Decreased muscle mass and increased central adiposity are independently related to mortality in older men

Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, United Kingdom.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 11/2007; 86(5):1339-46.
Source: PubMed


Aging is associated with significant changes in body composition. Body mass index (BMI; in kg/m(2)) is not an accurate indicator of overweight and obesity in the elderly.
We examined the relation between other anthropometric indexes of body composition (both muscle mass and body fat) and all-cause mortality in men aged 60-79 y.
The study was a prospective study of 4107 men aged 60-79 y with no diagnosis of heart failure and who were followed for a mean period of 6 y, during which time there were 713 deaths.
Underweight men (BMI < 18.5) had exceptionally high mortality rates. After the exclusion of these men, increased adiposity [BMI, waist circumference (WC), and waist-to-hip ratio] showed little relation with mortality after adjustment for lifestyle characteristics. Muscle mass [indicated by midarm muscle circumference (MAMC)] was significantly and inversely associated with mortality. After adjustment for MAMC, obesity markers, particularly high WC (>102 cm) and waist-to-hip ratio (top quartile), were associated with increased mortality. A composite measure of MAMC and WC most effectively predicted mortality. Men with low WC (</=102 cm) and above-median muscle mass showed the lowest mortality risk. Men with WC > 102 cm and above-median muscle mass showed significantly increased mortality [age-adjusted relative risk: 1.36; 95% CI: 1.07, 1.74), and this increased to 1.55 (95% CI: 1.01, 2.39) in those with WC > 102 and low MAMC.
The findings suggest that the combined use of both WC and MAMC provides simple measures of body composition to assess mortality risk in older men.

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    Diabetology and Metabolic Syndrome 02/2014; 6(1):27. DOI:10.1186/1758-5996-6-27 · 2.17 Impact Factor
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    • "However few population studies to date have examined the possible role of lean muscle mass, adipokines (leptin , adiponectin) and NT-proBNP in explaining the obesity paradox, although previous studies suggest that NT-proBNP and adiponectin may explain the obesity paradox in HF [18,21]. In a previous report, we observed a positive association between BMI and mortality in older adults without HF once muscle mass had been taken into account [13]. However , the association of BMI and mortality in men with CHD or HF has not been specifically examined. "
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    International journal of cardiology 11/2013; 171(1). DOI:10.1016/j.ijcard.2013.11.043 · 4.04 Impact Factor
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    • "However, in other studies, the r2 values between BMI and muscle mass were not so high (r2 = 0.22 to 0.40) [10,12,13]. The reasons for these lower r2 values are unknown, but it might be due to the fact that the previous studies used muscle girth or area estimated from the anthropometric data of the upper arm [10,13] or the upper arm and calf [12]. "
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