ArticleJournal of the American Heart Association2019
Associations Between Measures of Sarcopenic Obesity and Risk of Cardiovascular Disease and Mortality: A Cohort Study and Mendelian Randomization Analysis Using the UK Biobank.
Article in Journal of the American Heart Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
87 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Polygenic scores and physical fitness prediction: a systematic review.Human genetics · 2026Pooled it
- Sarcopenic obesity and risk of cardio-cerebrovascular disease and mortality: a systematic review and meta-analysis.International journal of obesity (2005) · 2025Pooled it
- Sarcopenic Obesity and Cardiovascular Disease Risk and Mortality: A Systematic Review and Meta-Analysis.Anatolian journal of cardiology · 2025Pooled it
- Dynapenic obesity and all-Cause mortality: A systematic review and Meta-analysis of prospective cohort studies.Aging clinical and experimental research · 2025Pooled it
- Pre-transplant Sarcopenic Obesity Worsens the Survival After Liver Transplantation: A Meta-Analysis and a Systematic Review.Frontiers in medicine · 2020Pooled it
- Effects of a multi-modal resistance exercise program and calcium-vitamin DEuropean journal of nutrition · 2021Trial
- Metabolic Age as a Potential Marker of Cardiometabolic Vulnerability in Institutionalised Older Adults: A Cross-Sectional Study.Journal of clinical medicine · 2026Article
- Interrelationship Between Sarcopenia, Frailty and Cardiovascular Disease-The Crucial Role of Obesity in Hypothesis Generation-A Narrative Review.Journal of personalized medicine · 2026Review
- A feasibility study of computed tomography muscle phenotyping for physiotherapy selection in peripheral arterial disease.Journal of vascular surgery cases and innovative techniques · 2026Article
- Association of sarcopenic obesity with advanced cardiovascular-kidney-metabolic syndrome and incident cardiovascular disease: a longitudinal and cross-sectional study.Diabetology & metabolic syndrome · 2026Article
- Impact of changes in sarcopenia status on incident cardiovascular disease and mortality in older adults.Scientific reports · 2026Article
- Contribution of Sport Type to the Association Between Handgrip Strength and Morbidity/Mortality: Future Follow-up Study and Possible Mechanisms.Sports medicine - open · 2026Review
- Increased epicardial adipose tissue area and radiodensity in sarcopenic obesity.Cardiovascular diabetology · 2026Article
- Sex- and phenotype-specific prognostic implications of body mass index in acute heart failure.ESC heart failure · 2026Article
- Association Between Dietary Index for Gut Microbiota and Sarcopenic Obesity in Middle-Aged and Elderly Population: The Mediation Role of Hepatic Steatosis Index.Food science & nutrition · 2026Article
- Article
- Obesity medications and precision nutrition: synergistic interventions and integrated approach in obesity management.Current obesity reports · 2026Review
- High-Fat Diet Anticipates Age-Related Sarcopenia Through Increased Oxidative Stress and Inflammation.British journal of biomedical science · 2026Article
- Fucoidan P Alleviates Sarcopenic Obesity by Regulating Muscle Protein and Energy Metabolism.International journal of biological sciences · 2026Article
- Associations between sarcopenic obesity and the risk of cardiovascular-kidney-metabolic syndrome progression: insights from the China health and retirement longitudinal study.Diabetology & metabolic syndrome · 2025Article
27 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
Background The "healthy obese" hypothesis suggests the risks associated with excess adiposity are reduced in those with higher muscle quality (mass/strength). Alternative possibilities include loss of muscle quality as people become unwell (reverse causality) or unmeasured confounding. Methods and Results We conducted a cohort study using the UK Biobank (n=452 931). Baseline body mass index ( BMI) was used to quantify adiposity and handgrip strength ( HGS ) used for muscle quality. Outcomes were fatal and non-fatal cardiovascular disease, and mortality. As a secondary analysis we used waist-hip-ratio or fat mass percentage instead of BMI , and skeletal muscle mass index instead of HGS . In a subsample, we used gene scores for BMI , waist-hip-ratio and HGS in a Mendelian randomization ( MR ). BMI defined obesity was associated with an increased risk of all outcomes (hazard ratio [ HR ] range 1.10-1.82). Low HGS was associated with increased risks of cardiovascular and all-cause mortality ( HR range 1.39-1.72). HR s for the association between low HGS and cardiovascular disease events were smaller ( HR range 1.05-1.09). There was no suggestion of an interaction between HGS and BMI to support the healthy obese hypothesis. Results using other adiposity metrics were similar. There was no evidence of an association between skeletal muscle mass index and any outcome. Factorial Mendelian randomization confirmed no evidence for an interaction. Low genetically predicted HGS was associated with an increased risk of mortality ( HR range 1.08-1.19). Conclusions Our analyses do not support the healthy obese concept, with no evidence that the adverse effect of obesity on outcomes was reduced by improved muscle quality. Lower HGS was associated with increased risks of mortality in both observational and MR analyses, suggesting reverse causality may not be the sole explanation.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.