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

<sec> <title>BACKGROUND</title> Sarcopenia is associated with cardiovascular diseases (CVDs). However, whether changes in sarcopenia status affect CVD risk remains unclear. In addition, how indoor fuel use impacts the sarcopenia transition process is less well studied. </sec> <sec> <title>OBJECTIVE</title> This study prospectively examined the association of sarcopenia transitions with CVD risk, while exploring the effect of indoor fuel on these transitions. </sec> <sec> <title>METHODS</title> In this prospective observational study, we used data from the China Health and Retirement Longitudinal Study waves 1 to 4 (2011 to 2018). In total, 8739 participants with complete data on sarcopenia and indoor fuel use were included for the indoor fuel use and sarcopenia transition analysis, and 6385 participants without previous CVDs were included for the sarcopenia transition and CVD risk analysis. Sarcopenia transition was defined according to the sarcopenia status at wave 1 (2011) and wave 2 (2013). Incident CVDs included heart diseases, stroke, and composite CVDs. Information on indoor fuel use was obtained at wave 1. Cox proportional hazards models were used to examine the effect of sarcopenia transition on incident CVDs. Logistic regression models were used to investigate the impact of indoor fuel use on these transitions. </sec> <sec> <title>RESULTS</title> During a median of 7.0 years of follow-up, 1233 incident CVDs were documented. Compared to stably normal participants, progressing from a normal state to possible or confirmed sarcopenia brought increased risk of incident CVD (hazard ratio 1.42, 95% CI 1.15-1.77). Conversely, recovering to a normal state was associated with decreased risk (hazard ratio 0.72, 95% CI 0.55-0.95) for baseline participants with possible sarcopenia. In addition, clean fuel use increased the odds of achieving a possible-to-normal transformation (odds ratio 1.32, 95% CI 1.06-1.64), while both solid cooking and heating fuel use were associated with a higher risk of deterioration in sarcopenia status. </sec> <sec> <title>CONCLUSIONS</title> An unfavorable transition in sarcopenia status is associated with higher CVD risk, while reversion from possible sarcopenia to a normal state could reduce the risk. Therefore, early intervention for sarcopenia is imperative for CVD prevention, and promoting clean indoor fuel use is recommended. </sec>