首页 期刊 论文 学科刊群 资讯 加盟 关于
EN
image
Article(id=1323941391566516705, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1323941237702668764, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202506304, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1750348800000, receivedDateStr=2025-06-20, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793581825390, onlineDateStr=2026-11-02, pubDate=1765296000000, pubDateStr=2025-12-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793581825390, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793581825390, creator=13701087609, updateTime=1793581825390, updator=13701087609, issue=Issue{id=1323941237702668764, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='23', pageStart='4225', pageEnd='4416', issueExtLink='null', onlineDate='null', pubDate='1765296000000', pubDateStr='2025-12-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793581788707, creator='13701087609', updateTime=1793581887795, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1323941653374959780, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1323941237702668764, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1323941653374959781, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1323941237702668764, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=4409, endPage=4416, ext={EN=ArticleExt(id=1323941391746871778, articleId=1323941391566516705, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association between sarcopenic obesity and cardiovascular disease risk in the elderly, columnId=1228016569138213037, journalTitle=Modern Preventive Medicine, columnName=Clinical Medicine and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the longitudinal association between sarcopenic obesity and cardiovascular disease (CVD) in the elderly in China.

Methods

Data from the China Health and Retirement Longitudinal Study (CHARLS) from 2015 to 2020 were used. A total of 4 349 elderly people aged 60 years and above were enrolled and divided into four groups based on body roundness index (BRI) and sarcopenia status,namely (1) normal BRI without sarcopenia group; (2) normal BRI with sarcopenia group; (3) high BRI without sarcopenia group; and (4) high BRI with sarcopenia group. Kaplan-Meier curves were used to estimate the cumulative incidence of CVD, stroke, and heart disease at different times. Multivariable-adjusted Cox proportional hazards regression models were then used to control for confounding factors to analyze the associations between sarcopenic obesity status and CVD, stroke, and heart disease. Finally, subgroup analyses were performed to test the consistency of the association effects of the four groups on CVD, stroke, and cardiac events.

Results

Based on different sarcopenic obesity status, Kaplan-Meier survival curves showed differences in cumulative incidence between different groups (P<0.001). After full adjustment of covariates, high BRI sarcopenia significantly increased the risk of CVD (HR=1.41, 95% CI: 1.14-1.75), stroke(HR=1.77, 95% CI: 1.26-2.49) and heart disease (HR=1.32, 95% CI: 1.03-1.69) compared with normal BRI without sarcopenia. This further proved that sarcopenic obesity was an important risk factor for CVD, stroke and heart disease. In the subgroup analysis, it was consistently found that high BRI with sarcopenia was associated and CVD, stroke and heart disease.

Conclusion

In the elderly population in China, high BRI with sarcopenia is significantly associated with the risk of CVD,stroke, and heart disease. It is recommended that preventing and improving sarcopenia, controlling weight and exercising moderately can help delay the progression of CVD and promote healthy aging in the elderly.

, authors=You-tao ZHANG, Li-ping DONG, Shu-tie LI, Jie KONG, authorsList=You-tao ZHANG, Li-ping DONG, Shu-tie LI, Jie KONG, authorCompany=null, correspAuthors=Shu-tie LI, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1323941394892599789, articleId=1323941391566516705, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=老年人肌肉减少性肥胖与心血管疾病风险之间的相关性, columnId=1228016570119680182, journalTitle=现代预防医学, columnName=临床与预防, runingTitle=null, highlight=null, articleAbstract=
目的

探究中国老年人肌肉减少性肥胖与心血管疾病（cardiovascular disease，CVD）之间的纵向关系。

方法

利用2015—2020年中国健康与养老追踪调查（China Health and Retirement Longitudinal Study, CHARLS）的数据。纳入4 349名60岁及以上老年人，基于身体圆度指数（body roundness index，BRI）和肌肉减少症状态分为四组，即正常BRI无肌肉减少症组、正常BRI肌肉减少症组、高BRI无肌肉减少症组、高BRI肌肉减少症组。采用了Kaplan～Meier曲线估计参与者CVD、脑卒中和心脏病在不同时间的累积发病率。然后使用多次调整的Cox比例风险回归模型控制混杂因素，分析肌肉减少性肥胖状态与CVD、脑卒中及心脏病之间的关联。最后，通过亚组分析检验四组人群对CVD、卒中及心脏事件关联效应的一致性。

结果

基于不同的肌肉减少性肥胖状态，Kaplan~Meier生存曲线显示不同组间累积发病率存在差异（P<0.001）。完全调整协变量后，与正常BRI无肌肉减少症组相比，高BRI肌肉减少症组显著增加了CVD（HR=1.41，95% CI：1.14～1.75）、脑卒中（HR=1.77，95% CI：1.26～2.49）及心脏病（HR=1.32，95% CI：1.03～1.69）的发病风险。进一步证明了肌肉减少性肥胖是CVD、脑卒中和心脏病的重要危险因素。在亚组分析中，一致发现高BRI与肌肉减少症和CVD、脑卒中和心脏病的关联。

结论

在中国老年人群中，高BRI肌肉减少症与CVD、脑卒中和心脏病发病风险显著相关，建议预防和改善肌肉减少症，控制体重和适量运动有助于延缓CVD的进展，促进老年人的健康衰老。

, authors=张友涛, 董利平, 李树铁, 孔洁, authorsList=张友涛, 董利平, 李树铁, 孔洁, authorCompany=null, correspAuthors=李树铁, authorNote=

张友涛（1987—），男，硕士，主治医师，研究方向：老年慢性病预防与诊治

, correspAuthorsNote=
李树铁，E-mail：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=43Ec77Asp8nGWHFnOtVq2w==, magXml=agRgDXK9jXmgaFb2gmYhBA==, pdfUrl=null, pdf=Oq4XVrbh9g1JwPxDJ9JdsA==, pdfFileSize=845401, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=SaMk4tpYY7kQSX0L6+fznQ==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=nmyCIGbv8e45FAwCgUDhVw==, mapNumber=null, fund=null)}, authors=[Author(id=1323941395236532722, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1323941395328807412, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941395236532722, language=EN, stringName=You-tao ZHANG, firstName=You-tao, middleName=null, lastName=ZHANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1323941395412693493, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941395236532722, language=CN, stringName=张友涛, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=河北北方学院附属第一医院老年医学科，河北　张家口　075031, bio={"content":"

张友涛（1987—），男，硕士，主治医师，研究方向：老年慢性病预防与诊治

"}, bioImg=null, bioContent=

张友涛（1987—），男，硕士，主治医师，研究方向：老年慢性病预防与诊治

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1323941395135869422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, xref=null, ext=[AuthorCompanyExt(id=1323941395144258031, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China), AuthorCompanyExt(id=1323941395152646640, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=河北北方学院附属第一医院老年医学科，河北　张家口　075031)])]), Author(id=1323941395614020087, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1323941395697906169, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941395614020087, language=EN, stringName=Li-ping DONG, firstName=Li-ping, middleName=null, lastName=DONG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1323941395769209338, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941395614020087, language=CN, stringName=董利平, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=河北北方学院附属第一医院老年医学科，河北　张家口　075031, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1323941395135869422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, xref=null, ext=[AuthorCompanyExt(id=1323941395144258031, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China), AuthorCompanyExt(id=1323941395152646640, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=河北北方学院附属第一医院老年医学科，河北　张家口　075031)])]), Author(id=1323941395832123900, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, orderNo=2, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=lishutie2005@126.com, emailSecond=null, emailThird=null, correspondingAuthor=1, authorType=1, ext={EN=AuthorExt(id=1323941395924398590, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941395832123900, language=EN, stringName=Shu-tie LI, firstName=Shu-tie, middleName=null, lastName=LI, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1323941396025061887, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941395832123900, language=CN, stringName=李树铁, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=河北北方学院附属第一医院老年医学科，河北　张家口　075031, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1323941395135869422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, xref=null, ext=[AuthorCompanyExt(id=1323941395144258031, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China), AuthorCompanyExt(id=1323941395152646640, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=河北北方学院附属第一医院老年医学科，河北　张家口　075031)])]), Author(id=1323941396134113793, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, orderNo=3, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1323941396272525827, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941396134113793, language=EN, stringName=Jie KONG, firstName=Jie, middleName=null, lastName=KONG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1323941396398354948, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941396134113793, language=CN, stringName=孔洁, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=河北北方学院附属第一医院老年医学科，河北　张家口　075031, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1323941395135869422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, xref=null, ext=[AuthorCompanyExt(id=1323941395144258031, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China), AuthorCompanyExt(id=1323941395152646640, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=河北北方学院附属第一医院老年医学科，河北　张家口　075031)])])], keywords=[Keyword(id=1323941396499018245, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=EN, orderNo=1, keyword=Cardiovascular disease), Keyword(id=1323941397753115142, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=EN, orderNo=2, keyword=Sarcopenic obesity), Keyword(id=1323941397841195527, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=EN, orderNo=3, keyword=Elderly), Keyword(id=1323941397912498696, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=EN, orderNo=4, keyword=China Health and Retirement Longitudinal Study), Keyword(id=1323941398000579081, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=CN, orderNo=1, keyword=心血管疾病), Keyword(id=1323941398059299338, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=CN, orderNo=2, keyword=肌肉减少性肥胖), Keyword(id=1323941398122213899, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=CN, orderNo=3, keyword=老年人), Keyword(id=1323941398185128460, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=CN, orderNo=4, keyword=中国健康与养老追踪调查)], refs=[Reference(id=1323941399552471581, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2024, volume=403, issue=10440, pageStart=2133, pageEnd=2161, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=Diseases G2, Collaborators I, journalName=Lancet, refType=null, unstructuredReference=Diseases G2, Collaborators I. Global burden of 371 diseases and injuries in 204 countries and territories,1990-2021: a systematic analysis for the Global Burden of Disease Study 2021 [J]. Lancet, 2024, 403 (10440): 2133-2161., articleTitle=Global burden of 371 diseases and injuries in 204 countries and territories,1990-2021: a systematic analysis for the Global Burden of Disease Study 2021, refAbstract=null), Reference(id=1323941399615386142, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2025, volume=32, issue=7, pageStart=539, pageEnd=552, url=null, language=null, rfNumber=[2], rfOrder=1, authorNames=Wang MS, Deng JW, Geng WY, journalName=European Journal of Preventive Cardiology, refType=null, unstructuredReference=Wang MS, Deng JW, Geng WY, et al. Temporal trend and attributable risk factors of cardiovascular disease burden for adults 55 years and older in 204 countries/territories from 1990 to 2021: an analysis for the Global Burden of Disease Study 2021 [J]. European Journal of Preventive Cardiology, 2025, 32 (7): 539-552., articleTitle=Temporal trend and attributable risk factors of cardiovascular disease burden for adults 55 years and older in 204 countries/territories from 1990 to 2021: an analysis for the Global Burden of Disease Study 2021, refAbstract=null), Reference(id=1323941399686689311, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=12, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[3], rfOrder=2, authorNames=民政部, 全国老龄办, journalName=公益时报, refType=null, unstructuredReference=民政部，全国老龄办. 民政部、全国老龄办发布《2023年度国家老龄事业发展公报》 [N]. 公益时报, 2024-10-15（12）., articleTitle=民政部、全国老龄办发布《2023年度国家老龄事业发展公报》, refAbstract=null), Reference(id=1323941399757992480, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=12, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[3], rfOrder=3, authorNames=Ministry of Civil Affairs, National Working Commission on Aging, journalName=Gongyi Shibao, refType=null, unstructuredReference=Ministry of Civil Affairs, National Working Commission on Aging. Ministry of Civil Affairs and National Working Commission on Aging Release the "2023 National Aging Cause Development Bulletin" [N]. Gongyi Shibao, 2024-10-15 (12)., articleTitle=Ministry of Civil Affairs and National Working Commission on Aging Release the "2023 National Aging Cause Development Bulletin", refAbstract=null), Reference(id=1323941399833489953, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2019, volume=16, issue=4, pageStart=203, pageEnd=212, url=null, language=null, rfNumber=[4], rfOrder=4, authorNames=Zhao D, Liu J, Wang M, journalName=Nature Reviews Cardiology, refType=null, unstructuredReference=Zhao D, Liu J, Wang M, et al. Epidemiology of cardiovascular disease in China: current features and implications [J]. Nature Reviews Cardiology, 2019, 16 (4): 203-212., articleTitle=Epidemiology of cardiovascular disease in China: current features and implications, refAbstract=null), Reference(id=1323941399908987426, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2020, volume=9, issue=4, pageStart=571, pageEnd=581, url=null, language=null, rfNumber=[5], rfOrder=5, authorNames=Elagizi A, Kachur S, Carbone S, journalName=Current Obesity Reports, refType=null, unstructuredReference=Elagizi A, Kachur S, Carbone S, et al. A review of obesity, physical activity, and cardiovascular disease [J]. Current Obesity Reports, 2020, 9 (4): 571-581., articleTitle=A review of obesity, physical activity, and cardiovascular disease, refAbstract=null), Reference(id=1323941399967707683, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2022, volume=14, issue=20, pageStart=4315, pageEnd=null, url=null, language=null, rfNumber=[6], rfOrder=6, authorNames=Moura LDANE, Pagotto V, Camargo Pereira C, journalName=Nutrients, refType=null, unstructuredReference=Moura LDANE, Pagotto V, Camargo Pereira C, et al. Does abdominal obesity increase All-Cause, cardiovascular disease, and cancer mortality risks in older adults? a 10-Year Follow-Up analysis [J]. Nutrients, 2022, 14 (20): 4315., articleTitle=Does abdominal obesity increase All-Cause, cardiovascular disease, and cancer mortality risks in older adults? a 10-Year Follow-Up analysis, refAbstract=null), Reference(id=1323941400039010852, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2024, volume=13, issue=19, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[7], rfOrder=7, authorNames=Yang M, Liu J, Shen Q, journalName=Journal of the American Heart Association, refType=null, unstructuredReference=Yang M, Liu J, Shen Q, et al. Body roundness index trajectories and the incidence of cardiovascular disease: evidence from the China health and retirement longitudinal study [J]. Journal of the American Heart Association, 2024, 13 (19): e034768., articleTitle=Body roundness index trajectories and the incidence of cardiovascular disease: evidence from the China health and retirement longitudinal study, refAbstract=null), Reference(id=1323941400139674149, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2022, volume=115, issue=3, pageStart=671, pageEnd=678, url=null, language=null, rfNumber=[8], rfOrder=8, authorNames=Wu MY, Yu X, Xu LL, journalName=American Journal of Clinical Nutrition, refType=null, unstructuredReference=Wu MY, Yu X, Xu LL, et al. Associations of longitudinal trajectories in body roundness index with mortality and cardiovascular outcomes: a cohort study [J]. American Journal of Clinical Nutrition, 2022, 115 (3): 671-678., articleTitle=Associations of longitudinal trajectories in body roundness index with mortality and cardiovascular outcomes: a cohort study, refAbstract=null), Reference(id=1323941400215171622, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2019, volume=393, issue=10191, pageStart=2636, pageEnd=2646, url=null, language=null, rfNumber=[9], rfOrder=9, authorNames=Cruz-Jentoft AJ, Sayer AA, journalName=Lancet, refType=null, unstructuredReference=Cruz-Jentoft AJ, Sayer AA. Sarcopenia [J]. Lancet, 2019, 393 (10191): 2636-2646., articleTitle=Sarcopenia, refAbstract=null), Reference(id=1323941400303252007, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2022, volume=44, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[10], rfOrder=10, authorNames=Gao K, Cao LF, Ma WZ, journalName=EClinical Medicine, refType=null, unstructuredReference=Gao K, Cao LF, Ma WZ, et al. Association between sarcopenia and cardiovascular disease among middle-aged and older adults: Findings from the China health and retirement longitudinal study [J]. EClinical Medicine, 2022, 44: 101264., articleTitle=Association between sarcopenia and cardiovascular disease among middle-aged and older adults: Findings from the China health and retirement longitudinal study, refAbstract=null), Reference(id=1323941400366166568, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2018, volume=11, issue=4, pageStart=294, pageEnd=305, url=null, language=null, rfNumber=[11], rfOrder=11, authorNames=Barazzoni R, Bischoff S, Boirie Y, journalName=Obesity Facts, refType=null, unstructuredReference=Barazzoni R, Bischoff S, Boirie Y, et al. Sarcopenic obesity: time to meet the challenge [J]. Obesity Facts, 2018, 11 (4): 294-305., articleTitle=Sarcopenic obesity: time to meet the challenge, refAbstract=null), Reference(id=1323941400441664041, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2020, volume=21, issue=3, pageStart=300, pageEnd=307.e2, url=null, language=null, rfNumber=[12], rfOrder=12, authorNames=Chen LK, Woo J, Assantachai P, journalName=Journal of the American Medical Directors Association, refType=null, unstructuredReference=Chen LK, Woo J, Assantachai P, et al. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment [J]. Journal of the American Medical Directors Association, 2020, 21 (3): 300-307.e2., articleTitle=Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment, refAbstract=null), Reference(id=1323941400512967210, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2021, volume=16, issue=3, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[13], rfOrder=13, authorNames=Wu X, Li X, Xu MH, journalName=PLOS One, refType=null, unstructuredReference=Wu X, Li X, Xu MH, et al. Sarcopenia prevalence and associated factors among older Chinese population: Findings from the China Health and Retirement Longitudinal Study [J]. PLOS One, 2021, 16 (3): e0247617., articleTitle=Sarcopenia prevalence and associated factors among older Chinese population: Findings from the China Health and Retirement Longitudinal Study, refAbstract=null), Reference(id=1323941400613630507, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2021, volume=18, issue=1, pageStart=281, pageEnd=null, url=null, language=null, rfNumber=[14], rfOrder=14, authorNames=Nkwana MR, Monyeki KD, Lebelo SL, journalName=International Journal of Environmental Research and Public Health, refType=null, unstructuredReference=Nkwana MR, Monyeki KD, Lebelo SL. Body roundness index, a body shape index, conicity index, and their association with nutritional status and cardiovascular risk factors in South African rural young adults [J]. International Journal of Environmental Research and Public Health, 2021, 18 (1): 281., articleTitle=Body roundness index, a body shape index, conicity index, and their association with nutritional status and cardiovascular risk factors in South African rural young adults, refAbstract=null), Reference(id=1323941400701710892, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2025, volume=45, issue=6, pageStart=444, pageEnd=450, url=null, language=null, rfNumber=[15], rfOrder=15, authorNames=杨鑫怡, 李新瑜, 朱礼华, journalName=中国农村卫生事业管理, refType=null, unstructuredReference=杨鑫怡，李新瑜，朱礼华, 等. 老年人抑郁状况影响因素分析基于中国健康与养老追踪调查（CHARLS）的实证研究 [J]. 中国农村卫生事业管理, 2025, 45 (6): 444-450., articleTitle=老年人抑郁状况影响因素分析基于中国健康与养老追踪调查（CHARLS）的实证研究, refAbstract=null), Reference(id=1323941400768819757, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2025, volume=45, issue=6, pageStart=444, pageEnd=450, url=null, language=null, rfNumber=[15], rfOrder=16, authorNames=Yang XY, Li XY, Zhu LH, journalName=Chinese Rural Health Service Administration, refType=null, unstructuredReference=Yang XY, Li XY, Zhu LH, et al. Analysis of influencing factors of depressive symptoms in older adults:an empirical study based on the China health and retirement longitudinal study（CHARLS） [J]. Chinese Rural Health Service Administration, 2025, 45 (6): 444-450. (In Chinese), articleTitle=Analysis of influencing factors of depressive symptoms in older adults:an empirical study based on the China health and retirement longitudinal study（CHARLS）, refAbstract=null), Reference(id=1323941400848511534, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2025, volume=16, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[16], rfOrder=17, authorNames=He XH, Zhu JL, Liang WF, journalName=Frontiers in Endocrinology, refType=null, unstructuredReference=He XH, Zhu JL, Liang WF, et al. Association of body roundness index with cardiovascular disease in patients with cardiometabolic syndrome: a cross-sectional study based on NHANES 2009-2018 [J]. Frontiers in Endocrinology, 2025, 16: 1524352., articleTitle=Association of body roundness index with cardiovascular disease in patients with cardiometabolic syndrome: a cross-sectional study based on NHANES 2009-2018, refAbstract=null), Reference(id=1323941400924009007, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2024, volume=22, issue=1, pageStart=607, pageEnd=null, url=null, language=null, rfNumber=[17], rfOrder=18, authorNames=Zeng QY, Zhao LJ, Zhong Q, journalName=BMC Medicine, refType=null, unstructuredReference=Zeng QY, Zhao LJ, Zhong Q, et al. Changes in sarcopenia and incident cardiovascular disease in prospective cohorts [J]. BMC Medicine, 2024, 22 (1): 607., articleTitle=Changes in sarcopenia and incident cardiovascular disease in prospective cohorts, refAbstract=null), Reference(id=1323941401020478000, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2025, volume=47, issue=6, pageStart=440, pageEnd=null, url=null, language=null, rfNumber=[18], rfOrder=19, authorNames=Dina C, Tit DM, Radu A, journalName=Current Issues in Molecular Biology, refType=null, unstructuredReference=Dina C, Tit DM, Radu A, et al. Obesity, dietary patterns, and cardiovascular disease: a narrative review of metabolic and molecular pathways [J]. Current Issues in Molecular Biology, 2025, 47 (6): 440., articleTitle=Obesity, dietary patterns, and cardiovascular disease: a narrative review of metabolic and molecular pathways, refAbstract=null), Reference(id=1323941401095975473, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, doi=null, pmid=null, pmcid=null, year=2023, volume=14, issue=3, pageStart=1183, pageEnd=1198, url=null, language=null, rfNumber=[19], rfOrder=20, authorNames=Zuo XR, Li XH, Tang K, journalName=Journal of Cachexia, Sarcopenia and Muscle, refType=null, unstructuredReference=Zuo XR, Li XH, Tang K, et al. Sarcopenia and cardiovascular diseases: A systematic review and meta-analysis [J]. Journal of Cachexia, Sarcopenia and Muscle, 2023, 14 (3): 1183-1198., articleTitle=Sarcopenia and cardiovascular diseases: A systematic review and meta-analysis, refAbstract=null)], funds=[Fund(id=1323941399456002588, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, awardId=20241344, language=CN, fundingSource=河北省医学科学研究课题(20241344), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1323941395135869422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, xref=null, ext=[AuthorCompanyExt(id=1323941395144258031, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China), AuthorCompanyExt(id=1323941395152646640, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=河北北方学院附属第一医院老年医学科，河北　张家口　075031)])], figs=[ArticleFig(id=1323941398302568973, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=EN, label=Figure 1, caption=Flowchart of research subjects, figureFileSmall=JrfnUdAN865U5S8tKG3hXg==, figureFileBig=SaMk4tpYY7kQSX0L6+fznQ==, tableContent=null), ArticleFig(id=1323941398373872142, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=CN, label=图1, caption=研究对象的流程图, figureFileSmall=JrfnUdAN865U5S8tKG3hXg==, figureFileBig=SaMk4tpYY7kQSX0L6+fznQ==, tableContent=null), ArticleFig(id=1323941398533255695, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=EN, label=Figure 2, caption=Kaplan-Meier curves evaluate the cumulative incidence of CVD, stroke and heart disease at different times, figureFileSmall=DgAuZhPrc5FT3yrUKnXxPQ==, figureFileBig=xR6eVkXQmzBytw68/u3ybA==, tableContent=null), ArticleFig(id=1323941398587781649, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=CN, label=图2, caption=Kaplan～Meier曲线评估CVD、脑卒中及心脏病不同时间的累积发病率

注：A为CVD；B为脑卒中；C为心脏病。

, figureFileSmall=DgAuZhPrc5FT3yrUKnXxPQ==, figureFileBig=xR6eVkXQmzBytw68/u3ybA==, tableContent=null), ArticleFig(id=1323941398663279122, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=EN, label=Table 1, caption=

Baseline characteristics of the research subjects ［（）， n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量Total(n=4 349)正常BRI高BRIF/χ2值P值
无肌肉减少症
（n=2 102）		肌肉减少症
（n=1 159）		无肌肉减少症
（n=639）		肌肉减少症
（n=449）
年龄（岁）67.46±6.2165.97±5.0669.87±7.2165.96±5.0670.29±6.82157.51<0.001
性别400.53<0.001
男2 169 (49.87)1 274 (60.61)628 (54.18)189 (29.58)78 (17.37)
女2 180 (50.13)828 (39.39)531 (45.82)450 (70.42)371 (82.63)
婚姻88.05<0.001
其他777 (17.87)2 85 (13.56)256 (22.09)101 (15.81)135 (30.07)
已婚3 572 (82.13)1 817 (86.44)903 (77.91)538 (84.19)314 (69.93)
居住地59.90<0.001
城镇1 404 (32.28)712 (33.87)280 (24.16)262 (41.00)150 (33.41)
农村2 945 (67.72)1 390 (66.13)879 (75.84)377 (59.00)299 (66.59)
文化程度141.83<0.001
小学及以下2 505 (57.60)1 048 (49.86)752 (64.88)375 (58.69)330 (73.50)
中学1 601 (36.81)886 (42.15)376 (32.44)232 (36.31)107 (23.83)
大专及以上243 (5.59)168 (7.99)31 (2.67)32 (5.01)12 (2.67)
吸烟127.53<0.001
否2 851 (65.56)1 232 (58.61)772 (66.61)474 (74.18)373 (83.07)
是1 498 (34.44)870 (41.39)387 (33.39)165 (25.82)76 (16.93)
饮酒238.04<0.001
否3 066 (70.50)1 317 (62.65)787 (67.90)550 (86.07)412 (91.76)
是1 283 (29.50)785 (37.35)372 (32.10)89 (13.93)37 (8.24)
CESD-10评分7.81±6.147.20±5.888.69±6.457.38±5.838.98±6.4921.58<0.001
舒张压（mm Hg）74.12±11.1973.86±11.1472.20±11.1277.21±11.0075.91±10.7232.55<0.001
收缩压（mm Hg）129.84±19.88127.75±19.25127.92±19.80135.47±19.13136.52±21.0646.75<0.001
高血压153.44<0.001
否2 964 (68.15)1 559 (74.17)826 (71.27)349 (54.62)230 (51.22)
是1 385 (31.85)543 (25.83)333 (28.73)290 (45.38)219 (48.78)
糖尿病45.51<0.001
否3 992 (91.79)1 971 (93.77)1 073 (92.58)550 (86.07)398 (88.64)
是357 (8.21)131 (6.23)86 (7.42)89 (13.93)51 (11.36)
血脂异常54.97<0.001
否3 738 (85.95)1 851 (88.06)1 025 (88.44)502 (78.56)360 (80.18)
是611 (14.05)251 (11.94)134 (11.56)137 (21.44)89 (19.82)
), ArticleFig(id=1323941398747165203, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=CN, label=表1, caption=

研究对象的基线特征［（），n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量Total(n=4 349)正常BRI高BRIF/χ2值P值
无肌肉减少症
（n=2 102）		肌肉减少症
（n=1 159）		无肌肉减少症
（n=639）		肌肉减少症
（n=449）
年龄（岁）67.46±6.2165.97±5.0669.87±7.2165.96±5.0670.29±6.82157.51<0.001
性别400.53<0.001
男2 169 (49.87)1 274 (60.61)628 (54.18)189 (29.58)78 (17.37)
女2 180 (50.13)828 (39.39)531 (45.82)450 (70.42)371 (82.63)
婚姻88.05<0.001
其他777 (17.87)2 85 (13.56)256 (22.09)101 (15.81)135 (30.07)
已婚3 572 (82.13)1 817 (86.44)903 (77.91)538 (84.19)314 (69.93)
居住地59.90<0.001
城镇1 404 (32.28)712 (33.87)280 (24.16)262 (41.00)150 (33.41)
农村2 945 (67.72)1 390 (66.13)879 (75.84)377 (59.00)299 (66.59)
文化程度141.83<0.001
小学及以下2 505 (57.60)1 048 (49.86)752 (64.88)375 (58.69)330 (73.50)
中学1 601 (36.81)886 (42.15)376 (32.44)232 (36.31)107 (23.83)
大专及以上243 (5.59)168 (7.99)31 (2.67)32 (5.01)12 (2.67)
吸烟127.53<0.001
否2 851 (65.56)1 232 (58.61)772 (66.61)474 (74.18)373 (83.07)
是1 498 (34.44)870 (41.39)387 (33.39)165 (25.82)76 (16.93)
饮酒238.04<0.001
否3 066 (70.50)1 317 (62.65)787 (67.90)550 (86.07)412 (91.76)
是1 283 (29.50)785 (37.35)372 (32.10)89 (13.93)37 (8.24)
CESD-10评分7.81±6.147.20±5.888.69±6.457.38±5.838.98±6.4921.58<0.001
舒张压（mm Hg）74.12±11.1973.86±11.1472.20±11.1277.21±11.0075.91±10.7232.55<0.001
收缩压（mm Hg）129.84±19.88127.75±19.25127.92±19.80135.47±19.13136.52±21.0646.75<0.001
高血压153.44<0.001
否2 964 (68.15)1 559 (74.17)826 (71.27)349 (54.62)230 (51.22)
是1 385 (31.85)543 (25.83)333 (28.73)290 (45.38)219 (48.78)
糖尿病45.51<0.001
否3 992 (91.79)1 971 (93.77)1 073 (92.58)550 (86.07)398 (88.64)
是357 (8.21)131 (6.23)86 (7.42)89 (13.93)51 (11.36)
血脂异常54.97<0.001
否3 738 (85.95)1 851 (88.06)1 025 (88.44)502 (78.56)360 (80.18)
是611 (14.05)251 (11.94)134 (11.56)137 (21.44)89 (19.82)
), ArticleFig(id=1323941398826856980, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=EN, label=Table 2, caption=

Cox proportional hazards regression analysis of sarcopenic obesity status

, figureFileSmall=null, figureFileBig=null, tableContent=
Model 1Model 2Model 3Model 4
HR (95% CI)P值HR (95% CI)P值HR (95% CI)P值HR (95% CI)P值
CVD
无肌肉减少症对照对照对照对照
肌肉减少症1.32 (1.16～1.50)<0.0011.22 (1.06～1.40)0.0051.18 (1.03～1.36)0.0191.17 (1.02～1.35)0.027
正常BRI对照对照对照对照
高BRI1.51 (1.32～1.74)<0.0011.43 (1.23～1.65)<0.0011.42 (1.23～1.65)<0.0011.21 (1.04～1.40)0.015
正常BRI无肌肉减少症对照对照对照对照
正常BRI肌肉减少症1.29（1.10～1.51）0.0021.22（1.03～1.44）0.0211.18（1.00～1.40）0.0551.15（0.97～1.37）0.097
高BRI无肌肉减少症1.49（1.23～1.79）<0.0011.42（1.18～1.73）<0.0011.43（1.18～1.73）<0.0011.18(0.97～1.44)0.093
高BRI肌肉减少症1.93（1.59～2.35）<0.0011.72（1.40～2.13）<0.0011.66（1.34～2.05）<0.0011.41(1.14～1.75)0.001
脑卒中
无肌肉减少症对照对照对照对照
肌肉减少症1.45 (1.17～1.80)<0.0011.39 (1.11～1.75)0.0051.33 (1.06～1.68)0.0151.32 (1.05～1.66)0.019
正常BRI对照对照对照对照
高BRI1.68 (1.35～2.10)<0.0011.78 (1.40～2.26)<0.0011.77 (1.39～2.25)<0.0011.34 (1.05～1.71)0.019
正常BRI无肌肉减少症对照对照对照对照
正常BRI肌肉减少症1.40（1.07～1.84）0.0131.37（1.03～1.81）0.0281.30（0.98～1.73）0.0651.27（0.96～1.69）0.092
高BRI无肌肉减少症1.63（1.20～～2.23）0.0021.75（1.27～2.40）<0.0011.74（1.26～2.39）<0.0011.28 (0.93～1.77)0.131
高BRI肌肉减少症2.34（1.72～3.20）<0.0012.46（1.76～3.45）<0.0012.34（1.67～3.28）<0.0011.77 (1.26～2.49)0.001
心脏病
无肌肉减少症对照对照对照对照
肌肉减少症1.30 （1.12～1.52）<0.0011.21 （1.03～1.42）0.0221.18 （1.00～1.39）0.0491.17 (0.99～1.38)0.065
正常BRI对照对照对照对照
高BRI1.41 （1.20～1.66）<0.0011.27 (1.07～1.50)0.0071.26 (1.06～1.50)0.0081.12（0.94～1.34）0.212
正常BRI无肌肉减少症对照对照对照对照
正常BRI肌肉减少症1.26（1.05～1.52）0.0151.19（0.98～1.44)0.0811.16(0.96～1.42)0.1321.14（0.94～1.39）0.195
高BRI无肌肉减少症1.36（1.08～1.69）0.0081.24(0.99～1.56)0.0671.24(0.99～1.56)0.0641.08（0.85～1.36）0.521
高BRI肌肉减少症1.81（1.44～2.28）<0.0011.53(1.20～1.96)<0.0011.48(1.16～1.90)0.0021.32（1.03～1.69）0.030
), ArticleFig(id=1323941398914937365, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=CN, label=表2, caption=

肌肉减少性肥胖状态的Cox比例风险回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
Model 1Model 2Model 3Model 4
HR (95% CI)P值HR (95% CI)P值HR (95% CI)P值HR (95% CI)P值
CVD
无肌肉减少症对照对照对照对照
肌肉减少症1.32 (1.16～1.50)<0.0011.22 (1.06～1.40)0.0051.18 (1.03～1.36)0.0191.17 (1.02～1.35)0.027
正常BRI对照对照对照对照
高BRI1.51 (1.32～1.74)<0.0011.43 (1.23～1.65)<0.0011.42 (1.23～1.65)<0.0011.21 (1.04～1.40)0.015
正常BRI无肌肉减少症对照对照对照对照
正常BRI肌肉减少症1.29（1.10～1.51）0.0021.22（1.03～1.44）0.0211.18（1.00～1.40）0.0551.15（0.97～1.37）0.097
高BRI无肌肉减少症1.49（1.23～1.79）<0.0011.42（1.18～1.73）<0.0011.43（1.18～1.73）<0.0011.18(0.97～1.44)0.093
高BRI肌肉减少症1.93（1.59～2.35）<0.0011.72（1.40～2.13）<0.0011.66（1.34～2.05）<0.0011.41(1.14～1.75)0.001
脑卒中
无肌肉减少症对照对照对照对照
肌肉减少症1.45 (1.17～1.80)<0.0011.39 (1.11～1.75)0.0051.33 (1.06～1.68)0.0151.32 (1.05～1.66)0.019
正常BRI对照对照对照对照
高BRI1.68 (1.35～2.10)<0.0011.78 (1.40～2.26)<0.0011.77 (1.39～2.25)<0.0011.34 (1.05～1.71)0.019
正常BRI无肌肉减少症对照对照对照对照
正常BRI肌肉减少症1.40（1.07～1.84）0.0131.37（1.03～1.81）0.0281.30（0.98～1.73）0.0651.27（0.96～1.69）0.092
高BRI无肌肉减少症1.63（1.20～～2.23）0.0021.75（1.27～2.40）<0.0011.74（1.26～2.39）<0.0011.28 (0.93～1.77)0.131
高BRI肌肉减少症2.34（1.72～3.20）<0.0012.46（1.76～3.45）<0.0012.34（1.67～3.28）<0.0011.77 (1.26～2.49)0.001
心脏病
无肌肉减少症对照对照对照对照
肌肉减少症1.30 （1.12～1.52）<0.0011.21 （1.03～1.42）0.0221.18 （1.00～1.39）0.0491.17 (0.99～1.38)0.065
正常BRI对照对照对照对照
高BRI1.41 （1.20～1.66）<0.0011.27 (1.07～1.50)0.0071.26 (1.06～1.50)0.0081.12（0.94～1.34）0.212
正常BRI无肌肉减少症对照对照对照对照
正常BRI肌肉减少症1.26（1.05～1.52）0.0151.19（0.98～1.44)0.0811.16(0.96～1.42)0.1321.14（0.94～1.39）0.195
高BRI无肌肉减少症1.36（1.08～1.69）0.0081.24(0.99～1.56)0.0671.24(0.99～1.56)0.0641.08（0.85～1.36）0.521
高BRI肌肉减少症1.81（1.44～2.28）<0.0011.53(1.20～1.96)<0.0011.48(1.16～1.90)0.0021.32（1.03～1.69）0.030
), ArticleFig(id=1323941398994629142, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=EN, label=Table 3, caption=

Subgroup analysis of the correlation between sarcopenic obesity and CVD

, figureFileSmall=null, figureFileBig=null, tableContent=
变量正常BRI肌肉减少症高BRI无肌肉减少症高BRI肌肉减少症
HR (95% CI)P值HR (95% CI)P值HR (95% CI)P值
年龄（岁）
< 651.58(1.21～2.05)<0.0011.66(1.27～2.17)<0.0011.66(1.12～2.45)0.011
≥ 651.03(0.84～1.26)0.7781.28(0.98～1.66)0.0661.66(1.31～2.09)<0.001
性别
男1.47(1.19～1.83)<0.0011.40(0.99～1.96)0.0542.42(1.63～3.59)<0.001
女1.05(0.83～1.33)0.6981.31(1.03～1.65)0.0271.51(1.19～1.92)<0.001
饮酒
否1.27(1.05～1.55)0.0151.57(1.27～1.95)<0.0011.79(1.43～2.23)<0.001
是1.23(0.93～1.63)0.1410.94(0.62～1.44)0.7841.79(1.13～2.83)0.013
吸烟
否1.19(0.98～1.44)0.0781.35(1.10～1.67)0.0051.75(1.41～2.16)<0.001
是1.44(1.09～1.91)0.0121.54(0.96～2.48)0.0741.46(1.21～2.99)<0.001
高血压
否1.31(1.07～1.60)0.0091.20(0.91～1.59)0.1961.53(1.13～2.07)0.006
是1.17(0.90～1.52)0.2401.38(1.06～1.79)0.0171.69(1.29～2.22)<0.001
糖尿病
否1.29(1.09～1.53)0.0041.43(1.16～1.76)<0.0011.77(1.42～2.19)<0.001
是1.09(0.68～1.73)0.7311.09(0.69～1.73)0.7171.72(1.06～2.78)0.028
血脂异常
否1.33(1.11～1.59)0.0021.40(1.12～1.75)0.0031.70(1.34～2.15)<0.001
是1.08(0.75～1.56)0.6721.19(0.84～1.70)0.3321.76(1.22～2.53)0.002
), ArticleFig(id=1323941399065932311, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=CN, label=表3, caption=

肌肉减少性肥胖状态与CVD相关性的亚组分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量正常BRI肌肉减少症高BRI无肌肉减少症高BRI肌肉减少症
HR (95% CI)P值HR (95% CI)P值HR (95% CI)P值
年龄（岁）
< 651.58(1.21～2.05)<0.0011.66(1.27～2.17)<0.0011.66(1.12～2.45)0.011
≥ 651.03(0.84～1.26)0.7781.28(0.98～1.66)0.0661.66(1.31～2.09)<0.001
性别
男1.47(1.19～1.83)<0.0011.40(0.99～1.96)0.0542.42(1.63～3.59)<0.001
女1.05(0.83～1.33)0.6981.31(1.03～1.65)0.0271.51(1.19～1.92)<0.001
饮酒
否1.27(1.05～1.55)0.0151.57(1.27～1.95)<0.0011.79(1.43～2.23)<0.001
是1.23(0.93～1.63)0.1410.94(0.62～1.44)0.7841.79(1.13～2.83)0.013
吸烟
否1.19(0.98～1.44)0.0781.35(1.10～1.67)0.0051.75(1.41～2.16)<0.001
是1.44(1.09～1.91)0.0121.54(0.96～2.48)0.0741.46(1.21～2.99)<0.001
高血压
否1.31(1.07～1.60)0.0091.20(0.91～1.59)0.1961.53(1.13～2.07)0.006
是1.17(0.90～1.52)0.2401.38(1.06～1.79)0.0171.69(1.29～2.22)<0.001
糖尿病
否1.29(1.09～1.53)0.0041.43(1.16～1.76)<0.0011.77(1.42～2.19)<0.001
是1.09(0.68～1.73)0.7311.09(0.69～1.73)0.7171.72(1.06～2.78)0.028
血脂异常
否1.33(1.11～1.59)0.0021.40(1.12～1.75)0.0031.70(1.34～2.15)<0.001
是1.08(0.75～1.56)0.6721.19(0.84～1.70)0.3321.76(1.22～2.53)0.002
), ArticleFig(id=1323941399141429784, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=EN, label=Table 4, caption=

Subgroup analysis of the correlation between sarcopenic obesity and stroke

, figureFileSmall=null, figureFileBig=null, tableContent=
变量正常BRI肌肉减少症高BRI无肌肉减少症高BRI肌肉减少症
HR (95% CI)P值HR (95% CI)P值HR (95% CI)P值
年龄（岁）
< 651.60(1.04～2.48)0.0341.93(1.26～2.97)0.0032.03(1.11～3.71)0.021
≥ 651.19(0.84～1.68)0.3191.34(0.86～2.10)0.1952.13(1.46～3.11)<0.001
性别
男1.50(1.07～2.10)0.0191.73(1.06～2.82)0.0292.52(1.38～4.63)0.003
女1.28(0.83～1.99)0.2661.69(1.10～2.59)0.0172.43(1.61～3.67)<0.001
饮酒
否1.37(0.98～1.91)0.0651.75(1.22～2.50)0.0022.29(1.60～3.26)<0.001
是1.42(0.90～2.23)0.1361.10(0.56～2.18)0.7741.95(1.05～4.12)0.045
吸烟
否1.27(0.91～1.77)0.1611.55(1.09～2.19)0.0142.21(1.57～3.12)<0.001
是1.66(1.06～2.63)0.0281.70(0.80～3.63)0.1682.05(1.74～5.72)<0.001
高血压
否1.36(0.94～1.97)0.1061.54(0.96～2.47)0.0752.06(1.25～3.39)0.005
是1.35 (0.91～2.00)0.1301.25(0.82～1.89)0.2981.76(1.17～2.64)0.007
糖尿病
否1.46(1.10～1.95)0.0091.56(1.11～2.21)0.0112.28(1.62～3.21)<0.001
是0.90(0.41～1.96)0.7871.23(0.61～2.50)0.5621.71(1.20～3.64)<0.001
血脂异常
否1.48(1.09～2.01)0.0131.67(1.16～2.42)0.0062.13(1.45～3.12)<0.001
是1.18(0.67～2.06)0.5691.09(0.62～1.92)0.7651.98(1.15～3.41)0.014
), ArticleFig(id=1323941399221121561, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=CN, label=表4, caption=

肌肉减少性肥胖状态与脑卒中相关性的亚组分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量正常BRI肌肉减少症高BRI无肌肉减少症高BRI肌肉减少症
HR (95% CI)P值HR (95% CI)P值HR (95% CI)P值
年龄（岁）
< 651.60(1.04～2.48)0.0341.93(1.26～2.97)0.0032.03(1.11～3.71)0.021
≥ 651.19(0.84～1.68)0.3191.34(0.86～2.10)0.1952.13(1.46～3.11)<0.001
性别
男1.50(1.07～2.10)0.0191.73(1.06～2.82)0.0292.52(1.38～4.63)0.003
女1.28(0.83～1.99)0.2661.69(1.10～2.59)0.0172.43(1.61～3.67)<0.001
饮酒
否1.37(0.98～1.91)0.0651.75(1.22～2.50)0.0022.29(1.60～3.26)<0.001
是1.42(0.90～2.23)0.1361.10(0.56～2.18)0.7741.95(1.05～4.12)0.045
吸烟
否1.27(0.91～1.77)0.1611.55(1.09～2.19)0.0142.21(1.57～3.12)<0.001
是1.66(1.06～2.63)0.0281.70(0.80～3.63)0.1682.05(1.74～5.72)<0.001
高血压
否1.36(0.94～1.97)0.1061.54(0.96～2.47)0.0752.06(1.25～3.39)0.005
是1.35 (0.91～2.00)0.1301.25(0.82～1.89)0.2981.76(1.17～2.64)0.007
糖尿病
否1.46(1.10～1.95)0.0091.56(1.11～2.21)0.0112.28(1.62～3.21)<0.001
是0.90(0.41～1.96)0.7871.23(0.61～2.50)0.5621.71(1.20～3.64)<0.001
血脂异常
否1.48(1.09～2.01)0.0131.67(1.16～2.42)0.0062.13(1.45～3.12)<0.001
是1.18(0.67～2.06)0.5691.09(0.62～1.92)0.7651.98(1.15～3.41)0.014
), ArticleFig(id=1323941399288230426, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=EN, label=Table 5, caption=

Subgroup analysis of the correlation between sarcopenic obesity and heart disease

, figureFileSmall=null, figureFileBig=null, tableContent=
变量正常BRI肌肉减少症高BRI无肌肉减少症高BRI肌肉减少症
HR (95% CI)P值HR (95% CI)P值HR (95% CI)P值
年龄（岁）
<651.59(1.18～2.16)0.0021.42(1.02～1.97)0.0361.31(0.80～2.15)0.287
≥ 651.00(0.79～1.27)0.9911.27(0.93～1.72)0.1301.67(1.28～2.19)<0.001
性别
男1.49(1.15～1.94)0.0031.17(0.75～1.83)0.4782.51(1.57～4.01)<0.001
女1.00(0.77～1.31)0.9921.16(0.88～1.52)0.2901.31(1.00～1.73)0.049
饮酒
否1.20(0.95～1.51)0.1221.41(1.09～1.82)0.0081.62(1.25～2.11)<0.001
是1.31(0.95～1.81)0.1010.90(0.54～1.51)0.7022.03(1.22～3.40)0.007
吸烟
否1.19(0.96～1.49)0.1181.26(0.98～1.61)0.0671.66(0.99～2.13)0.051
是1.34(0.95～1.89)0.0911.26(0.69～2.31)0.4541.25(0.51～3.09)0.624
高血压
否1.24(0.98～1.57)0.0681.07(0.77～1.50)0.6711.49(1.06～2.11)0.024
是1.23(0.89～1.68)0.2051.37(1.00～1.89)0.0521.69(1.22～2.35)0.002
糖尿病
否1.20(0.98～1.46)0.0761.32(1.03～1.68)0.0271.60(1.24～2.07)<0.001
是1.58(0.93～2.69)0.0931.09(0.61～1.95)0.7642.21(1.26～3.87)0.006
血脂异常
否1.27(1.03～1.56)0.0241.23(0.94～1.61)0.1251.49(1.12～1.97)0.006
是1.19（0.77～1.85）0.4241.28（0.84～1.96）0.2492.10（1.38～3.20）<0.001
), ArticleFig(id=1323941399363727899, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, language=CN, label=表5, caption=

肌肉减少性肥胖状态与心脏病相关性的亚组分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量正常BRI肌肉减少症高BRI无肌肉减少症高BRI肌肉减少症
HR (95% CI)P值HR (95% CI)P值HR (95% CI)P值
年龄（岁）
<651.59(1.18～2.16)0.0021.42(1.02～1.97)0.0361.31(0.80～2.15)0.287
≥ 651.00(0.79～1.27)0.9911.27(0.93～1.72)0.1301.67(1.28～2.19)<0.001
性别
男1.49(1.15～1.94)0.0031.17(0.75～1.83)0.4782.51(1.57～4.01)<0.001
女1.00(0.77～1.31)0.9921.16(0.88～1.52)0.2901.31(1.00～1.73)0.049
饮酒
否1.20(0.95～1.51)0.1221.41(1.09～1.82)0.0081.62(1.25～2.11)<0.001
是1.31(0.95～1.81)0.1010.90(0.54～1.51)0.7022.03(1.22～3.40)0.007
吸烟
否1.19(0.96～1.49)0.1181.26(0.98～1.61)0.0671.66(0.99～2.13)0.051
是1.34(0.95～1.89)0.0911.26(0.69～2.31)0.4541.25(0.51～3.09)0.624
高血压
否1.24(0.98～1.57)0.0681.07(0.77～1.50)0.6711.49(1.06～2.11)0.024
是1.23(0.89～1.68)0.2051.37(1.00～1.89)0.0521.69(1.22～2.35)0.002
糖尿病
否1.20(0.98～1.46)0.0761.32(1.03～1.68)0.0271.60(1.24～2.07)<0.001
是1.58(0.93～2.69)0.0931.09(0.61～1.95)0.7642.21(1.26～3.87)0.006
血脂异常
否1.27(1.03～1.56)0.0241.23(0.94～1.61)0.1251.49(1.12～1.97)0.006
是1.19（0.77～1.85）0.4241.28（0.84～1.96）0.2492.10（1.38～3.20）<0.001
)], attaches=null, journal=Journal(id=1227664546253402114, delFlag=0, nameCn=现代预防医学, nameEn=Modern Preventive Medicine, nameHistory1=null, nameHistory2=null, issn=1003-8507, eissn=null, cn=51-1365/R, coden=null, periodic=3, language=CN, oaType=null, ccby=null, superviseOffice=null, ownerOffice=null, pubOffice=null, editorOffice=null, officeType=null, aims=null, clcCode=null, officeProv=null, officeCity=null, officeAddr=null, officeZip=null, officeEmail=null, officePhone=null, editDirector=null, officeDirector=null, officeDirectorPhone=null, officeStaffNum=null, officeEmpNum=null, coverPicUrl=IeiuPXEZi6AA+k0VfvoiOQ==, journalPrice=null, startedYear=null, abbrevIsoEn=Modern Preventive Medicine, journalRemark=null, publicationField=null, createdTime=1770627636734, updatedTime=1788949112281, createdBy=18614031015, updatedBy=13041195026, firstLetterCn=X, firstLetterEn=X, subjectCode=Medical and Pharmaceutical Sciences, subjectName=null, subjectCodeEn=Medical and Pharmaceutical Sciences, subjectNameEn=null, picCn=IeiuPXEZi6AA+k0VfvoiOQ==, picEn=/9iTl8/ndms4tBz1fL28Pg==, jcr=null, cjcr=null, exts=[JournalExt(id=1304510385713861624, language=CN, name=现代预防医学, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1788949112585, updatedTime=1788949112585, createdBy=13041195026, updatedBy=13041195026, submissionGuidelinesUrl=, submissionAuthorUrl=http://xdyfyxzz.paperopen.com/#/regist, submissionEditorUrl=http://xdyfyxzz.paperopen.com/#/Login, submissionReviewUrl=http://xdyfyxzz.paperopen.com/#/Login, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""}), JournalExt(id=1304510385772581881, language=EN, name=Modern Preventive Medicine, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1788949112599, updatedTime=1788949112599, createdBy=13041195026, updatedBy=13041195026, submissionGuidelinesUrl=, submissionAuthorUrl=http://xdyfyxzz.paperopen.com/#/regist, submissionEditorUrl=http://xdyfyxzz.paperopen.com/#/Login, submissionReviewUrl=http://xdyfyxzz.paperopen.com/#/Login, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""})], databaseList=null, tenantJournalId=1227665162245664772, websiteList=[Website(id=1227687234141352800, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1227665162245664772, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/xdyfyx/CN, language=CN, createTime=1770633045945, createBy=18614031015, updateTime=1770633090526, updateBy=18614031015, name=现代预防医学-中文, tplId=1146099689490845704, title=现代预防医学, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1227687735088051072, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=articleTextType, value=kx, createTime=1770633165380, updateTime=1770633165380, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735071273853, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=banner, value=null, createTime=1770633165376, updateTime=1770633165376, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735113216899, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=grayFlag, value=0, createTime=1770633165386, updateTime=1770633165386, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735062885244, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=logo, value=https://castjournals.cast.org.cn/joweb/xdyfyx/CN/file/pic?fileId=/XB5plC0xuykmQnycvtyrw==, createTime=1770633165374, updateTime=1770633165374, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735125799813, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=minRunFlag, value=0, createTime=1770633165389, updateTime=1770633165389, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735083856767, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/xdyfyx/CN/file/pic, createTime=1770633165379, updateTime=1770633165379, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735121605508, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=silenceFlag, value=0, createTime=1770633165388, updateTime=1770633165388, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735079662462, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_cn_619/, createTime=1770633165378, updateTime=1770633165378, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735096439681, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=themeColor, value=null, createTime=1770633165382, updateTime=1770633165382, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735104828290, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=themeStyle, value=null, createTime=1770633165384, updateTime=1770633165384, creator=18614031015, updator=18614031015)]), Website(id=1227687234338485094, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1227665162245664772, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/xdyfyx/EN, language=EN, createTime=1770633045992, createBy=18614031015, updateTime=1770633115374, updateBy=18614031015, name=现代预防医学-英文, tplId=1146101810881728533, title=Modern Preventive Medicine, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1227687709129507332, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=articleTextType, value=kx, createTime=1770633159191, updateTime=1770633159191, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709108535809, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=banner, value=null, createTime=1770633159186, updateTime=1770633159186, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709167256071, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=grayFlag, value=0, createTime=1770633159200, updateTime=1770633159200, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709095952896, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=logo, value=https://castjournals.cast.org.cn/joweb/xdyfyx/EN/file/pic?fileId=/XB5plC0xuykmQnycvtyrw==, createTime=1770633159183, updateTime=1770633159183, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709179838985, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=minRunFlag, value=0, createTime=1770633159203, updateTime=1770633159203, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709121118723, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/xdyfyx/EN/file/pic, createTime=1770633159189, updateTime=1770633159189, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709171450376, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=silenceFlag, value=0, createTime=1770633159201, updateTime=1770633159201, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709112730114, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_en_623/, createTime=1770633159187, updateTime=1770633159187, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709133701637, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=themeColor, value=null, createTime=1770633159192, updateTime=1770633159192, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709154673158, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=themeStyle, value=null, createTime=1770633159197, updateTime=1770633159197, creator=18614031015, updator=18614031015)])], journalTitle=现代预防医学, weixinUrl=null, journalUrl=http://xdyfyxzz.paperopen.com/, iacademicId=null, status=1, seqNo=null, journalTitleEn=Modern Preventive Medicine, journalPhotoCn=IeiuPXEZi6AA+k0VfvoiOQ==, journalPhotoEn=/9iTl8/ndms4tBz1fL28Pg==, journalFirstLetter=X, journalRecommend=null, journalNew=null, journalCollection=null, jcrJf=null, cjcrJf=null, jcrJfStr=null, cjcrJfStr=null, submissionFirstDecision=null, sciSubjectClassification=null, casSubjectClassification=null, citeScore=null, totalCitationFrequency=null, icpCode=null, psCode=null, advertisingLicenseCode=null, copyrightInformation=null, country=null, option=, provinceCode=null, provinceName=null, collectFlag=false, interPubPlatform=, interPubPlatformUrl=null), detailUrlCn=https://castjournals.cast.org.cn/joweb/xdyfyx/CN/10.20043/j.cnki.MPM.202506304, detailUrlEn=https://castjournals.cast.org.cn/joweb/xdyfyx/EN/10.20043/j.cnki.MPM.202506304, pdfUrlCn=https://castjournals.cast.org.cn/joweb/xdyfyx/CN/PDF/10.20043/j.cnki.MPM.202506304, pdfUrlEn=https://castjournals.cast.org.cn/joweb/xdyfyx/EN/PDF/10.20043/j.cnki.MPM.202506304, aliStartDate=0, aliEndDate=0, collectionFlag=false, citedCount=null, citedUrl=null, previewStatus=0, delFlag=0, hasFullText=1, orderTime=1765296000000, fullTextJson=null, articleText=null, reference=null)
收藏切换
老年人肌肉减少性肥胖与心血管疾病风险之间的相关性
收藏切换
PDF下载
张友涛 , 董利平 , 李树铁 , 孔洁
现代预防医学 | 临床与预防 2025,52(23): 4409-4416
收起
收藏切换
现代预防医学 |临床与预防 2025 , 52 (23) : 4409 -4416
老年人肌肉减少性肥胖与心血管疾病风险之间的相关性
全屏
[Author(id=1323941395236532722, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1323941395328807412, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941395236532722, language=EN, stringName=You-tao ZHANG, firstName=You-tao, middleName=null, lastName=ZHANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1323941395412693493, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941395236532722, language=CN, stringName=张友涛, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=河北北方学院附属第一医院老年医学科，河北　张家口　075031, bio={"content":"

张友涛（1987—），男，硕士，主治医师，研究方向：老年慢性病预防与诊治

"}, bioImg=null, bioContent=

张友涛（1987—），男，硕士，主治医师，研究方向：老年慢性病预防与诊治

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1323941395135869422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, xref=null, ext=[AuthorCompanyExt(id=1323941395144258031, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China), AuthorCompanyExt(id=1323941395152646640, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=河北北方学院附属第一医院老年医学科，河北　张家口　075031)])]), Author(id=1323941395614020087, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1323941395697906169, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941395614020087, language=EN, stringName=Li-ping DONG, firstName=Li-ping, middleName=null, lastName=DONG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1323941395769209338, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941395614020087, language=CN, stringName=董利平, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=河北北方学院附属第一医院老年医学科，河北　张家口　075031, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1323941395135869422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, xref=null, ext=[AuthorCompanyExt(id=1323941395144258031, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China), AuthorCompanyExt(id=1323941395152646640, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=河北北方学院附属第一医院老年医学科，河北　张家口　075031)])]), Author(id=1323941395832123900, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, orderNo=2, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=lishutie2005@126.com, emailSecond=null, emailThird=null, correspondingAuthor=1, authorType=1, ext={EN=AuthorExt(id=1323941395924398590, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941395832123900, language=EN, stringName=Shu-tie LI, firstName=Shu-tie, middleName=null, lastName=LI, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1323941396025061887, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941395832123900, language=CN, stringName=李树铁, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=河北北方学院附属第一医院老年医学科，河北　张家口　075031, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1323941395135869422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, xref=null, ext=[AuthorCompanyExt(id=1323941395144258031, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China), AuthorCompanyExt(id=1323941395152646640, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=河北北方学院附属第一医院老年医学科，河北　张家口　075031)])]), Author(id=1323941396134113793, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, orderNo=3, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1323941396272525827, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941396134113793, language=EN, stringName=Jie KONG, firstName=Jie, middleName=null, lastName=KONG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1323941396398354948, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, authorId=1323941396134113793, language=CN, stringName=孔洁, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=河北北方学院附属第一医院老年医学科，河北　张家口　075031, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1323941395135869422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, xref=null, ext=[AuthorCompanyExt(id=1323941395144258031, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China), AuthorCompanyExt(id=1323941395152646640, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941391566516705, companyId=1323941395135869422, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=河北北方学院附属第一医院老年医学科，河北　张家口　075031)])])]
张友涛, 董利平, 李树铁 , 孔洁
作者信息
  • 河北北方学院附属第一医院老年医学科，河北　张家口　075031
通讯作者:
李树铁，E-mail：
作者简介:

张友涛（1987—），男，硕士，主治医师，研究方向：老年慢性病预防与诊治

Association between sarcopenic obesity and cardiovascular disease risk in the elderly
You-tao ZHANG, Li-ping DONG, Shu-tie LI , Jie KONG
Affiliations
  • Department of Geriatric Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075031, China
出版时间: 2025-12-10 doi: 10.20043/j.cnki.MPM.202506304
文章导航
收藏切换
摘要
收起
目的

探究中国老年人肌肉减少性肥胖与心血管疾病（cardiovascular disease，CVD）之间的纵向关系。

方法

利用2015—2020年中国健康与养老追踪调查（China Health and Retirement Longitudinal Study, CHARLS）的数据。纳入4 349名60岁及以上老年人，基于身体圆度指数（body roundness index，BRI）和肌肉减少症状态分为四组，即正常BRI无肌肉减少症组、正常BRI肌肉减少症组、高BRI无肌肉减少症组、高BRI肌肉减少症组。采用了Kaplan～Meier曲线估计参与者CVD、脑卒中和心脏病在不同时间的累积发病率。然后使用多次调整的Cox比例风险回归模型控制混杂因素，分析肌肉减少性肥胖状态与CVD、脑卒中及心脏病之间的关联。最后，通过亚组分析检验四组人群对CVD、卒中及心脏事件关联效应的一致性。

结果

基于不同的肌肉减少性肥胖状态，Kaplan~Meier生存曲线显示不同组间累积发病率存在差异（P<0.001）。完全调整协变量后，与正常BRI无肌肉减少症组相比，高BRI肌肉减少症组显著增加了CVD（HR=1.41，95% CI：1.14～1.75）、脑卒中（HR=1.77，95% CI：1.26～2.49）及心脏病（HR=1.32，95% CI：1.03～1.69）的发病风险。进一步证明了肌肉减少性肥胖是CVD、脑卒中和心脏病的重要危险因素。在亚组分析中，一致发现高BRI与肌肉减少症和CVD、脑卒中和心脏病的关联。

结论

在中国老年人群中，高BRI肌肉减少症与CVD、脑卒中和心脏病发病风险显著相关，建议预防和改善肌肉减少症，控制体重和适量运动有助于延缓CVD的进展，促进老年人的健康衰老。

心血管疾病  /  肌肉减少性肥胖  /  老年人  /  中国健康与养老追踪调查
Objective

To investigate the longitudinal association between sarcopenic obesity and cardiovascular disease (CVD) in the elderly in China.

Methods

Data from the China Health and Retirement Longitudinal Study (CHARLS) from 2015 to 2020 were used. A total of 4 349 elderly people aged 60 years and above were enrolled and divided into four groups based on body roundness index (BRI) and sarcopenia status,namely (1) normal BRI without sarcopenia group; (2) normal BRI with sarcopenia group; (3) high BRI without sarcopenia group; and (4) high BRI with sarcopenia group. Kaplan-Meier curves were used to estimate the cumulative incidence of CVD, stroke, and heart disease at different times. Multivariable-adjusted Cox proportional hazards regression models were then used to control for confounding factors to analyze the associations between sarcopenic obesity status and CVD, stroke, and heart disease. Finally, subgroup analyses were performed to test the consistency of the association effects of the four groups on CVD, stroke, and cardiac events.

Results

Based on different sarcopenic obesity status, Kaplan-Meier survival curves showed differences in cumulative incidence between different groups (P<0.001). After full adjustment of covariates, high BRI sarcopenia significantly increased the risk of CVD (HR=1.41, 95% CI: 1.14-1.75), stroke(HR=1.77, 95% CI: 1.26-2.49) and heart disease (HR=1.32, 95% CI: 1.03-1.69) compared with normal BRI without sarcopenia. This further proved that sarcopenic obesity was an important risk factor for CVD, stroke and heart disease. In the subgroup analysis, it was consistently found that high BRI with sarcopenia was associated and CVD, stroke and heart disease.

Conclusion

In the elderly population in China, high BRI with sarcopenia is significantly associated with the risk of CVD,stroke, and heart disease. It is recommended that preventing and improving sarcopenia, controlling weight and exercising moderately can help delay the progression of CVD and promote healthy aging in the elderly.

Cardiovascular disease  /  Sarcopenic obesity  /  Elderly  /  China Health and Retirement Longitudinal Study
张友涛, 董利平, 李树铁, 孔洁. 老年人肌肉减少性肥胖与心血管疾病风险之间的相关性. 现代预防医学, 2025 , 52 (23) : 4409 -4416 . DOI: 10.20043/j.cnki.MPM.202506304
You-tao ZHANG, Li-ping DONG, Shu-tie LI, Jie KONG. Association between sarcopenic obesity and cardiovascular disease risk in the elderly[J]. Modern Preventive Medicine, 2025 , 52 (23) : 4409 -4416 . DOI: 10.20043/j.cnki.MPM.202506304
正文
收起
心血管疾病（cardiovascular disease, CVD）是全球主要的死亡和致残原因之一，尤其在老年人群中，其影响尤为显著[1-2]。截至2023年，中国60岁及以上老年人口已达2.97亿，占总人口的21.1%，而CVD在该人群中的高患病率严重威胁老年人的生命健康和生活质量[3-4]。因此，识别CVD危险因素并探讨其与老年健康状态的关系，对于制定有效预防和干预策略具有重要意义。
肥胖是CVD的重要可改变危险因素[5]，其中腹部肥胖的危害尤甚[6]。身体圆度指数（body roundness index, BRI）作为一种新型体脂及内脏脂肪评估指标，结合身高和腰围信息，能够更准确反映内脏脂肪水平，研究显示其与CVD发生密切相关[7-8]。
肌肉减少症是一种与年龄相关的骨骼肌退行性疾病，特征为肌肉质量、力量及功能下降，不仅增加跌倒和残疾风险，还与多种慢性疾病密切相关，尤其是CVD[9-10]。近年来，肌肉减少性肥胖作为一个结合肥胖与肌肉减少症的概念，引起了广泛关注，其定义通常指肌肉质量和力量下降的同时伴有肥胖[11]。然而，现有研究大多为横断面分析，纵向数据对肌肉减少性肥胖与CVD关系的研究仍相对缺乏。
基于此，本研究利用中国健康与养老追踪调查（China Health and Retirement Longitudinal Study,CHARLS）的纵向数据，将高BRI且存在肌肉减少症者定义为肌肉减少性肥胖，系统评估其与CVD发病风险的关系，旨在为中老年人群CVD风险评估和干预提供科学依据。
1　资料与方法
收起
1.1　资料来源
CHARLS是由北京大学国家发展研究所主持的全国性追踪研究项目，旨在系统收集45岁及以上中老年人群的健康、社会经济及养老相关数据。北京大学生物医学伦理委员会的批准（批准号：IRB00001052～11015）。在本研究中，我们回顾性分析了CHARLS 2015—2020的数据。本研究的纳入标准：（1）HARLS 2015中有完整评估肌肉减少症的数据；（2）并且年龄≥60岁。排除标准：（1）HARLS 2015中缺少评估肌肉减少症的数据；（2）年龄<60岁或没有年龄信息；（3）缺少腰围数据；（4）CHARLS 2018和2020关于CVD失访者。最终纳入4 349名研究对象。见图1。
1.2　肌肉减少性肥胖状态的评估
首先，本研究基于亚洲肌少症工作组（AWGS 2019）标准评估肌肉减少状态[12]，综合肌肉力量、肌肉质量和身体机能三要素进行诊断。可能的肌肉减少症定义为低肌肉力量或身体机能下降，当检测到低肌肉质量加上低肌肉力量或身体机能低时，即诊断为肌肉减少症。肌肉力量通过电子握力计测量（男性<28kg、女性<18kg判定为低肌肉力量），肌肉质量采用中国人群验证公式（ASM=0.193×体重+0.107×身高-4.157×性别- 0.037×年龄-2.631）推算（性别赋值：男=1，女=2），并以身高平方矫正肌量指数（ASM/Ht2）的第20百分位数为阈值定义低肌肉质量（男<6.87 kg/m2、女<5.05 kg/m2）。在身体机能方面，步态速度和椅子站立测试使用 Wu等人[13]描述的方法进行。将可能肌肉减少症与确诊肌肉减少症合并分类（无肌肉减少症2 741名，肌肉减少症1 608名）。
然后，BRI通过公式[14]。鉴于目前缺乏统一分类标准，本研究依据人群BRI分布的四分位数划分组别，将BRI≥第75百分位（即前25%高值）定义为“高BRI组”。最终，高BRI合并肌肉减少症被定义为肌肉减少性肥胖，受试者被分为四组：正常BRI无肌肉减少症组、正常BRI肌肉减少症组、高BRI无肌肉减少症组、高BRI肌肉减少症组。
1.3　CVD的评估
CVD定义为通过自我报告：“您是否被医生诊断出患有心脏病”“您是否被医生诊断出患有卒中”。CHARLS调查仅提供疾病是否被诊断的信息，并未记录确切的首次诊断时间。因此，本研究将首次报告事件的随访调查时间点（2015—2018—2020）作为发病时间的近似估计。本研究主要结局为第4—5次随访期内新发CVD（包括卒中或心脏病），次要结局分别分析卒中及心脏病的独立风险。
1.4　确定协变量
根据以前的研究，本研究在CHARLS 2015时纳入了潜在的协变量。（1）社会人口学信息：年龄、性别、文化水平、婚姻状况和居住地；（2）生活方式：当前吸烟和饮酒，吸烟和饮酒状况是根据“您目前是否吸烟”“您目前正在饮酒”进行定义；（3）健康状况：CESD～10评分[15]（中文版10项流行病学研究中心抑郁量表的总分来衡量，分数越高表示抑郁症状越严重）、舒张压和收缩压、高血压、糖尿病和血脂异常，这些慢性病都是通过自我报告进行定义。
1.5　统计分析
本研究数据分析采用R 4.2.3统计软件完成。符合正态分布的连续变量以（均值±标准差）形式呈现；非正态分布变量则以中位数（四分位数间距）描述。分类变量采用频数（构成比）表示。基线时参与者被分为四组：正常BRI无肌肉减少症组、正常BRI肌肉减少症组、高BRI无肌肉减少症组、高BRI肌肉减少症组。分类变量采用χ2检验进行比较；正态分布连续变量采用方差分析（ANOVA），非正态分布连续变量采用Kruskal～Wallis检验。多组比较时，应用Bonferroni校正进行事后分析。
Kaplan～Meier曲线用于估计不同分组参与者CVD、卒中及心脏病的累积发病概率，并采用log～rank检验比较各组差异。随后，使用Cox比例风险回归模型评估单独肌肉减少症、单独高BRI及二者联合状态对CVD、卒中和心脏病发生风险的影响，结果以风险比（hazard ratio，HR）及95%置信区间（confidence interval,CI）表示。在模型拟合前，采用Schoenfeld残差检验验证比例风险假设。分析中，逐步调整以下协变量：模型1调整性别、年龄；模型2进一步调整居住地、婚姻状况和文化水平；模型3进一步调整饮酒状况、CESD～10评分、收缩压和舒张压；模型4进一步调整高血压、血脂异常和糖尿病。
此外，本研究通过亚组分析检验四组人群对CVD、卒中及心脏事件关联效应的一致性。分层变量包括：年龄（<65岁/≥65岁）、性别（男/女）、吸烟（有/无）、饮酒（有/无）、基础疾病（高血压/糖尿病/血脂异常：否/是）。在Cox比例风险回归模型中引入交互项，以检验分层因素与肌肉减少性肥胖状态对CVD、卒中及心脏病风险的交互作用，显著性检验水准设定为α=0.05，双侧检验。
2　结果
收起
2.1　研究对象的基线特征
本研究共纳入了4 349名研究对象。其中有2 169名男性（49.8%），基线人群的平均年龄为67.45岁。4 349名老年人群中，肌肉减少症并伴有高BRI的检出率为10.3%（449/4 349），55.1%的研究受试者有肌肉减少症但不伴有高BRI。四组间在社会人口学信息、生活方式和健康状况变量间差异都具有统计学意义。按BRI状态和肌肉减少症分层的基线特征见表1。
2.2　肌肉减少性肥胖状态与CVD、脑卒中和心脏病的关联分析
在本研究中，4 349名研究对象接受了最长五年的随访。由于CHARLS为三年一次随访设计，大部分受试者均随访至2020年，因此中位随访时间为5.0年（IQR：5.0～5.0年）。随访期间，共有917例（21.0%）发生CVD事件，发病密度为42.2/千人年；其中589例在第三年发生，328例在第五年发生。共有336例（7.7%）发生卒中事件，发病密度为15.5/千人年（第三年224例，第五年112例）；共有664例（15.2%）发生心脏病事件，发病密度为30.7/千人年（第三年401例，第五年263例）。4组人群（基于BRI状态与肌少症分类）的CVD（图2A）、脑卒中（图2B）及心脏病（图2C）Kaplan-Meier生存曲线评估不同组别累积发病率，结果显示不同组间累积发病率存在显著差异（log-rank检验P<0.001）。
为了了解BRI和肌肉减少性肥胖状态对CVD、脑卒中、心脏病之间的关联，本研究构建了4个具有不同调整的协变量模型来反映这种关系。表2显示了Cox比例风险回归分析的结果，发现与正常BRI无肌肉减少症组相比，高BRI肌肉减少症组与CVD、脑卒中、心脏病风险均呈显著正相关（P<0.05）。在完全调整协变量的模型4中，显示高BRI肌肉减少症显著增加了CVD（HR=1.41，95% CI：1.14～1.75）、卒中（HR=1.77，95% CI：1.26～2.49）及心脏病（HR=1.32，95% CI：1.03～1.69）的发病风险。比例风险假设检验结果提示，各Cox模型均满足比例风险假设（均P>0.05）。
2.3　亚组分析
在亚组分析中（以正常BRI与无肌肉减少症作为对照）。高BRI合并肌少症组在大多数社会人口学、生活方式和健康状况变量中，均显示与CVD、卒中及心脏病风险显著升高。见表3、4。表5显示心脏病相关性的亚组分析，仅在年龄<65岁和不吸烟者中未观察到显著关联（P>0.05）。此外，未观察到分层因素与肌肉减少性肥胖状态在CVD、卒中及心脏病风险上的显著交互作用（均P>0.05）。
3　讨论
收起
在本研究中，我们利用具有全国代表性的大型中国人群数据库，纳入4 349名65岁及以上老年人，系统评估了肌肉减少性肥胖与CVD、脑卒中及心脏病的纵向关联。研究结果显示，与正常BRI无肌肉减少症相比，高BRI肌肉减少症显著增加了CVD（HR=1.41，95% CI：1.14～1.75）、卒中（HR=1.77，95% CI：1.26～2.49）及心脏病（HR=1.32，95% CI：1.03～1.69）的发病风险。这表明肥胖与肌肉减少的双重负担对心血管结局具有叠加效应。在亚组分析中，这一关联在不同社会人口学特征、生活方式及健康状况人群中均表现一致性。
既往研究多将BRI或肌肉减少症单独作为风险因子进行探讨。例如，纵向研究显示BRI动态轨迹与CVD风险负荷显著相关，持续高BRI轨迹人群发生CVD、中风或心脏事件的风险增加[7]。横断面研究亦表明BRI是CVD风险的重要预测指标，并与CVD死亡及全因死亡呈U形关系[16]。另一方面，肌肉减少症本身也被证实是CVD的独立危险因素[17]。
本研究的创新之处在于首次将BRI与肌肉减少症联合考察，发现高BRI合并肌肉减少症的风险效应显著高于单独肥胖或单独肌肉减少症。这提示肥胖相关的代谢紊乱（如胰岛素抵抗、脂代谢异常及血压调控失衡）与肌肉减少相关的慢性炎症和线粒体功能障碍可能存在协同作用，共同加速心血管损伤进程。这种“双击效应”凸显了临床实践中不能仅关注体重或体脂指标，而应结合肌肉量与功能进行全面评估，以更准确预测心血管风险。
在病理机制方面，肥胖可通过代谢紊乱、炎症和氧化应激诱发心血管损伤，而肌肉减少症可导致线粒体功能障碍、慢性炎症及心脏负荷增加[18-19]。当两者共存时，代谢与炎症途径可能相互放大，从而进一步提升CVD风险。近期队列研究亦显示，肌肉减少症与心血管事件及死亡风险显著相关，其效应强度高于单纯肥胖或单纯肌肉减少症，进一步支持本研究发现。综上所述，在中国老年人群中，肌肉减少性肥胖与CVD、卒中及心脏病发病风险显著相关。本研究提供新的纵向证据，强调应将肥胖和肌肉减少作为一个综合状态评估，而非孤立指标。临床上加强体成分监测，并通过合理的体重管理及阻力训练改善肌肉量与功能，可能有助于降低心血管疾病风险，促进老年人健康衰老。
本研究存在一定局限性：一是，CVD事件依赖自我报告的医生诊断，可能存在信息偏倚。二是，尽管调整了多个混杂因素，残余混杂仍可能存在，如遗传易感性及饮食结构。未来研究应结合影像学、实验室指标及干预性随访，更深入揭示肌肉减少性肥胖与CVD之间的因果关系。
基金
收起
  • 河北省医学科学研究课题(20241344)
文献
收起
参考文献 引证文献
排序方式：
[1]
Diseases G2, Collaborators I. Global burden of 371 diseases and injuries in 204 countries and territories,1990-2021: a systematic analysis for the Global Burden of Disease Study 2021 [J]. Lancet, 2024, 403 (10440): 2133-2161.
[2]
Wang MS, Deng JW, Geng WY, et al. Temporal trend and attributable risk factors of cardiovascular disease burden for adults 55 years and older in 204 countries/territories from 1990 to 2021: an analysis for the Global Burden of Disease Study 2021 [J]. European Journal of Preventive Cardiology, 2025, 32 (7): 539-552.
[3]
民政部，全国老龄办. 民政部、全国老龄办发布《2023年度国家老龄事业发展公报》 [N]. 公益时报, 2024-10-15（12）.
Ministry of Civil Affairs, National Working Commission on Aging. Ministry of Civil Affairs and National Working Commission on Aging Release the "2023 National Aging Cause Development Bulletin" [N]. Gongyi Shibao, 2024-10-15 (12).
[4]
Zhao D, Liu J, Wang M, et al. Epidemiology of cardiovascular disease in China: current features and implications [J]. Nature Reviews Cardiology, 2019, 16 (4): 203-212.
[5]
Elagizi A, Kachur S, Carbone S, et al. A review of obesity, physical activity, and cardiovascular disease [J]. Current Obesity Reports, 2020, 9 (4): 571-581.
[6]
Moura LDANE, Pagotto V, Camargo Pereira C, et al. Does abdominal obesity increase All-Cause, cardiovascular disease, and cancer mortality risks in older adults? a 10-Year Follow-Up analysis [J]. Nutrients, 2022, 14 (20): 4315.
[7]
Yang M, Liu J, Shen Q, et al. Body roundness index trajectories and the incidence of cardiovascular disease: evidence from the China health and retirement longitudinal study [J]. Journal of the American Heart Association, 2024, 13 (19): e034768.
[8]
Wu MY, Yu X, Xu LL, et al. Associations of longitudinal trajectories in body roundness index with mortality and cardiovascular outcomes: a cohort study [J]. American Journal of Clinical Nutrition, 2022, 115 (3): 671-678.
[9]
Cruz-Jentoft AJ, Sayer AA. Sarcopenia [J]. Lancet, 2019, 393 (10191): 2636-2646.
[10]
Gao K, Cao LF, Ma WZ, et al. Association between sarcopenia and cardiovascular disease among middle-aged and older adults: Findings from the China health and retirement longitudinal study [J]. EClinical Medicine, 2022, 44: 101264.
[11]
Barazzoni R, Bischoff S, Boirie Y, et al. Sarcopenic obesity: time to meet the challenge [J]. Obesity Facts, 2018, 11 (4): 294-305.
[12]
Chen LK, Woo J, Assantachai P, et al. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment [J]. Journal of the American Medical Directors Association, 2020, 21 (3): 300-307.e2.
[13]
Wu X, Li X, Xu MH, et al. Sarcopenia prevalence and associated factors among older Chinese population: Findings from the China Health and Retirement Longitudinal Study [J]. PLOS One, 2021, 16 (3): e0247617.
[14]
Nkwana MR, Monyeki KD, Lebelo SL. Body roundness index, a body shape index, conicity index, and their association with nutritional status and cardiovascular risk factors in South African rural young adults [J]. International Journal of Environmental Research and Public Health, 2021, 18 (1): 281.
[15]
杨鑫怡，李新瑜，朱礼华, 等. 老年人抑郁状况影响因素分析基于中国健康与养老追踪调查（CHARLS）的实证研究 [J]. 中国农村卫生事业管理, 2025, 45 (6): 444-450.
Yang XY, Li XY, Zhu LH, et al. Analysis of influencing factors of depressive symptoms in older adults:an empirical study based on the China health and retirement longitudinal study（CHARLS） [J]. Chinese Rural Health Service Administration, 2025, 45 (6): 444-450. (In Chinese)
[16]
He XH, Zhu JL, Liang WF, et al. Association of body roundness index with cardiovascular disease in patients with cardiometabolic syndrome: a cross-sectional study based on NHANES 2009-2018 [J]. Frontiers in Endocrinology, 2025, 16: 1524352.
[17]
Zeng QY, Zhao LJ, Zhong Q, et al. Changes in sarcopenia and incident cardiovascular disease in prospective cohorts [J]. BMC Medicine, 2024, 22 (1): 607.
[18]
Dina C, Tit DM, Radu A, et al. Obesity, dietary patterns, and cardiovascular disease: a narrative review of metabolic and molecular pathways [J]. Current Issues in Molecular Biology, 2025, 47 (6): 440.
[19]
Zuo XR, Li XH, Tang K, et al. Sarcopenia and cardiovascular diseases: A systematic review and meta-analysis [J]. Journal of Cachexia, Sarcopenia and Muscle, 2023, 14 (3): 1183-1198.
2025年第52卷第23期
PDF下载
16
8
引用本文
BibTeX
文章信息
doi: 10.20043/j.cnki.MPM.202506304
  • 接收时间：2025-06-20
  • 首发时间：2026-11-02
  • 出版时间：2025-12-10
补充材料
相关文章
文章信息
作者
出版历史
  • 收稿日期：2025-06-20
基金
河北省医学科学研究课题(20241344)
作者信息
    河北北方学院附属第一医院老年医学科，河北　张家口　075031

通讯作者:

李树铁，E-mail：
参考文献
分享链接
https://castjournals.cast.org.cn/joweb/xdyfyx/CN/10.20043/j.cnki.MPM.202506304
分享至
全文二维码

扫描看全文

引用本文
BibTeX
本文的引用情况
2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
关闭全屏
相关链接
论文
最新文章
热读文章
热点专题
内参
蓝皮书
产业发展报告
传播力报告
期刊分级目录
资讯
学术新闻
行业新闻
学术会议
行业会议
关于
关于我们
联系我们
北京市海淀区学院南路86号
100081
010-62662699（运营及技术支持）
qkjq@cast.org.cn

中国科学技术协会版权所有 京ICP 备10216604号-4 海淀分局备案 1101084647
科技导报社主办 中国科协信息中心技术支持