Association of Appendicular Lean Mass, and Subcutaneous and Visceral Adipose Tissue With Mortality in Older Brazilians: The Sao Paulo Ageing & Health Study

Author(s)

de Santana, Felipe M. ^[1] ; Domiciano, Diogo S. ^[1] ; Goncalves, Michel A. ^[1] ; Machado, Luana G. ^[1] ; Figueiredo, Camille P. ^[1] ; Lopes, Jaqueline B. ^[1] ; Caparbo, Valeria F. ^[1] ; Takayama, Lilliam ^[1] ; Menezes, Paulo R. ^[2] ; Pereira, Rosa M. R. ^[1]

Affiliation

^[1] Univ Sao Paulo, Fac Med, Div Rheumatol, Bone Metab Lab, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Fac Med, Dept Prevent Med, Sao Paulo - Brazil

• Document type: Journal article
• Source: Journal of Bone and Mineral Research; v. 34, n. 7, p. 1264-1274, JUL 2019.
• Web of Science Citations: 1

Abstract

Body composition changes as a result of ageing may impact the survival of older adults. However, its influence on mortality risk is uncertain. Currently, the best method for body composition analysis in clinical practice is DXA. Nonetheless, the few studies on body composition by DXA and mortality risk in the elderly have some limitations. We investigated the association between body composition by DXA and mortality in a cohort of elderly subjects. Eight hundred thirty-nine community-dwelling subjects (516 women, 323 men) >= 65 years of age were assessed by a questionnaire, clinical data, laboratory exams, and body composition by DXA at baseline. Total fat and its components (eg, visceral adipose tissue {[}VAT]) were estimated. Appendicular lean mass (ALM) adjusted for fat and ALM divided by height(2) was used to ascertain the presence of low muscle mass (LMM). Mortality was recorded during follow-up. Multivariate logistic regression was used to compute ORs for all-cause and cardiovascular mortality. Over a mean follow-up of 4.06 +/- 1.07 years, there were 132 (15.7%) deaths. In men, after adjustment for relevant variables, the presence of LMM (OR, 11.36, 95% CI, 2.21 to 58.37, P = 0.004) and VAT (OR, 1.99, 95% CI, 1.38 to 2.87, P < 0.001, for each 100-g increase) significantly increased all-cause mortality risk, whereas total fat, measured by the fat mass index, was associated with decreased mortality risk (OR, 0.48, 95% CI, 0.33 to 0.71, P < 0.001). Similar results were observed for cardiovascular mortality. In women, only LMM was a predictor of all-cause (OR, 62.88, 95% CI, 22.59 to 175.0, P < 0.001) and cardiovascular death (OR, 74.54, 95% CI, 9.72 to 571.46, P < 0.001). LMM ascertained by ALM adjusted for fat and fat mass by itself are associated with all-cause and cardiovascular mortality risk in the elderly. Visceral and subcutaneous fat have opposite roles on mortality risk in elderly men. Thus, DXA is a promising tool to estimate risk of mortality in the elderly. (c) 2019 American Society for Bone and Mineral Research. (AU)

• FAPESP's process: 09/15346-4 - Incidence of vertebral fractures and non-vertebral clinical fractures in a population of individuals aged 65 or more
• Grantee: Rosa Maria Rodrigues Pereira
• Support Opportunities: Regular Research Grants
• FAPESP's process: 03/09313-0 - Prevalence of osteoporosis, vertebral and non-vertebral fractures in a female population aged 65 or older in the Butantã area
• Grantee: Rosa Maria Rodrigues Pereira
• Support Opportunities: Regular Research Grants
• FAPESP's process: 04/12694-8 - Incidence of dementia and cognitive decline in low-income elderly in São Paulo: a cohort study
• Grantee: Isabela Judith Martins Bensenor
• Support Opportunities: Regular Research Grants
• FAPESP's process: 11/00411-5 - Incidence of vertebral fractures and non-vertebral clinical fractures in a population of individuals age 65 or more
• Grantee: Diogo Souza Domiciano
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)