Associations of Skeletal Muscle Mass and Fat Mass With Incident Cardiovascular Disease and All-Cause Mortality: A Prospective Cohort Study of UK Biobank Participants.
Associations of Skeletal Muscle Mass and Fat Mass With Incident Cardiovascular Disease and All-Cause Mortality: A Prospective Cohort Study of UK Biobank Participants.
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骨骼肌质量和脂肪质量与心血管疾病和全因死亡率的关联：英国生物银行参与者的前瞻性队列研究。
DOI：
10.1161/jaha.120.019337
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发表时间：
2021-05-04
影响因子：
5.4
通讯作者：
Piernas C
中科院分区：
文献类型：
--
作者：
Knowles R;Carter J;Jebb SA;Bennett D;Lewington S;Piernas C
关于体重指数是否能很好地预测健康结果还存在争议，因为不同的组织，即骨骼肌质量(SMM)和脂肪质量(FM)，可能与风险有不同的关联。我们调查了阑尾SMM(ASMM)和FM与致命性和非致命性心血管疾病(CVD)和全因死亡率的关系。我们比较了它们与体重指数的预后价值。我们研究了356至590名年龄在40岁至69岁之间的英国Biobank参与者，使用全身FM的生物阻抗分析数据并预测肢体肌肉质量(以计算aSMM)。使用多变量COX比例风险模型检验aSMM和FM与心血管疾病和全因死亡率的关系。在3,749/501人年的随访中，共发生27,784例心血管事件，15,844例全因死亡。在男性中，aSMM与心血管疾病发病率呈正相关(每1 SD的风险比[HR]为1.07；95%可信区间为1.06-1.09)，而女性则呈曲线相关。男性和女性的FM与CVD呈较强的正相关，每标准差HRs分别为1.20(95%CI，1.19~1.22)和1.25(95%CI，1.23~1.27)。在FM三联体中，aSMM和心血管疾病风险之间的关联基本上持续存在。无论男女，aSMM和FM与全因死亡率呈J型相关。体重指数在区分心血管疾病风险方面略好一些。Fm与心血管疾病风险呈显著正相关。ASMM与CVD风险的关系在性别上存在差异，潜在的机制有待进一步研究。在预测人群水平的心血管疾病发病率或全因死亡率方面，体脂和SMM生物阻抗测量并不优于体重指数。
There is debate whether body mass index is a good predictor of health outcomes because different tissues, namely skeletal muscle mass (SMM) and fat mass (FM), may be differentially associated with risk. We investigated the association of appendicular SMM (aSMM) and FM with fatal and nonfatal cardiovascular disease (CVD) and all‐cause mortality. We compared their prognostic value to that of body mass index. We studied 356 590 UK Biobank participants aged 40 to 69 years with bioimpedance analysis data for whole‐body FM and predicted limb muscle mass (to calculate aSMM). Associations between aSMM and FM with CVD and all‐cause mortality were examined using multivariable Cox proportional hazards models. Over 3 749 501 person‐years of follow‐up, there were 27 784 CVD events and 15 844 all‐cause deaths. In men, aSMM was positively associated with CVD incidence (hazard ratio [HR] per 1 SD 1.07; 95% CI, 1.06–1.09) and there was a curvilinear association in women. There were stronger positive associations between FM and CVD with HRs per SD of 1.20 (95% CI, 1.19–1.22) and 1.25 (95% CI, 1.23–1.27) in men and women respectively. Within FM tertiles, the associations between aSMM and CVD risk largely persisted. There were J‐shaped associations between aSMM and FM with all‐cause mortality in both sexes. Body mass index was modestly better at discriminating CVD risk. FM showed a strong positive association with CVD risk. The relationship of aSMM with CVD risk differed between sexes, and potential mechanisms need further investigation. Body fat and SMM bioimpedance measurements were not superior to body mass index in predicting population‐level CVD incidence or all‐cause mortality.