardiovascular risk. J Am Coll Cardiol 2014; 63(25_PA): 2886.
  14. Kim JH, Hwangbo Y, Hong ES, Ohn JH, Kim CH, Kim HW et al. Investigation of sarcopenia and its association with cardiometabolic risk factors in elderly subjects. J Korean Geriatr Soc 2010; 14(3): 121-130. https://doi.org/10.4235/jkgs.2010.14.3.121
  15. Cheng Q, Zhu X, Zhang X, Li H, Du Y, Hong W et al. A crosssectional study of loss of muscle mass corresponding to sarcopenia in healthy Chinese men and women: reference values, prevalence, and association with bone mass. J Bone Miner Metab 2014; 32(1): 78-88. https://doi.org/10.1007/s00774-013-0468-3
  16. Chin SO, Rhee SY, Chon S, Hwang YC, Jeong IK, Oh S et al. Sarcopenia is independently associated with cardiovascular disease in older Korean adults: the Korea National Health and Nutrition Examination Survey (KNHANES) from 2009. PLoS One 2013; 8(3): e60119. https://doi.org/10.1371/journal.pone.0060119
  17. Kim JH, Cho JJ, Park YS. Relationship between sarcopenic obesity and cardiovascular disease risk as estimated by the Framingham risk score. J Korean Med Sci 2015; 30(3): 264-271. https://doi.org/10.3346/jkms.2015.30.3.264
  18. Hwang B, Lim JY, Lee J, Choi NK, Ahn YO, Park BJ. Prevalence rate and associated factors of sarcopenic obesity in Korean elderly population. J Korean Med Sci 2012; 27(7): 748-755. https://doi.org/10.3346/jkms.2012.27.7.748
  19. Park S, Ham JO, Lee BK. A positive association between stroke risk and sarcopenia in men aged ${\geq}$50 years, but not women: Results from the Korean National Health and Nutrition Examination Survey 2008-2010. J Nutr Health Aging 2014; 18(9): 806-812. https://doi.org/10.1007/s12603-014-0553-x
  20. Roubenoff R. Sarcopenic obesity: does muscle loss cause fat gain? Lessons from rheumatoid arthritis and osteoarthritis. Ann N Y Acad Sci 2000; 904: 553-557.
  21. Jensen GL. Inflammation: roles in aging and sarcopenia. J Parenter Enteral Nutr 2008; 32(6): 656-659. https://doi.org/10.1177/0148607108324585
  22. Choi CS. Pathogenesis of insulin resistance. Korean J Med 2009; 77(2): 171-177.
  23. Walsh K. Adipokines, myokines and cardiovascular disease. Circ J 2009; 73(1): 13-18. https://doi.org/10.1253/circj.CJ-08-0961
  24. Lee JS, Auyeung TW, Kwok T, Lau EM, Leung PC, Woo J. Associated factors and health impact of sarcopenia in older Chinese men and women: a cross-sectional study. Gerontology 2007; 53(6): 404-410. https://doi.org/10.1159/000107355
  25. Lee K. 10-year risk for atherosclerotic cardiovascular disease and coronary heart disease among Korean adults: findings from the Korean National Health and Nutrition Examination Survey 2009- 2010. Int J Cardiol 2014; 176(2): 418-422. https://doi.org/10.1016/j.ijcard.2014.07.101
  26. Kim KM, Park SK, Kim DH, Shin SG. The relationship between serum ferritin level and cardiovascular disease risk calculated by atherosclerotic cardio vascular disease risk estimator in middleaged men in Korea. Korean J Fam Pract 2016; 6(2): 79-83. https://doi.org/10.21215/kjfp.2016.6.2.79

Cited by

  1. 폐경 중년여성에서 심혈관질환 위험 유무에 따른 신체활동, 중심비만 및 우울이 삶의 질에 미치는 영향: 이차 자료분석 vol.29, pp.4, 2016, https://doi.org/10.7475/kjan.2017.29.4.382
  2. 근육건강에 대한 일반적 특성에 따른 인식, 태도 및 지식의 차이 vol.21, pp.2, 2016, https://doi.org/10.7586/jkbns.2019.21.2.152
  3. Association among the Prevalence of Sarcopenia without Obesity, Nonsarcopenic Obesity, Sarcopenic Obesity, and Metabolic Syndrome in Cancer Survivors: Based on Korea National Health and Nutrition Exam vol.8, pp.6, 2016, https://doi.org/10.4103/apjon.apjon-2116
  4. 폐경 전·후 성인 여성에서 근감소증과 관련된 식생활 요인 및 대사성 질환 위험도: 국민건강영양조사(2009-2011) 자료를 활용하여 vol.36, pp.4, 2016, https://doi.org/10.7318/kjfc/2021.36.4.401