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Transitional Dynamics of Sarcopenia and Associations of Nutritional Indices with State Transitions in Chinese aged ≥ 50

  • Original Research
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The journal of nutrition, health & aging

Abstract

Objectives

Sarcopenia’s temporal profile can be regarded as a dynamic process with distinct states, in which malnutrition plays an important role. This study aimed to address two research gaps: sarcopenia’s transitional dynamics and associations of nutritional indices with state transitions in community-dwelling Chinese adults aged 50 and older.

Design

A prospective population-based cohort study.

Setting

Community-based setting in western China.

Participants

The analytic sample included data from 1910 participants aged ≥ 50 in the West China Health and Aging Trend study between 2018–2022.

Measurements

We defined three states: the initial normal state (normal muscle strength, physical performance and muscle mass), the worst sarcopenia state (low muscle mass plus low muscle strength and/or low physical performance) and the intermediate subclinical state (the other scenarios). The relevant measurement methods and cut-off points were based on the 2019 AWGS consensus. Using a continuous-time multistate Markov model, we calculated probabilities of transitions between different states over 1, 2 and 4 years; we also examined associations between nutritional indices and transitions, including body mass index (BMI), calf circumference (CC), mid-arm circumference (MAC), triceps skinfold thickness (TST), albumin (ALB), geriatric nutrition risk index (GNRI), vitamin D (VitD) and prealbumin (PA).

Results

For individuals in the normal state, their probabilities of remaining stable versus progressing to a subclinical state were 53.4% versus 42.1% at 2 years, and 40.6% versus 49.0% at 4 years. In the subclinical population, their 2- and 4-year chances were 60.2% and 51.2% for maintaining this state, 11.8% and 16.2% for developing sarcopenia, 28.0% and 32.6% for reverting to normal. For sarcopenic individuals, the likelihood of staying stable versus retrogressing to the subclinical state were 67.0% versus 26.3% at 2 years, and 48.3% versus 36.3% at 4 years. Increased BMI, CC, MAC, TST, ALB, GNRI and PA correlated with reversion from the subclinical state, among which increased TST, ALB and PA were also paralleled with reversion from sarcopenia, while decreased BMI, CC, MAC, TST and GNRI were associated with progression to sarcopenia. VitD was not significantly associated with any transitions.

Conclusion

This study reveals how sarcopenia changes over time in a Chinese population. It also highlights the usefulness of simple and cost-effective nutritional status indices for indicating state transitions, which can help identify individuals at risk of sarcopenia and guide targeted interventions within the optimal time window.

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Acknowledgement: We thank all the participants for their contribution in the WCHAT study.

Funding

Funding statement: This study was supported by the following grants: Chinese National Science & Technology Pillar Program (2020YFC2005600); Sichuan Science and Technology Program (2021YFS0136); 1.3.5 project for disciplines of excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University (19HXFH012); National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University (Z2023LC008, Z20191012); 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZYJC21005); Project of Max Cynader Academy of Brain Workstation, WCHSCU (HXYS19005).

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  1. These authors contributed equally to this work

Authors and Affiliations

  1. Department of Geriatrics, West China Hospital of Sichuan University, 37 GuoXue Lane, Chengdu, Sichuan, 610041, P.R. China

    Y. Li, Q. Xiang, B. Dong, R. Liang, Q. Song, L. Deng,  Ning Ge &  Jirong Yue

  2. National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, 37 GuoXue Lane, Chengdu, Sichuan, 610041, P.R. China

    Y. Li, Q. Xiang, B. Dong, R. Liang, Q. Song, L. Deng,  Ning Ge &  Jirong Yue

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  1. Y. Li
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Contributions

Author Contribution: Yuxiao Li and Qiao Xiang contributed to the conception of the study, performed the data analyses, wrote the main manuscript text, as well as prepared the tables and figures. Birong Dong supervised the project and provided instructions on result interpretation. Rui Liang, Quhong Song and Linghui Deng contributed to data collection and database construction. Jirong Yue and Ni Ge supervised the project, provided instructions on the study design and revised the manuscript. All authors reviewed the manuscript.

Corresponding authors

Correspondence to Ning Ge or Jirong Yue.

Ethics declarations

Ethical statements: The research complied with the current laws of China. The study was approved by the Ethical Committee of Sichuan University West China Hospital and adhered to the principles of the Declaration of Helsinki.

Conflict of Interest: The authors declare that they have no conflicts of interest to this work.

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Li, Y., Xiang, Q., Dong, B. et al. Transitional Dynamics of Sarcopenia and Associations of Nutritional Indices with State Transitions in Chinese aged ≥ 50. J Nutr Health Aging 27, 741–751 (2023). https://doi.org/10.1007/s12603-023-1974-1

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