Subclinical atherosclerosis and sarcopenia: A prospective study

The relationship between subclinical carotid artery atherosclerosis and sarcopenia has not been clarified in many respects. In this study, the possible relationship between composite clinical sarcopenia indices and various levels of subclinical atherosclerosis parameters was revisited. The Ishii score (Ishii-max and Ishii-average) was used to determine sarcopenia in 257 prospectively recruited healthy controls and patients with neurological diseases (age: 65 ± 10 years, 50% female). Carotid artery distensibility indices (stress, strain, modulus, stiffness, and distensibility), intima-media thickness (IMT-max and IMT-mean), and 10 Kate plaque burden score were obtained for ultrasonographic subclinical atherosclerosis evaluation, together with detailed clinical and anthropometric, quality of life, and nutritional assessments. Sarcopenic subjects (n = 75) were older, slimmer, and at higher risk of malnutrition (Malnutrition Universal Screening Tool score > 0) than nonsarcopenic subjects (n = 182). IMT-mean and IMT-max were significantly higher in sarcopenic cases (mean difference: 45 microns and 60 microns, respectively, P < .05). Carotid plaque burden score was significantly higher in sarcopenic patients (average score: 2.2 vs 0.8 in sarcopenic and nonsarcopenic ones, P < .001). There was no difference in terms of carotid artery distensibility parameters. In various regression models, the Ishii score was always determined as an independent predictor of IMT-max and IMT-mean in the models (standardized beta, from 0.132-0.168; partial-r, from 0.156-0.201; p, from 0.019-0.001). Structural indices of subclinical atherosclerosis (carotid IMT and plaque burden), but not functional ones (carotid artery modulus and distensibility), are significantly abnormal in sarcopenic subjects. If future research validates these findings, employing ultrasonographic atherosclerosis indices as surrogate markers in sarcopenia treatments could address a crucial unmet need.