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BMC Geriatrics
Published in: BMC Geriatrics 1/2023

Open Access 01-12-2023 | Obesity | Research

Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate

Authors: Qiang Qu, Qixin Guo, Jinyu Sun, Xinyi Lu, Iokfai Cheang, Xu Zhu, Wenming Yao, Xinli Li, Haifeng Zhang, Yanli Zhou, Shengen Liao, Rongrong Gao

Published in: BMC Geriatrics | Issue 1/2023

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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.
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Metadata
Title
Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate
Authors
Qiang Qu
Qixin Guo
Jinyu Sun
Xinyi Lu
Iokfai Cheang
Xu Zhu
Wenming Yao
Xinli Li
Haifeng Zhang
Yanli Zhou
Shengen Liao
Rongrong Gao
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2023
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-023-04326-x

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