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Accepted for/Published in: JMIR Aging

Date Submitted: Dec 10, 2024
Date Accepted: Aug 1, 2025

The final, peer-reviewed published version of this preprint can be found here:

Changes in Sarcopenia Status and Subsequent Cardiovascular Outcomes: Prospective Cohort Study

Zhu Y, Wang K, Lu Z, Li F, Xu Y, Shen L, Bi Y, Hu W

Changes in Sarcopenia Status and Subsequent Cardiovascular Outcomes: Prospective Cohort Study

JMIR Aging 2025;8:e69860

DOI: 10.2196/69860

PMID: 40921062

PMCID: 12455154

Changes in Sarcopenia Status and Subsequent Cardiovascular Outcomes: Prospective Cohort Study

  • Yuanyue Zhu; 
  • Kan Wang; 
  • Zuolin Lu; 
  • Feika Li; 
  • Yu Xu; 
  • Linhui Shen; 
  • Yufang Bi; 
  • Weiguo Hu

ABSTRACT

Background:

Sarcopenia is associated with cardiovascular diseases (CVDs), however, whether the changes in sarcopenia affect CVD risk remained unclear. Additionally, how indoor fuel use impact the transitions process is less studied.

Objective:

The study prospectively examined the association of sarcopenia transitions with CVD risk, while exploring the impact of indoor fuel on these transitions.

Methods:

The prospective observational study used data from the China Health and Retirement Longitudinal Study (CHARLS) waves 1 to 4 (2011-2018). In total, 8739 participants with full data on sarcopenia and indoor fuel use were included for “indoor fuel use and sarcopenia transition” analysis, and 6385 participants without previous CVDs were included for “sarcopenia transition and CVD risk” analysis. Transition of sarcopenia was defined according to sarcopenia status at wave 1 (2011) and wave 2 (2013). Incident CVD included heart diseases, stroke and composite CVD. Information on indoor fuel were obtained at wave 1. Cox proportional hazards models were conducted to examine the effect of transition in sarcopenia on incident CVD. Logistic regression models were performed to investigate the impact of indoor fuel on these transitions.

Results:

During a median of 7.0 years follow-up, 1233 incident CVDs were documented. Compared to stably normal participants, progressing from normal to possible or confirmed sarcopenia brought increased risk of incident CVD (hazard ratio (HR):1.42, 95% confidence (CI):1.15-1.77). Conversely, recovering to normal state was associated with decreased risk (HR:0.72, 95% CI: 0.55-0.95) for possible sarcopenia individuals. Additionally, clean fuel use increased the odds of achieving a possible-to-normal transformation (odds ratio (OR):1.32, 95% CI: 1.06-1.64), while both solid cooking and heating fuel use were associated with higher risk of deterioration in sarcopenia status.

Conclusions:

Unfavorable transition in sarcopenia status is associated with higher CVD risk, while reversion from possible sarcopenia to normal could reduce the risk. Therefore, early intervention for sarcopenia is imperative for CVD prevention, and promoting clean fuel use is recommended. Clinical Trial: Not applicable


 Citation

Please cite as:

Zhu Y, Wang K, Lu Z, Li F, Xu Y, Shen L, Bi Y, Hu W

Changes in Sarcopenia Status and Subsequent Cardiovascular Outcomes: Prospective Cohort Study

JMIR Aging 2025;8:e69860

DOI: 10.2196/69860

PMID: 40921062

PMCID: 12455154

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