Abstract 11239: Fat and Lean Mass Distributions and Cardiovascular and All-cause Mortality in Older Adults: the Cardiovascular Health Study
Introduction: Understanding contributions of fat and lean tissue to cardiovascular and all-cause cardiovascular mortality may help clarify areas of prevention in older adults
Hypothesis: We hypothesized that greater fat and lower lean mass would be associated with a higher risk of mortality.
Methods: A total of 1335 participants of the Cardiovascular Health Study who underwent dual-energy x-ray absorptiometry (DEXA) scans were included. We used principal components analysis (PCA) to define two independent sources of variation in DEXA-derived body composition, corresponding to principal components composed of fat (“fat PC”) and lean (“lean PC”) tissue. We used Cox proportional hazards regression using these PCs to investigate the relationship between body composition and mortality.
Results: Mean age was 76.2±4.8 years (56% women) with mean body mass index 27.1±4.4 kg/m2. In spline models, fat PC had a non-linear association with mortality in unadjusted but not adjusted models; lean PC was associated with mortality risk linearly. The lowest quartile of the fat PC (least adiposity) was associated with a greater hazard of all-cause mortality (HR = 1.24, 95% CI 1.04-1.48, P=0.02) relative to fat PCs between the 25th-75th percentile, but the highest quartile did not have a significantly greater hazard (P=0.70). A greater lean PC was associated with lower all-cause (HR=0.91, 95% CI 0.84-0.98, P=0.01) and cardiovascular mortality (HR=0.84, 95% CI 0.74-0.95, P=0.005).
Conclusions: Greater lean tissue mass is associated with improved cardiovascular and overall mortality in the elderly. The lowest levels of fat tissue mass are linked with adverse prognosis, but the highest levels show no significant mortality protection. Prevention efforts in the elderly frail may be best targeted toward improvements in lean muscle mass.
Author Disclosures: A. Spahillari: None. K. Mukamal: None. J.R. Kizer: Ownership Interest; Significant; Gilead Sciences, Inc; Pfizer, Inc. J.S. Gottdiener: None. L. Djoussé: None. M.F. Lyles: None. T.M. Bartz: None. V.L. Murthy: None. R.V. Shah: None.
- © 2016 by American Heart Association, Inc.