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Updated: Mar 24, 2026
Author Spotlight: Decellularization-Based Quantification of Skeletal Muscle Fatty Infiltration
Published on: June 9, 2023
Relation of Muscle Mass and Fat Mass to Cardiovascular Disease Mortality
Preethi Srikanthan1, Tamara B Horwich2, Chi Hong Tseng3
1Division of Endocrinology, Department of Medicine, University of California, Los Angeles, California.
Insights
Higher muscle and fat mass, along with body mass index (BMI), are linked to better survival in cardiovascular disease (CVD) patients. A high muscle/low fat mass composition showed the lowest mortality risk.
Area of Science:
- Cardiology
- Body Composition Analysis
- Public Health
Background:
- Cardiovascular disease (CVD) poses a significant mortality risk.
- Body composition is increasingly recognized as a factor influencing health outcomes.
- Understanding the relationship between body composition and mortality in CVD patients is crucial for risk stratification.
Purpose of the Study:
- To investigate the association between body composition components (muscle mass, fat mass) and mortality in patients with established CVD.
- To determine if specific body composition profiles are associated with differential risks of total and CVD-related mortality.
- To assess the predictive value of body composition beyond traditional metrics like BMI.
Main Methods:
- Utilized data from the National Health and Nutrition Examination Survey (1999-2004) for body composition via dual x-ray absorptiometry.
- Linked body composition data with mortality records (1999-2006) for 6,451 patients diagnosed with CVD.
- Employed Kaplan-Meier survival analysis and adjusted Cox proportional hazards regression to analyze mortality endpoints across body composition categories.
Main Results:
- Higher quartiles of muscle mass, fat mass, and body mass index (BMI) were significantly associated with lower rates of cardiovascular and total mortality (p <0.001).
- The subgroup with high muscle mass and low fat mass exhibited the lowest risk for both CVD and total mortality.
- Risk-adjusted hazard ratios for CVD and total mortality were substantially reduced in the high muscle/low fat mass group.
Conclusions:
- Increasing muscle mass, fat mass, and BMI are independently correlated with improved survival in patients with cardiovascular disease.
- Body composition assessment, particularly identifying individuals with high muscle and low fat mass, is important for predicting mortality risk in CVD patients.
- These findings highlight the need to consider body composition as a key element in managing and predicting outcomes for cardiovascular disease.
Abstract:
We evaluated the relation between components of body composition and mortality in patients with cardiovascular disease (CVD). Dual x-ray absorptiometry body composition data from the National Health and Nutrition Examination Survey 1999 to 2004 was linked to total and CVD mortality data 1999 to 2006 in 6,451 patients with CVD. Kaplan-Meier survival analysis for the end points of total and CVD mortality was plotted by quartiles of muscle mass, fat mass, and categories of body mass index (BMI). Subjects were stratified into 4 groups (low muscle/low fat mass, low muscle/high fat mass, high muscle/low fat mass, and high muscle/high fat mass). Adjusted Cox proportional hazards regression determined hazard ratios for total and CVD mortality. Rates of cardiovascular/total mortality were lower in higher quartiles of muscle mass, fat mass, and higher categories of BMI (p <0.001). The high muscle/low fat mass group had a lower risk of CVD and total mortality (risk-adjusted hazard ratios of 0.32, 95% confidence interval 0.14 to 0.73 and 0.38, 95% confidence interval 0.22 to 0.68, for CVD and total mortality, respectively). Thus, increasing fat mass, muscle mass, and BMI were all correlated with improved survival. The specific subgroup of high muscle and low fat mass had the lowest mortality risk compared with other body composition subtypes. This suggests the importance of body composition assessment in the prediction of cardiovascular and total mortality in patients with CVD.
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