Zhongguo quanke yixue (Dec 2022)
Prevalence and Influencing Factors of Sarcopenia in Essential Hypertension
Abstract
Background The prevalence of sarcopenia is rising along with global population aging, and it is estimated that there will be about 200 million sarcopenia patients worldwide by the mid-21st century. Both essential hypertension and sarcopenia are common in the elderly, but the correlation between them has been rarely studied in China. Objective To examine the prevalence and risk factors of sarcopenia in middle-aged and elderly patients with essential hypertension, providing a reference for secondary prevention and early delivery of intervention of sarcopenia in this group. Methods A total of 107 patients with essential hypertension aged ≥50 years who were hospitalized in Geriatric Department, the First People's Hospital of Yunnan Province from December 2020 to December 2021 were enrolled. Sarcopenia was diagnosed by the recommendation from Asian Working Group for Sarcopenia in 2019. Nutrition status was assessed using the Mini-Nutritional Assessment Scale-Short Form (MNA-SF) . The general demographics, sarcopenia diagnostic indicators, laboratory indicators and MNA-SF assessment results were collected. Binary Logistic regression analysis was used to explore the influencing factors of sarcopenia in essential hypertension. The receiver operating characteristic (ROC) analysis was performed to explore the predictive value of body mass index (BMI) for sarcopenia in essential hypertension. Results Among the 107 patients, 53 (49.5%) were diagnosed with sarcopenia, and other 54 (50.5%) cases had no sarcopenia. The prevalence of sarcopenia in slightly underweight, normal weight, overweight or obesity patients was 83.3% (5/6) , 64.2% (34/53) , 30.0% (12/40) , 25.0% (2/8) , respectively. The prevalence rate of sarcopenia decreased with the increase of BMI (χ2trend=15.027, P=0.001) . Logistic regression analysis showed that female〔OR=0.175, 95%CI (0.059, 0.518) 〕, overweight〔OR=0.039, 95%CI (0.003, 0.513) 〕, obesity〔OR=0.019, 95%CI (0.001, 0.459) 〕, higher 25- (OH) D〔OR=0.914, 95%CI (0.843, 0.991) 〕, and higher MNA-SF score〔OR=0.832, 95%CI (0.697, 0.992) 〕 were associated with decreased risk of sarcopenia (P<0.05) , while older age〔OR=1.139, 95%CI (1.073, 1.209) 〕, increased systolic blood pressure〔OR=1.038, 95%CI (1.001, 1.076) 〕 and increased diastolic blood pressure〔OR=1.095, 95%CI (1.035, 1.159) 〕 were associated with increased risk of sarcopenia (P<0.05) . The area under the ROC curve of BMI in predicting sarcopenia was 0.749〔95%CI (0.656, 0.843) 〕, with 52.8% sensitivity and 88.9% specificity when 22.0 kg/m2 was determined as the optimal cut-off value. Conclusion The prevalence of sarcopenia was high in middle-aged and elderly patients with essential hypertension, the risk of which was increased with advanced age, higher systolic blood pressure and diastolic blood pressure, and declined with being female, overweight, obesity, higher vitamin D and good nutrition. BMI may be a good predictor of sarcopenia in essential hypertension.
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