Skip to main content
SpringerLink
Log in

A positive association between stroke risk and sarcopenia in men aged ≥ 50 years, but not women: Results from the Korean National Health and Nutrition Examination Survey 2008–2010

  • Published:
The journal of nutrition, health & aging

Abstract

Background and aims

Sarcopenia, the loss of skeletal muscle mass and strength, develops with aging and may be a pivotal risk factor in individual cardiovascular diseases (CVDs). We examined whether sarcopenia was positively associated with the prevalence of CVDs, including angina pectoris, myocardial infarction, and stroke, in adults of each gender aged >50 years, independent of other covariates and possible confounders.

Methods and results

This cross-sectional study included 3,009 men and 4,199 women aged >50 years who participated in the 2008–2010 Korean National Health and Nutrition Examination Survey. Sarcopenia was defined as appendicular skeletal muscle mass/body weight <1 (moderate) or 2 (severe) standard deviations below gender-specific means for young adults. CVD prevalence was positively associated with sarcopenia in men after adjusting for confounders involved in CVD risk factors (Class I, OR=1.847 and Class II, OR=2.347; P<0.05). However, no such association was found in women. Furthermore, for individual CVDs, a strong positive association between stroke and sarcopenia (Class I, OR=1.734 and Class II, OR=3.725; P<0.05) and a moderate association between angina pectoris and sarcopenia (Class I, OR=1.988 and Class II, OR=1.347; P<0.05) were observed in men only. Interestingly, only the estimated homeostasis model assessment of insulin resistance was greater in men with moderate and severe sarcopenia than in those with normal states, whereas only serum total cholesterol levels were significantly higher in women with severe sarcopenia than in those with normal states. In both genders, serum 25-hydroxyvitamin D levels were significantly lower in moderate and severe sarcopenic states.

Conclusions

men aged >50 years with sarcopenia showed elevated prevalence of CVDs, especially stroke, in a representative sample of the general South Korean population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry ID, Borden WB, et al. Heart Disease and Stroke Statistics — 2013 Update. A report from the American Heart Association. Circulation 2013;127:e6–e245.

    Article  PubMed  Google Scholar 

  2. Laslett LJ, Alagona P Jr, Clark BA 3rd, Drozda JP Jr, Saldivar F, Wilson SR, et al. The worldwide environment of cardiovascular disease: prevalence, diagnosis, therapy, and policy issues: a report from the American College of Cardiology. J Am Coll Cardiol 2012;60:S1–S49.

    Article  PubMed  Google Scholar 

  3. Laurent S. Defining vascular aging and cardiovascular risk. J Hypertens 2012;30:S3–S8.

    Article  CAS  PubMed  Google Scholar 

  4. Kernan WN, Inzucchi SE, Sawan C, Macko RF, Furie KL. Obesity: a stubbornly obvious target for stroke prevention. Stroke 2013;44:278–286.

    Article  PubMed  Google Scholar 

  5. Hong KS, Yegiaian S, Lee M, Lee J, Saver JL. Declining stroke and vascular event recurrence rates in secondary prevention trials over the past 50 years and consequences for current trial design. Circulation 2011;123:2111–2119.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Anker MS, von Haehling S, Springer J, Banach M, Anker SD. Highlights of mechanistic and therapeutic cachexia and sarcopenia research 2010 to 2012 and their relevance for cardiology. Arch Med Sci 2013;9:166–171.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Park SJ, Shin SD, Ro YS, Song KJ, Oh J. Gender differences in emergency stroke care and hospital outcome in acute ischemic stroke: a multicenter observational study. Am J Emerg Med 2013; 31:178–184.

    Article  PubMed  Google Scholar 

  8. Sanada K, Miyachi M, Tanimoto M, Yamamoto K, Murakami H, Okumura S, et al. A cross-sectional study of sarcopenia in Japanese men and women: reference values and association with cardiovascular risk factors. Eur J Appl Physiol 2010;110: 57–65.

    Article  CAS  PubMed  Google Scholar 

  9. Chin SO, Rhee SY, Chon S, Hwang YC, Jeong IK, Oh S, et al. Sarcopenia is independently associated with cardiovascular disease in older Korean adults: the Korea National Health and Nutrition Examination Survey (KNHANES) from 2009. PLoS One 2013;8:e60119.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Aubertin-Leheudre M, Lord C, Goulet ED, Khalil A, Dionne IJ. Effect of sarcopenia on cardiovascular disease risk factors in obese postmenopausal women. Obesity (Silver Spring) 2006;14:2277–2283.

    Article  Google Scholar 

  11. Davison KK, Ford ES, Cogswell ME, Dietz WH. Percentage of body fat and body mass index are associated with mobility limitations in people aged 70 and older from NHANES III. J Am Geriatr Soc 2002;50:1802–1809.

    Article  PubMed  Google Scholar 

  12. Loncar G, Fülster S, von Haehling S, Popovic V. Metabolism and the heart: an overview of muscle, fat, and bone metabolism in heart failure. Int J Cardiol 2013;162:77–85.

    Article  PubMed  Google Scholar 

  13. Goldspink DF. Ageing and activity: their effects on the functional reserve capacities of the heart and vascular smooth and skeletal muscles. Ergonomics 2005;48:1334–1351.

    Article  PubMed  Google Scholar 

  14. Park S, Lee BK. Vitamin D deficiency is an independent risk factor for cardiovascular disease in Koreans aged ≥ 50 years: results from the Korean National Health and Nutrition Examination Survey. Nutr Res Pract 2012;6:162–168.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–419.

    Article  CAS  PubMed  Google Scholar 

  16. Korea Centers for Disease Control and Prevention. Guideline for the Evaluation of the Fourth Korea National Health and Nutrition Survey. Korea Centers for Disease Control and Prevention. Ministry of Health and Welfare: Korea; 2009.

    Google Scholar 

  17. World Health Organization Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157–163.

    Article  Google Scholar 

  18. Shiwaku K, Anuurad E, Enkhmaa B, Nogi A, Kitajima K, Shimono K, et al. Overweight Japanese with body mass indexes of 23.0–24.9 have higher risks for obesity-associated disorders: a comparison of Japanese and Mongolians. Int J Obes Relat Metab Disord 2004;28:152–158.

    Article  CAS  PubMed  Google Scholar 

  19. Heymsfield SB, Smith R, Aulet M, Bensen B, Lichtman S, Wang J, et al. Appendicular skeletal muscle mass: measurement by dual-photon absorptiometry. Am J Clin Nutr 1990; 52:214–218.

    CAS  PubMed  Google Scholar 

  20. Janssen I, Heymsfield SB, Wang ZM, Ross R. Skeletal muscle mass and distribution in 468 men and women aged 18–88 yr. J Appl Physiol 2000;89:81–88.

    CAS  PubMed  Google Scholar 

  21. Stenholm S, Harris TB, Rantanen T, Visser M, Kritchevsky SB, Ferrucci L. Sarcopenic obesity: definition, cause and consequences. Curr Opin Clin Nutr Metab Care 2008; 11:693–700.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Kirby JB, Liang L, Chen HJ, Wang Y. Race, place, and obesity: the complex relationships among community racial/ethnic composition, individual race/ethnicity, and obesity in the United States. Am J Public Health 2012;102:1572–1578.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Amato MC, Guarnotta V, Giordano C. Body composition assessment for the definition of cardiometabolic risk. J Endocrinol Invest 2013;36:537–543.

    CAS  PubMed  Google Scholar 

  24. Karcher HS, Holzwarth R, Mueller HP, Ludolph AC, Huber R, Kassubek J, et al. Body Fat Distribution as a Risk Factor for Cerebrovascular Disease: An MRI-Based Body Fat Quantification Study. Cerebrovasc Dis 2013;35:341–348.

    Article  PubMed  Google Scholar 

  25. Imai K, Gregg EW, Chen YJ, Zhang P, Rekeneire N, Williamson DF. The association of BMI with functional status and self-rated health in US adults. Obesity 2008;16:402–408.

    Article  PubMed  Google Scholar 

  26. Jee SH, Sull JW, Park JY, Lee SY, Ohrr HC, Guallar E, et al. Body-mass index and mortality in Korean men and women. New Engl J Med 2006;355;779–787.

    Article  CAS  PubMed  Google Scholar 

  27. Roubenoff R. Physical activity, inflammation, and muscle loss. Nutr Rev 2007; 65:S208–S212.

    Article  PubMed  Google Scholar 

  28. Srinivas-Shankar U, Wu FC. Frailty and muscle function: role for testosterone? Front Horm Res 2009;37:133–149.

    Article  CAS  PubMed  Google Scholar 

  29. Ochi M, Kohara K, Tabara Y, Kido T, Uetani E, Ochi N, et al. Arterial stiffness is associated with low thigh muscle mass in middle-aged to elderly men. Atherosclerosis 2010;212:327–332.

    Article  CAS  PubMed  Google Scholar 

  30. Sanada K, Iemitsu M, Murakami H, Gando Y, Kawano H, Kawakami R, et al. Adverse effects of coexistence of sarcopenia and metabolic syndrome in Japanese women. Eur J Clin Nutr 2012;66:1093–1098.

    Article  CAS  PubMed  Google Scholar 

  31. Visser M, Kritchevsky SB, Goodpaster BH, Newman AB, Nevitt M, Stamm E. Leg muscle mass and composition in relation to lower extremity performance in men and women aged 70 to 79: the health, aging and body composition study. J Am Geriatr Soc 2002;50:897–904.

    Article  PubMed  Google Scholar 

  32. Kim TN, Park MS, Lim KI, Choi HY, Yang SJ, Yoo HJ, et al. Relationships between sarcopenic obesity and insulin resistance, inflammation, and vitamin D status: the Korean Sarcopenic Obesity Study. Clin Endocrinol (Oxf) 2013;78:525–532.

    Article  CAS  Google Scholar 

  33. Ahn S, Park YJ, Min SI, Kim SY, Ha J, Kim SJ, et al. High prevalence of peripheral arterial disease in Korean patients with coronary or cerebrovascular disease. J Korean Med Sci 2012;27:625–629.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  34. Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 1998; 147:755–763.

    Article  CAS  PubMed  Google Scholar 

  35. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing 2010;39:412–423.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Food and Nutrition, Hoseo University, Asan-Si, South Korea

    S. Park

  2. Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital, Cheonan, South Korea

    J. -O. Ham

  3. Korea Industrial Health Association, 1490-32 Seocho-3 Dong, Seocho-Ku, Seoul, 137-870, South Korea

    Byung Kook Lee

Authors
  1. S. Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. -O. Ham
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Byung Kook Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Byung Kook Lee.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Park, S., Ham, J.O. & Lee, B.K. A positive association between stroke risk and sarcopenia in men aged ≥ 50 years, but not women: Results from the Korean National Health and Nutrition Examination Survey 2008–2010. J Nutr Health Aging 18, 806–812 (2014). https://doi.org/10.1007/s12603-014-0553-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-014-0553-x

Key words

Search

Navigation