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Table 1. General Characteristics of the Study Participants at Baseline by Exposure Status... Table 2. Characteristics of Overall Cardiovascular Disease... Table 3. Characteristics of Each Cardiovascular Disease... Table 4. Risks of Cardiovascular Diseases Related to Exposure by Each Model... Table 5. Estimates of Sarcopenic Obesity and Covariates for CVD in Model 3... Table 6. Association of Sarcopenia, Obesity, and Sarcopenic Obesity with CVD in the Male... Table 7. Association of Sarcopenia, Obesity, and Sarcopenic Obesity with CVD in the Female... Table 8. Association of Sarcopenia, Obesity, and Sarcopenic Obesity with CVD in the Middle-aged Group (40-59)... Table 9. Association of Sarcopenia, Obesity, and Sarcopenic Obesity with CVD in the Older Group (60-69)... VII
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IRB No. E1608/002-003).
Table 1. General Characteristics of the Study Participants at Baseline by Exposure Status Characteristics Normal Sarcopenia Obesity Sarcopenic Obesity N=2790 N=2798 N=3869 N=238 (28.8%) (28.9%) (40.0%) (2.3%) P-value Sociodemographic Factor Female, n (%) 1337 (47.9) 1440 (51.5) 2200 (56.7) 132 (58.4) <.0001 Age, mean SD 52.0 9.0 52.2 ± 9.3 51.7 ± 8.4 56.7 ± 8.4 <.0001 Age group, n (%) 40-44 779 (27.9) 817 (29.2) 1003 (25.8) 24 (10.6) 45-49 574 (20.6) 525 (18.8) 893 (23.0) 33 (14.6) 50-54 365 (13.1) 339 (12.1) 542 (14.0) 32 (14.2) 55-59 333 (11.9) 324 (11.6) 548 (14.1) 35 (15.5) 60-64 175 (13.4) 379 (13.6) 509 (13.1) 50 (20.1) 65-69 364 (13.1) 414 (14.8) 386 (10.0) 52 (23.0) <.0001 Spouse, n (%) Yes 2502 (90.4) 2501 (90.0) 3446 (89.3) 189 (86.7).2222 Education, n (%) <6 y 919 (33.3) 855 (30.8) 1343 (34.9) 83 (37.2) 6 y, <12 y 1517 (55.0) 1528 (55.0) 1991 (51.7) 109 (48.9).001 12 y 322 (11.7) 397 (14.3) 520 (13.5) 31 (13.9) Income, n (%) Low 1041 (38.0) 947 (34.4) 1284 (33.7) 73 (33.8) Middle 1270 (46.4) 1324 (48.1) 1814 (47.6) 104 (48.2) High 427 (15.6) 483 (17.5) 714 (18.7) 39 (18.1).0037 Behavioral Factor Drinker, n (%) None 1331 (47.7) 1500 (53.6) 2079 (53.6) 134 (59.3) Moderate 1120 (40.1) 1027 (36.7) 1399 (36.1) 72 (31.9) Heavy 339 (12.2) 271 (9.7) 403 (10.4) 20 (8.9) Smoker, n (%) None 1484 (53.2) 1607 (57.4) 2399 (61.8) 141 (62.4) Physical Activity, n (%) Light 358 (12.8) 312 (11.2) 449 (11.6) 17 (7.5) Moderate 775 (27.8) 745 (26.6) 856 (22.1) 47 (21.0) Heavy 173 (6.2) 134 (4.8) 177 (4.6) 21 (9.3) None 43 (1.6) 48 (1.8) 72 (1.9) 8 (3.7) Low 712 (26.7) 1008 (37.4) 1248 (33.4) 87 (40.1) Moderate 1184 (44.3) 1134 (42.1) 1564 (42.6) 82 (37.8) High 731 (27.4) 507 (18.8) 828 (22.1) 40 (18.4) <.0001 <.0001 <.0001
Table 1. General Characteristics of the Study Participants at Baseline by Exposure Status Characteristics Risk Factors for Cardiovascular Disease Normal Sarcopenia Obesity Sarcopenic Obesity N=2790 N=2798 N=3869 N=238 (28.8%) (28.9%) (40.0%) (2.3%) P-value Hypertension, n (%) 290 (10.4) 253 (9.0) 821 (21.2) 42 (18.6) <.0001 Diabetes, n (%) 164 (5.9) 159 (5.7) 294 (7.6) 15 (6.6).0196 Kidney Disease, n (%) 75 (2.7) 69 (2.5) 110 (2.8) 7 (3.1).8043 Family History Hypertension, n (%) 454 (16.3) 476 (17.0) 848 (21.9) 33 (14.6) <.0001 Diabetes, n (%) 309 (11.1) 294 (10.5) 486 (12.5) 26 (11.5).066 Heart Disease, n (%) 126 (4.5) 125 (4.5) 179 (4.6) 8 (3.5).897 CRP (mg/dl), mean±sd Total Cholesterol (mg/dl), mean±sd HDL (mg/dl), mean±sd LDL (mg/dl), mean±sd Triglyceride (mg/dl), mean±sd 0.23 ± 0.72 185.0 ± 34.4 45.5 ± 10.2 113.5 ± 33.7 149.6 ± 97.1 0.22 ± 0.49 0.25 ± 0.38 0.28 ± 0.36.0004 187.8 ± 36.1 197.2 ± 35.6 200.1 ± 36.5 <.0001 47.2 ± 10.6 42.3 ± 9.0 44.4 ± 10.3 <.0001 115.9 ± 34.3 142.6 ± 86.3 122.8 ± 34.9 184.2 ± 116.8 125.0 ± 35.6 <.0001 179.8 ± 115.0.0006 Physical Variable BMI, mean±sd 23.1 ± 1.6 21.8 ± 1.8 27.5 ± 2.1 25.9 ± 0.8.0003 FFMI, mean±sd 18.2 ± 1.2 16.4 ± 1.2 19.0 ± 1.5 16.9 ± 1.1 <.0001 SD = Standard Deviation; CRP = C-Reactive Protein; HDL = High-density Lipoprotein; LDL = Low-density Lipoprotein; BMI = Body Mass Index; FFMI = Fat-free Mass Index
Prevalence of Sarcopenia, Obesity, and Sardopenic Obesity (per 1000 person-year) 50.00 45.00 40.00 35.00 30.00 25.00 20.00 15.00 10.00 5.00 0.00 0 2 4 6 8 10 Follow-up year 100.0 80.0 60.0 40.0 20.0 0.0 Attrition Rate (%) Normal Sarcopenia Obesity Sarcopenic Obesity Attrition (%)
25.00 Prevalence of CVD (per 10000 person-year) 20.00 15.00 10.00 5.00 0.00 1 2 3 4 5 6 7 8 9 10 Follow-up year Overall CVD (n=229) MI (n=40) CeVD (n=94) CHF (n=5) CAD (n=98)
Table 4. Risks of Cardiovascular Diseases Related to Exposure by Each Model Model 1 Model 2 Model 3 Cardiovascular Disease (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic 0.71 (0.53-0.96)* 0.68 (0.50-0.92)* 0.72 (0.53-0.98)* Obese 1.57 (1.21-2.04)* 1.61 (1.23-2.11)* 1.46 (1.11-1.93)* Sarcopenic-Obese 1.06 (0.44-2.58) 1.12 (0.46-2.72) 1.04 (0.43-2.52) Congestive Heart Disease (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic 0.53 (0.06-4.82) 0.46 (0.05-4.67) 0.45 (0.04-4.88) Obese 5.67 (0.63-51.1) 6.40 (0.68-60.7) 6.75 (0.65-70.3) Sarcopenic-Obese - - - Myocardial Infarction (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic 0.73 (0.36-1.48) 0.65 (0.31-1.35) 0.70 (0.33-1.46) Obese 2.21 (1.17-4.19)* 2.60 (1.33-5.06)* 2.42 (1.22-4.79)* Sarcopenic-Obese 4.11 (1.25-13.45)* 4.08 (1.24-13.46)* 3.86 (1.16-12.8)* Coronary Artery Disease (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic 0.64 (0.41-1.02) 0.60 (0.37-0.97)* 0.67 (0.41-1.09) Obese 1.34 (0.89-2.02) 1.43 (0.94-2.17) 1.21 (0.79-1.85) Sarcopenic-Obese 0.48 (0.07-3.45) 0.52 (0.07-3.71) 0.46 (0.06-3.32) Cerebrovascular Disease (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic 0.87 (0.56-1.35) 0.89 (0.57-1.39) 0.93 (0.59-1.46) Obese 1.41 (0.94-2.12) 1.35 (0.89-2.05) 1.25 (0.81-1.92) Sarcopenic-Obese 0.48 (0.07-3.46) 0.50 (0.07-3.62) 0.43 (0.06-3.14) Results are reported as hazard ratio (95% confidence interval). *p<0.05 vs referent group. Model 1 : adjusted for age, sex, education level, marital status, and income. Model 2 : same as Model 1 + behavioral factors including alcohol, smoking, and physical activity. Model 3 : same as Model 2 + cardiovascular risk factors including hypertension, diabetes, kidney disease, CRP, total cholesterol, HDL, LDL, triglycerides and family history.
Table 8. Association of Sarcopenia, Obesity, and Sarcopenic Obesity with CVD in the Middle-aged Group (40-59) Model 1 Model 2 Model 3 Overall Cardiovascular Disease (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic 0.84 (0.58-1.21) 0.78 (0.53-1.14) 0.83 (0.57-1.22) Obese 1.30 (0.93-1.79) 1.31 (0.94-1.83) 1.16 (0.83-1.63) Sarcopenic obese 0.93 (0.23-3.76) 0.92 (0.23-3.73) 0.87 (0.21-3.51) Congestive Heart Failure (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic 0.85 (0.09-8.42) 1.03 (0.10-10.43) 1.23 (0.11-13.27) Obese 4.02 (0.41-39.57) 3.91 (0.39-38.93) 3.04 (0.28-33.17) Sarcopenic obese - - - Myocardial Infarction (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic 0.40 (0.14-1.17) 0.30 (0.09-0.99)* 0.30 (0.09-1.02) Obese 2.04 (0.94-4.40) 2.55 (1.12-5.80)* 2.47 (1.07-5.71)* Sarcopenic obese 2.73 (0.37-20.27) 2.73 (0.36-20.67) 2.63 (0.35-20.00) Coronary Artery Disease (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic 0.86 (0.47-1.55) 0.84 (0.47-1.53) 0.93 (0.51-1.70) Obese 1.00 (0.59-1.70) 0.97 (0.56-1.66) 0.80 (0.46-1.39) Sarcopenic obese 1.20 (0.17-8.67) 1.19 (0.16-8.66) 1.15 (0.16-8.37) Cerebrovascular Disease (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic 1.13 (0.66-1.93) 1.07 (0.62-1.85) 1.11 (0.64-1.93) Obese 1.16 (0.70-1.93) 1.19 (0.71-1.99) 1.12 (0.66-1.89) Sarcopenic obese - - - CVD: Cardiovascular disease Results are reported as hazard ratio (95% confidence interval). *p<0.05 vs referent group. Model 1 : adjusted for age, sex, education level, marital status, and income. Model 2 : same as Model 1 + behavioral factors including alcohol, smoking, and physical activity. Model 3 : same as Model 2 + cardiovascular risk factors including hypertension, diabetes, kidney disease, CRP, total cholesterol, HDL, LDL, triglycerides and family history.
Table 9. Association of Sarcopenia, Obesity, and Sarcopenic Obesity with CVD in the Older Group (60-69) Model 1 Model 2 Model 3 Overall Cardiovascular Disease (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic 0.58 (0.36-0.93)* 0.51 (0.34-0.92)* 0.56 (0.34-0.94)* Obese 2.15 (1.38-3.36)* 2.31 (1.45-3.68)* 2.22 (1.37-3.59)* Sarcopenic obese 1.22 (0.38-3.86) 1.43 (0.45-4.57) 1.21 (0.37-3.92) Congestive Heart Failure (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic - - - Obese - - - Sarcopenic obese - - - Myocardial Infarction (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic 2.12 (0.70-6.45) 2.04 (0.67-6.24) 2.46 (0.77-7.80) Obese 2.09 (0.67-6.51) 2.10 (0.67-6.58) 1.91 (0.58-6.32) Sarcopenic obese 5.99 (1.31-27.51)* 5.44 (1.17-25.31)* 5.61 (1.16-27.08)* Coronary Artery Disease (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic 0.44 (0.21-0.93)* 0.36 (0.16-0.81)* 0.38 (0.17-0.87)* Obese 2.04 (1.07-3.92)* 2.64 (1.33-5.25)* 2.49 (1.21-5.12)* Sarcopenic obese - - - Cerebrovascular Disease (HR) Normal 1.00 (REF) 1.00 (REF) 1.00 (REF) Sarcopenic 0.57 (0.27-1.19) 0.63 (0.29-1.35) 0.64 (0.29-1.39) Obese 2.00 (0.99-4.02) 1.77 (0.85-3.68) 1.72 (0.80-3.70) Sarcopenic obese 0.95 (0.13-6.93) 1.10 (0.15-8.13) 0.86 (0.11-6.67) CVD: Cardiovascular disease Results are reported as hazard ratio (95% confidence interval). *p<0.05 vs referent group. Model 1 : adjusted for age, sex, education level, marital status, and income. Model 2 : same as Model 1 + behavioral factors including alcohol, smoking, and physical activity. Model 3 : same as Model 2 + cardiovascular risk factors including hypertension, diabetes, kidney disease, CRP, total cholesterol, HDL, LDL, triglycerides and family history.
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