Muscle quality index is associated with advanced stages in patients with cardiovascular-kidney-metabolic syndrome: A
1Department of Cardiovascular Medicine, Xinfeng County People's Hospital, Ganzhou, Jiangxi, China.
Insights
Higher muscle quality index (MQI) is linked to lower odds of advanced Cardiovascular-Kidney-Metabolic (CKM) syndrome. This protective effect is more pronounced in males and high-income individuals, suggesting muscle quality is a key factor.
Area of Science:
- Cardiology
- Nephrology
- Metabolic Health
- Muscle Physiology
Background:
- Cardiovascular-Kidney-Metabolic (CKM) syndrome is a complex condition with significant health and economic impacts.
- Muscle mass and strength are established prognostic indicators in CKM-related diseases.
- The association between muscle quality index (MQI) and advanced CKM syndrome is not well-defined.
Purpose of the Study:
- To investigate the relationship between the muscle quality index (MQI) and the prevalence of advanced Cardiovascular-Kidney-Metabolic (CKM) syndrome.
- To explore potential threshold effects and effect modifications by demographic factors.
Main Methods:
- Cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data (2011-2014).
- MQI calculated as handgrip strength divided by appendicular skeletal muscle mass.
- Advanced CKM syndrome defined by American Heart Association criteria (stages 3-4).
- Multivariable logistic regression, restricted cubic splines, and stratified analyses were used.
Main Results:
- Among 2012 participants, 4.7% had advanced CKM syndrome.
- An elevated MQI was associated with reduced odds of advanced CKM syndrome (OR=0.54 per unit increase).
- A threshold effect was observed at MQI=2.66, with stronger inverse association below this value.
- Significant effect modification by sex and income was noted; the inverse association was primarily observed in males and high-income individuals.
Conclusions:
- Muscle quality, assessed by MQI, demonstrates a threshold-dependent inverse association with advanced CKM syndrome.
- The protective effect of muscle quality is more pronounced in males and higher socioeconomic groups.
- Maintaining muscle quality may be a clinically relevant strategy for managing advanced CKM syndrome.
Abstract:
Cardiovascular-kidney-metabolic (CKM) syndrome represents a complex systemic condition involving interconnected dysfunctions across metabolic, renal, and cardiovascular systems, presenting significant prevalence rates and imposing considerable clinical and economic challenges. Muscle mass and handgrip strength are recognized as independent prognostic indicators in cardiovascular, kidney, and metabolic diseases. The muscle quality index (MQI), integrating measures of muscle strength and mass, has demonstrated relevance for various health outcomes, but its association with advanced CKM syndrome remains unclear. This investigation employed a cross-sectional design utilizing National Health and Nutrition Examination Survey data from 2011 to 2014. The MQI was calculated as the ratio of handgrip strength to appendicular skeletal muscle mass. Advanced CKM syndrome was defined as stages 3 to 4 according to American Heart Association criteria. We employed multivariable logistic regression, restricted cubic spline analysis, and stratified analyses to examine the association between MQI and advanced CKM syndrome. Among 2012 participants, 4.7% had advanced CKM syndrome. Elevated MQI was associated with a reduced prevalence of advanced CKM syndrome (odds ratio = 0.54 per unit increase; 95% confidence interval = 0.29-0.99), with a threshold effect observed at MQI = 2.66, indicating stronger protection below this level. Notably, significant effect modifications by sex (P-interaction = .0083) and income (P-interaction < .0001) were observed: the inverse association was evident only in males and the highest-income individuals. Muscle quality exhibits a threshold-dependent effect against advanced CKM syndrome, with enhanced benefits in males and high-income populations. This suggests that maintaining muscle quality may be an important clinical consideration. Prospective longitudinal studies are warranted to clarify this association.
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