Sarcopenia and cardiovascular disease among adults with cardiovascular-kidney-metabolic syndrome stages 0-3: A prospective cohort study.

Background: Substantial evidence has demonstrated the correlation between sarcopenia and cardiovascular disease (CVD). However, it remains uncertain whether this correlation exists in individuals with cardiovascular-kidney-metabolic (CKM) syndrome. Methods: This study used data from the China Health and Retirement Longitudinal Study (CHARLS). Sarcopenia state was determined according to the Asian Working Group for Sarcopenia 2019 criteria. Muscle mass was estimated by the height-adjusted muscle mass. Cox proportional hazard models were employed to calculate the hazard ratio (HR) and 95 % confidence interval (95 % CI. Results: A total of 7428 participants (mean age: 59.0 years; male: 47.6 %) were included in this study. Of these, non-sarcopenia, possible sarcopenia, and sarcopenia individuals were 4398 (59.2 %), 2162 (29.1 %), and 869 (11.7 %), respectively. During a median follow-up of 9.0 years, participants with possible sarcopenia (HR: 1.32, 95 % CI: 1.19-1.47) and sarcopenia (HR: 1.45, 95 % CI: 1.23-1.72) exhibited an increased risk of incident CVD compared to those with non-sarcopenia. Higher quintiles of muscle mass presented significantly increased risks of incident CVD than those with the lowest quintile (quintile 2: HR 1.34, 95 % CI 1.15-1.56; quintile 3: HR 1.41, 95 % CI 1.19-1.67; quintile 4: HR 1.71, 95 % CI 1.40-2.09; quintile 5: HR 2.20, 95 % CI 1.75-2.77). The dose-response curve indicated a positive linear association between muscle mass and incident CVD (P for overall <0.001, P for nonlinear = 0.795). Conclusion: Both possible sarcopenia and sarcopenia were associated with an increased risk of incident CVD among individuals with CKM syndrome stages 0-3.