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

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.

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.

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.