The prevalence of sarcopenia and subtypes in cardiovascular diseases, and a new diagnostic approach

Background: The prevalence of sarcopenia and its subtypes, such as sarcopenic obesity, osteosarcopenia, and osteosarcopenic obesity, is little known in patients with cardiovascular diseases (CVD). Methods: Physical, motor functional, and nutritional assessments were performed for 230 community-dwelling (CD) adults who came to receive a physical check-up, and 160 patients with CVD who were admitted to our hospital. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia guidelines. The subtypes of sarcopenia were consecutively diagnosed according to increased body fat percentage and decreased bone density. Results: The CVD patients had malnutrition when compared to the CD adults. Impaired motor function of the CVD patients occurred in females as compared with males. The prevalence of sarcopenia, osteosarcopenia, and osteosarcopenic obesity was higher in the CVD patients than in the CD adults (16.9% vs. 4.4%, p < 0.001; 8.8% vs. 2.6%, p = 0.009; and 4.4% vs. 0.9%, p = 0.036, respectively). The prevalence of sarcopenia in the participants positively correlated with the serum N-terminal prohormone of brain natriuretic peptide concentration. Sarcopenia in the CVD patients was present in a younger population as compared with sarcopenia in the CD adults. The prevalence odds ratio of sarcopenia in the CVD patients was higher in females (6.40, 95% CI: 2.38-17.25, p < 0.001) than males (4.03, 95% CI: 1.02-15.90, p = 0.047). Based on the data of this study, we determined a calculation formula to get an index alternative to skeletal muscle index, followed by an easy diagnosis of sarcopenia. The formula was composed of sex, weight, and calf circumference. The sensitivity and specificity for the diagnosis with the index were 80.8% and 95.6%, respectively. Conclusions: CVD may accelerate sarcopenia, osteosarcopenia, and osteosarcopenic obesity. Our calculation formula for the easy diagnosis of sarcopenia may help in an early diagnosis and prevent it before worsening the patient's prognosis. (C) 2020 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.