Article

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: 6.92). 11/2007; 86(5):1339-46.
Source: PubMed

ABSTRACT 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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    • "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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    ABSTRACT: We have investigated the role of muscle mass, natriuretic peptides and adipokines in explaining the obesity paradox. The obesity paradox relates to the association between obesity and increased survival in patients with coronary heart disease (CHD) or heart failure (HF). Prospective study of 4046 men aged 60-79years followed up for a mean period of 11years, during which 1340 deaths occurred. The men were divided according to the presence of doctor diagnosed CHD and HF: (i) no CHD or HF ii), with CHD (no HF) and (iii) with HF. Overweight (BMI 25-9.9kg/m(2)) and obesity (BMI≥30kg/m(2)) were associated with lower mortality risk compared to men with normal weight (BMI 18.5-24.9kg/m(2)) in those with CHD [hazards ratio (HR) 0.71 (0.56,0.91) and 0.77 (0.57,1.04); p=0.04 for trend] and in those with HF [HR 0.57 (0.28,1.16) and 0.41 (0.16,1.09; p=0.04 for trend). Adjustment for muscle mass and NT-proBNP attenuated the inverse association in those with CHD (no HF) [HR 0.78 (0.61,1.01) and 0.96 (0.68,1.36) p=0.60 for trend) but made minor differences to those with HF [p=0.05]. Leptin related positively to mortality in men without HF but inversely to mortality in those with HF; adjustment for leptin abolished the BMI mortality association in men with HF [HR 0.82 (0.31,2.20) and 0.99 (0.27,3.71); p=0.98 for trend]. The lower mortality risk associated with excess weight in men with CHD without HF may be due to higher muscle mass. In men with HF, leptin (possibly reflecting cachexia) explain the inverse association.
    International journal of cardiology 11/2013; 171(1). DOI:10.1016/j.ijcard.2013.11.043 · 6.18 Impact Factor
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    • "Existe también una asociación entre la pérdida de masa muscular en la vejez y la disminución de las expectativas de vida (Wannamethee et al., 2007; Szulc, 2010). Un reciente estudio demuestra que la masa muscular de las extremidades es un mejor predictor de salud que el IMC (Wijnhoven, 2010). "
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    ABSTRACT: Las ecuaciones antropométricas para estimar la masa muscular, permiten obtener los valores de sólo la masa muscular total (MM total). En un reciente trabajo (Rodríguez et al., 2010), propone una ecuación para la estimación de la masa muscular de los miembros superiores e inferiores. Se evalúan 68 sujetos, estudiantes de educación física, rugbistas, futbolistas y gimnastas. El grupo de rugbistas presenta mayor cantidad de masa muscular en los miembros superiores (MMES) que el resto de los grupos. La MM total y la Masa muscular de los miembros inferiores (MMEI) son significativamente más altas en los rugbistas y futbolistas en comparación a los otros sujetos. La distribución de la masa muscular por regiones corporales es distinta entre las disciplinas deportivas, ya que los requerimientos musculares difieren de uno a otro, volviéndose cada deportista, especialista en su área de desarrollo motriz. La MMEI representa más de mitad de la MM total, por lo tanto a mayor MMEI, mayor MM total.
    International Journal of Morphology 01/2012; 30(1):7-14. · 0.20 Impact Factor
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    • "Such information results significant for advanced adults, where the high muscle mass plays an important role (Wannamethee et al., 2007; Szulc et al., 2010), acknowledging some physical activities develop a distinct muscle mass distribution. In this group the muscle mass of the lower extremities represents more than half of the total muscle mass, so sports promoting the development this muscles, such as running, soccer or cycling (Knechtle et al., 2007) may result advantageous and more efficient to prevent sarcopenia compared to other sports that involve a higher muscle mass development of the upper limbs or trunk, like swimming or rowing, for example (Andreoli et al., 2001). "
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    International Journal of Morphology 01/2012; 30(2):550-556. · 0.20 Impact Factor
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