The influence of multiple air pollutants on sarcopenia progression: a multi-state analysis in a prospective cohort

Air pollution's influence on sarcopenia progression remains insufficiently studied.

Using the UK Biobank cohort, we included 50381 participants initially free of probable sarcopenia and sarcopenia. Exposures to PM2.5, PM10, PM2.5-10, NO2, and NOx for each transition stage were estimated at each participant's residential addresses using data from the UK's department. Parametric g-computation was applied to estimate cumulative risks under hypothetical pollution reduction scenarios. Multistate models were used to examine associations between air pollution and sarcopenia progression.

During 8.98 years (median), 4445 (8.8%) participants developed probable sarcopenia; 17 (0.4%) progressed to sarcopenia. Parametric g-computation estimated that a simultaneous 10% reduction in all 4 pollutants would decrease the 15-year cumulative risk (risk ratio [RR] = 0.93; risk difference [RD] = -2.21). In multistate models, PM2.5 increased risks of probable sarcopenia (hazard ratio [HR]: 1.06; 95% confidence interval [CI]: 1.02-1.10), sarcopenia (HR: 1.18; 95% CI: 1.04-1.34), baseline to death (HR: 1.11; 95% CI: 1.02-1.20,) and probable sarcopenia to death (HR: 1.24; 95% CI: 1.04-1.50). NO2 showed similar associations: probable sarcopenia (HR: 1.06; 95% CI: 1.02-1.10), sarcopenia (HR: 1.23; 95% CI: 1.09-1.39), baseline to death (HR: 1.10; 95% CI: 1.01-1.19), and probable sarcopenia to death (HR: 1.23; 95% CI: 1.01-1.50). NOx increased risks for probable sarcopenia (HR: 1.06; 95% CI: 1.03-1.09), sarcopenia (HR: 1.15; 95% CI: 1.04-1.26), and probable sarcopenia to death (HR: 1.22; 95% CI: 1.04-1.43). Stratified analyses indicated effect modification by sex, household income, and body mass index (BMI).

These findings highlight the critical role of clean air in preventing and delaying sarcopenia progression, especially in vulnerable populations.