EFFECT OF CHANGES IN BODY COMPOSITION ON CARDIOMETABOLIC DISEASE BY SEX AND PRESENCE OF SARCOPENIA

Objective: Muscle mass loss and fat mass increase are risk factors for cardiometabolic disease (CMD). We evaluated the effect of changes in body composition on CMD development in older adults with or without sarcopenia. Design and method: Changes in body composition and cardiometabolic factors over 2-years were measured in community-dwelling older adults recruited from the Korean Frailty Aging Cohort Study. Individuals with sarcopenia were matched to non-sarcopenia via propensity score matching. Results: Among a total of 1,634 eligible subjects, 353 were identified with sarcopenia. In non-sarcopenic men, an increase in obesity indices was associated with an increased risk of CMD development. Conversely, an increase in appendicular lean mass (ALM) by 1 kg was 41% and 28% less likely to develop cardiovascular disease and hyperlipidemia, respectively. However, there was no significant association between changes in body composition and any incident CMD in sarcopenic men. In non-sarcopenic women, there was an inverse association between CMD and change in weight or body fat. In sarcopenic women, the risk of diabetes mellitus was reduced by 30% with an increase in weight (by 1 kg), while the risk of hyperlipidemia was 3 times increased with an increase in ALM (by 1 kg). Conclusions: In non-sarcopenia, a decrease in obesity and muscle gain is beneficial for older men, but an obesity paradox was reported in older women. We found no cardiometabolic benefit of increasing lean mass in sarcopenia regardless of sex.