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Clinical Research

A simple method of sarcopenia detection can predict adverse cardiovascular events in patients with abdominal obesity

International Journal of Obesity volume 45, pages 2214–2220 (2021)Cite this article

Subjects

Abstract

Background

Although sarcopenic obesity is associated with a higher risk of cardiovascular events compared with obesity without sarcopenia, it is difficult to diagnose sarcopenia in daily clinical settings. Recently, a simple scoring system has been developed to identify sarcopenia patients based on three variables (age, hand grip strength, and calf circumference). However, the utility of this score for cardiovascular risk stratification in patients with abdominal obesity is unknown.

Methods

We calculated the sarcopenia score in 262 patients with abdominal obesity, defined as a waist circumference ≥90 cm in women or ≥85 cm in men. The composite endpoint of this study was cardiovascular mortality, nonfatal myocardial infarction, stroke, unstable angina, and heart failure hospitalization.

Results

Of the 262 patients, 108 had a high sarcopenia score based on previously established criteria (≥105 in men and ≥120 in women). The patients with a high sarcopenia score had a significantly higher plasma level of B-type natriuretic peptide compared with those with a low sarcopenia score (median 56.7, interquartile range [28.2–142.9] vs. 37.9 [13.8–76.1] pg/mL; p < 0.0001). Kaplan–Meier curves revealed a significantly lower event-free survival rate in those with a high compared with a low sarcopenia score (log-rank test p = 0.001), even after adjustment for confounding factors using propensity score matching (log-rank test p = 0.009). Multivariate Cox proportional hazard analysis identified a high sarcopenia score (hazard ratio: 2.46; 95% confidence interval: 1.31–4.64, p = 0.005) as an independent predictor of the primary endpoints. The combination of a high sarcopenia score and low body mass index (<25 kg/m2) predicted a significantly higher risk of future adverse events (p = 0.005). Furthermore, patients with a high sarcopenia score and high B-type natriuretic peptide level (≥200 pg/mL) had the poorest prognosis (p < 0.0001).

Conclusions

This simple screening test for sarcopenia can predict future adverse cardiovascular events in patients with abdominal obesity.

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Fig. 1: Kaplan-Meier analysis of the probability of developing adverse cardiovascular events.
Fig. 2: Kaplan-Meier analysis of the probability of developing adverse cardiovascular events.
Fig. 3: Kaplan–Meier analysis of the probability of developing adverse cardiovascular events in patient subgroups stratified by sarcopenia score and B-type natriuretic peptide (BNP) level.

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Acknowledgements

This study was supported in part by a Grant-in-Aid for Young Scientists B (16K19412) to SH and a Grant-in-Aid for Scientific Research C (18K08110) to KT from the Ministry of Education, Science, and Culture.

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Author notes

  1. These authors contributed equally: Shinsuke Hanatani, Yasuhiro Izumiya.

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Shinsuke Hanatani, Yasuhiro Izumiya, Masahiro Yamamoto, Satoshi Araki, Koichiro Fujisue, Yuichiro Arima, Seiji Takashio, Eiichiro Yamamoto, Koichi Kaikita, Kenichi Matsushita & Kenichi Tsujita

  2. Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan

    Yasuhiro Izumiya

  3. International Research Center for Medical Sciences (IRCMS), Kumamoto University, Kumamoto, Japan

    Yuichiro Arima

  4. Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan

    Kenichi Tsujita

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  1. Shinsuke Hanatani
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Correspondence to Yasuhiro Izumiya.

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Hanatani, S., Izumiya, Y., Yamamoto, M. et al. A simple method of sarcopenia detection can predict adverse cardiovascular events in patients with abdominal obesity. Int J Obes 45, 2214–2220 (2021). https://doi.org/10.1038/s41366-021-00895-2

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