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Rapid Progression of Aortic Calcification in Older Men with Low Appendicular Lean Mass and Poor Physical Function

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Assessment of the progression of abdominal aortic calcification (AAC) may be a surrogate marker of the impact of physical function on cardiovascular risk. Our aim was to assess the risk of rapid AAC progression in older men with low relative appendicular lean mass (RALM) and poor physical function.

Design

Prospective cohort study.

Setting

Community-dwelling older men.

Participants

621 men aged 50–85 followed prospectively (baseline, 3 and 7.5 years).

Measurements

Body composition was assessed by DXA. Poor physical function was defined as incapacity to perform ≥1 of 5 clinical tests (balance, muscle strength). AAC was assessed using Kauppila’s semiquantitative score. Reclassification improvement was assessed by comparing the areas under the curve (AUC) using DeLong’s method.

Results

Rapid AAC progression (>0.6 point/year) was found in 168 men (27.1%). After adjustment for confounders including baseline AAC, the risk of rapid AAC progression increased with lower RALM (OR=1.42/SD, 95%CI: 1.09–1.86, p<0.01) and was higher in the lowest (<7.5kg/m2) vs. highest (>8.6kg/m2) quartile (OR=2.15, 95%CI: 1.17–3.95, p<0.01). Poor physical performance was associated with rapid AAC progression (OR=2.76, 95%CI: 1.48–5.91, p<0.005). Low RALM (<7.84kg/m2 defined using Youden’s index) and poor physical function contributed to the risk of rapid AAC progression jointly. Men who had low RALM and poor physical function had higher risk of rapid AAC progression vs. men without these traits (OR=4.66, 95%CI: 1.72–12.62, p<0.05). RALM and physical function improved the identification of men with rapid AAC progression (AAUC=0.026, 95%CI: 0.005–0.046, p<0.05) after adjustment for confounders including baseline AAC score.

Conclusions

Low RALM and poor physical function are associated with higher risk of rapid AAC progression and possibly represent another measure of cardiovascular risk.

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Acknowledgements

Authors’ roles: Funding acquisition: PS. Study design and conceptualization: PS, RC. Study conduct: PS. Data collection: PS. Data analysis: PS. Data interpretation: PS, RC. Drafting manuscript: PS. Revising manuscript content and editing: PS, RC. Approving final version of manuscript: PS, RC. PS takes responsibility for the integrity of the data analysis. Sponsor’s role: The funding organization did not have access to the data, nor was involved in any analysis of this study.

Funding

Funding: Grants from INSERM/Merck Sharp & Dohme Chibret, France.

Author information

Authors and Affiliations

  1. INSERM UMR 1033, Hôpital Edouard Herriot, Place d’Arsonval, 69437, Lyon, France

    Pawel Szulc & R. Chapurlat

  2. University of Lyon, Lyon, France

    Pawel Szulc & R. Chapurlat

  3. Department of Rheumatology, Hôpital Edouard Herriot, Lyon, France

    R. Chapurlat

Authors
  1. Pawel Szulc
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  2. R. Chapurlat
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Corresponding author

Correspondence to Pawel Szulc.

Ethics declarations

Ethical standard: The protocol of the MINOS study complied with the law in France which was valid when the study was performed.

Conflict of interest: All the authors have no conflict of interest concerning this study.

Additional information

Abstract presented: (plenary oral) during the 47th European Calcified Tissue Society Congress, 2020, doi:10.1016/j.bonr.2020.100323.

Electronic supplementary material

Supplementary Table 1

Comparison of men who were or were not followed up

Supplemental Table 2

Bivariate comparisons according to the quartiles of the progression of the abdominal aortic calcification (AAC) in 621 men

Suppl. Figure 1

Average (median, interquartile range) yearly progression of abdominal aortic calcification per age group.

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Szulc, P., Chapurlat, R. Rapid Progression of Aortic Calcification in Older Men with Low Appendicular Lean Mass and Poor Physical Function. J Nutr Health Aging 25, 1217–1225 (2021). https://doi.org/10.1007/s12603-021-1697-0

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