Association of metabolic syndrome and sarcopenia with all-cause and cardiovascular mortality: a prospective cohort study based on the NHANES

Weihong Huang; Siyi Deng; Siyang Liu; Qintao Ma; Liting Cao; Lan Liu; Heng Wan; Jie Shen

doi:10.3389/fendo.2024.1346669

Association of metabolic syndrome and sarcopenia with all-cause and cardiovascular mortality: a prospective cohort study based on the NHANES

Front Endocrinol (Lausanne). 2024 Mar 26:15:1346669. doi: 10.3389/fendo.2024.1346669. eCollection 2024.

Authors

Weihong Huang^#¹, Siyi Deng^#², Siyang Liu^#¹, Qintao Ma¹, Liting Cao¹, Lan Liu¹, Heng Wan¹, Jie Shen¹

Affiliations

¹ Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China.
² Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.

^# Contributed equally.

Abstract

Background: Metabolic syndrome (MetS) and sarcopenia (SP) have emerged as significant public health concerns in contemporary societies, characterized by shared pathophysiological mechanisms and interrelatedness, leading to profound health implications. In this prospective cohort study conducted within a US population, we aimed to examine the influence of MetS and SP on all-cause and cardiovascular mortality.

Methods: This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) III for the years 1999-2006 and 2011-2018, and death outcomes were ascertained by linkage to National Death Index (NDI) records through December 31, 2019. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for all-cause and cardiovascular mortality. In addition, subgroup and sensitivity analyses were conducted to test the robustness of the results.

Results: Over a median follow-up period of 13.3 years (95% CI: 12.8-13.8), 1714 deaths were observed. The groups characterized by MetS-/SP+, MetS+/SP-, and MetS+/SP+ exhibited higher all-cause mortality rates in comparison to the MetS-/SP- group, with the MetS+/SP+ group (HR 1.76, 95% CI: 1.37-2.25) displaying the highest all-cause mortality. Increased cardiovascular mortality was observed in the MetS+/SP- (HR 1.84, 95% CI: 1.24-2.72), and MetS+/SP+ groups (HR 2.39, 95% CI: 1.32-4.35) compared to the MetS-/SP- group, whereas it was not statistically significant in the MetS-/SP+ group. However, among males and individuals aged < 60, the presence of both MetS and SP (MetS+/SP+ group) was found to be significantly associated with a higher risk of all-cause and cardiovascular mortality.

Conclusion: The coexistence of MetS and SP increased the risk of all-cause and cardiovascular mortality, particularly in males and in nonelderly populations. Individuals with either MetS or SP may require more careful management to prevent the development of other diseases and thereby reduce mortality.

Keywords: NHANES; all-cause mortality; cardiovascular mortality; metabolic syndrome; sarcopenia.

MeSH terms

Cardiovascular Diseases* / etiology
Humans
Male
Metabolic Syndrome* / complications
Metabolic Syndrome* / diagnosis
Metabolic Syndrome* / epidemiology
Nutrition Surveys
Prospective Studies
Sarcopenia* / complications
Sarcopenia* / epidemiology

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by Medical Scientific Research Foundation of Guangdong Province of China (B2021264) and the Guangdong Basic and Applied Basic Research Foundation (2021A1515110682).