Low Lean Mass with and Without Obesity, and Mortality: Results from the 1999-2004 National Health and Nutrition Examination Survey

John A. Batsis, Todd A. Mackenzie, Rebecca T. Emeny, Francisco Lopez-Jimenez, Stephen J. Bartels

Research output: Contribution to journalArticle

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Abstract

Background The Foundation for the NIH Sarcopenia Project validated cutpoints for appendicular lean mass. We ascertained the relationship between low lean mass (LLM), obesity, and mortality and identified predictors in this subgroup. Methods A total of 4,984 subjects aged 60 years and older were identified from the National Health and Nutrition Examination Survey 1999-2004 linked to the National Death Index. LLM was defined using reduced appendicular lean mass (men < 19.75 kg; females < 15.02 kg). Obesity was defined using dual-energy x-ray absorptiometry body fat (males ≥ 25%; females ≥ 35%). LLM with obesity was defined using criteria for both LLM and obesity. Proportional hazard models determined mortality risk for LLM and LLM with obesity, separately (referent = no LLM and no LLM with obesity, respectively). Results Mean age was 71.1 ± 0.19 years (56.5% female). Median follow-up was 102 months (interquartile range: 78, 124) with 1,901 deaths (35.0%). Prevalence of LLM with obesity was 33.5% in females and 12.6% in males. In those with LLM, overall mortality risk was 1.49 (1.27, 1.73) in males and 1.19 (1.02, 1.40) in females. Mortality risk in LLM with obesity was 1.31 (1.11, 1.55) and 0.99 (0.85, 1.16) in males and females, respectively. Age, diabetes, history of stroke, congestive heart failure, cancer, and kidney disease were predictive of death. Conclusions Risk of death is higher in subjects with LLM than with LLM and obesity. Having advanced age, diabetes, stroke, heart failure, cancer, and renal disease predict a worse prognosis in both classifications.

Original languageEnglish (US)
Pages (from-to)1445-1451
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume72
Issue number10
DOIs
StatePublished - Oct 1 2017

Fingerprint

Nutrition Surveys
Obesity
Mortality
Heart Neoplasms
Heart Failure
Stroke
Sarcopenia
Kidney Neoplasms
Kidney Diseases
Proportional Hazards Models
Adipose Tissue
X-Rays
Kidney

Keywords

  • Epidemiology
  • Low lean mass
  • Survival

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

Cite this

Low Lean Mass with and Without Obesity, and Mortality : Results from the 1999-2004 National Health and Nutrition Examination Survey. / Batsis, John A.; Mackenzie, Todd A.; Emeny, Rebecca T.; Lopez-Jimenez, Francisco; Bartels, Stephen J.

In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 72, No. 10, 01.10.2017, p. 1445-1451.

Research output: Contribution to journalArticle

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abstract = "Background The Foundation for the NIH Sarcopenia Project validated cutpoints for appendicular lean mass. We ascertained the relationship between low lean mass (LLM), obesity, and mortality and identified predictors in this subgroup. Methods A total of 4,984 subjects aged 60 years and older were identified from the National Health and Nutrition Examination Survey 1999-2004 linked to the National Death Index. LLM was defined using reduced appendicular lean mass (men < 19.75 kg; females < 15.02 kg). Obesity was defined using dual-energy x-ray absorptiometry body fat (males ≥ 25{\%}; females ≥ 35{\%}). LLM with obesity was defined using criteria for both LLM and obesity. Proportional hazard models determined mortality risk for LLM and LLM with obesity, separately (referent = no LLM and no LLM with obesity, respectively). Results Mean age was 71.1 ± 0.19 years (56.5{\%} female). Median follow-up was 102 months (interquartile range: 78, 124) with 1,901 deaths (35.0{\%}). Prevalence of LLM with obesity was 33.5{\%} in females and 12.6{\%} in males. In those with LLM, overall mortality risk was 1.49 (1.27, 1.73) in males and 1.19 (1.02, 1.40) in females. Mortality risk in LLM with obesity was 1.31 (1.11, 1.55) and 0.99 (0.85, 1.16) in males and females, respectively. Age, diabetes, history of stroke, congestive heart failure, cancer, and kidney disease were predictive of death. Conclusions Risk of death is higher in subjects with LLM than with LLM and obesity. Having advanced age, diabetes, stroke, heart failure, cancer, and renal disease predict a worse prognosis in both classifications.",
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