Sex differences in the association between chest computed tomography-defined sarcopenia and cardiovascular risk...

While sarcopenia has been found to be associated with increased risks of cardiovascular diseases (CVDs), evidence exploring sex-related differences remains insufficient. This study aimed to investigate the differences in how often sarcopenia occurs in each sex, as determined by skeletal muscle area (SMA) in chest CT images, and its association with CVD common risk factors.

This cross-sectional study involved 1,340 inpatients from the Department of Geriatrics of Renji Hospital, affiliated to Shanghai Jiaotong University School of Medicine. Data on age, sex, body mass index (BMI), smoking status, disease history, and clinical parameters were collected. Sarcopenia was defined using chest CT images with a cut-off value of T12-SMA/height² <25.75 cm²/m² in male patients and <20.16 cm²/m² in female patients. Cardiovascular risk was assessed using the Framingham risk score (FRS). The association between T12-SMA/height²-defined sarcopenia and CVD risk factors by sex was evaluated using a multivariate logistic regression analysis.

The overall prevalence of T12-SMA/height²-defined sarcopenia (<25.75 cm²/m² for male patients, <20.16 cm²/m² for female patients) was 54.03%, with 48.09% in male patients and 63.19% in female patients. The proportion of male patients with high CVD risk was greater than that of female patients. The multivariate analysis revealed that T12-SMA/height²-defined sarcopenia was independently associated with age (in male patients only), systolic blood pressure (SBP), cholesterol, and high-density lipoprotein cholesterol (HDL-C) among the six FRS cardiovascular risk indices.

Our results suggest that T12-SMA/height²-defined sarcopenia was more prevalent in male patients than in female patients. Sarcopenia was associated with higher levels of SBP and HDL-C and lower levels of cholesterol. Increasing age had a more significant effect on CVD risk in male patients.