Table 1 Characteristics of the study population by gender
|
Men
|
Women
|
p*
|
N
|
6390
|
14087
|
|
Age (years)
|
62.87 ± 8.07
|
60.30 ± 8.00
|
<0.0001
|
High education level (%)
|
14.76
|
11.05
|
<0.0001
|
Current smokers (%)
|
31.84
|
2.27
|
<0.0001
|
Current alcohol user (%)
|
40.30
|
8.03
|
<0.0001
|
Regular exercise (%)
|
20.09
|
18.41
|
<0.0001
|
Type 2 diabetes (%)
|
11.07
|
9.86
|
<0.0001
|
Hypertension (%)
|
30.76
|
26.65
|
<0.0001
|
Height (cm)
|
168.6 ± 5.88
|
158.24 ± 5.35
|
<0.0001
|
Weight (kg)
|
69.78 ± 10.52
|
61.13 ± 9.35
|
<0.0001
|
BMI (kg/m2)
|
24.51 ± 3.23
|
24.39 ± 3.40
|
0.014
|
SMM (kg)
|
49.36 ± 6.18
|
38.13 ± 4.32
|
<0.0001
|
LAMM (kg)
|
3.30 ± 0.48
|
2.50 ± 0.33
|
<0.0001
|
RAMM (kg)
|
3.31 ± 0.49
|
2.49 ± 0.35
|
<0.0001
|
LLMM (kg)
|
9.05 ± 1.28
|
7.00 ± 0.93
|
<0.0001
|
RLMM (kg)
|
9.06 ± 1.27
|
6.99 ± 0.90
|
<0.0001
|
TMM (kg)
|
24.65 ± 2.78
|
19.16 ± 1.96
|
<0.0001
|
ASM (kg)
|
24.72 ± 3.47
|
18.98 ± 2.42
|
<0.0001
|
ASMI (kg/m2)
|
8.68 ± 0.98
|
7.57 ± 0.78
|
<0.0001
|
BFP (%)
|
23.50 (19.70, 26.90)
|
31.80 (28.50, 34.70)
|
<0.0001
|
baPWV (cm/s)
|
1650.00 (1449.00, 1894.00)
|
1567.00 (1372.00, 1822.00)
|
<0.0001
|
SBP (mmHg)
|
137.41±19.00
|
135.87±20.63
|
<0.0001
|
DBP (mmHg)
|
81.32±10.95
|
78.34±11.14
|
<0.0001
|
PP (mmHg)
|
58.00±12.19
|
59.58±13.13
|
<0.0001
|
ABI
|
1.21±0.012
|
1.18±0.10
|
<0.0001
|
MAP (%)
|
39.85±3.93
|
42.50±3.46
|
<0.0001
|
UT (s)
|
144.00 (133.00, 160.00)
|
156.00 (142.00, 174.00)
|
<0.0001
|
Values are percentage, mean ± SD or medians (25th and 75th percentile)
* Test for difference between gender groups was performed using the Chi-square test for categorical variables, Kruskal–Wallis test for non-normally distributed continuous variables and T test for normally distributed continuous variables.
Abbreviations: BMI body mass index, SMM Total muscle mass, LAMM Left arm muscle mass, RAMM Right arm muscle mass, LLMM Left arm muscle mass, RLMM Right leg muscle mass, TMM Trunk muscle mass, BFP total body fat percentage, ASM appendicular skeletal muscle, ASMI appendicular skeletal muscle index, baPWV brachial-ankle pulse wave velocity, SBP systolic blood pressure, DBP diastolic blood pressure, PP Pulse pressure, ABI ankle brachial index, MAP mean artery pressure, UT upstroke time.
Table 2 Characteristics of the study population according to ASMI tertiles
|
ASMI
|
p*
|
|
T1
|
T2
|
T3
|
Men (n=6390)
|
Age (years)
|
64.62 ± 8.28
|
62.73 ± 7.94
|
61.86 ± 8.17
|
<0.0001
|
Height (cm)
|
167.71 ± 5.78
|
168.68 ± 5.91
|
169.42 ± 5.81
|
<0.0001
|
Weight (kg)
|
60.67 ± 6.86
|
70.33 ± 6.92
|
78.34 ± 8.97
|
<0.0001
|
BMI (kg/m2)
|
21.55 ± 2.05
|
24.71 ± 1.97
|
27.27 ± 2.60
|
<0.0001
|
ASMI (kg/m2)
|
7.71 ± 0.37
|
8.53 ± 0.22
|
9.78 ± 0.73
|
<0.0001
|
ASM (kg)
|
21.71 ± 1.87
|
24.31 ± 1.83
|
28.12 ± 2.90
|
<0.0001
|
SMM (kg)
|
44.30 ± 3.66
|
48.70 ± 3.71
|
55.09 ± 5.34
|
<0.0001
|
LAMM (kg)
|
2.89 ± 0.26
|
3.25 ± 0.26
|
3.77 ± 0.41
|
<0.0001
|
RAMM (kg)
|
2.89 ± 0.27
|
3.25 ± 0.27
|
3.77 ± 0.44
|
<0.0001
|
LLMM (kg)
|
7.96 ± 0.70
|
8.90 ± 0.69
|
10.29 ± 1.11
|
<0.0001
|
RLMM (kg)
|
7.97 ± 0.69
|
8.91 ± 0.68
|
10.29 ± 1.08
|
<0.0001
|
TMM (kg)
|
22.59 ± 1.88
|
24.39 ± 1.94
|
26.96 ± 2.51
|
<0.0001
|
BFP (%)
|
21.10 (17.40, 24.40)
|
25.10 (22.00, 28.00)
|
23.90 (20.10, 27.80)
|
<0.0001
|
baPWV (cm/s)
|
1677.00 (1459.00, 1945.00)
|
1647.00 (1451.00, 1876.00)
|
1629.00 (1434.00, 1854.00)
|
<0.0001
|
SBP (mmHg)
|
134.35 ± 18.81
|
137.39 ± 18.14
|
140.50 ± 19.52
|
<0.0001
|
DBP (mmHg)
|
79.16 ± 10.44
|
81.48 ± 10.70
|
83.31 ± 11.30
|
<0.0001
|
PP (mmHg)
|
57.18 ± 12.40
|
57.79 ± 11.92
|
59.03 ± 12.18
|
<0.0001
|
ABI
|
1.19 ± 0.11
|
1.21 ± 0.12
|
1.23 ± 0.12
|
<0.0001
|
MAP (%)
|
40.14 ± 3.80
|
39.74 ± 3.94
|
39.66 ± 4.02
|
<0.0001
|
UT (s)
|
143.50 (132.00, 160.00)
|
144.00 (132.00, 159.00)
|
145.00 (134.00, 161.00)
|
0.0238
|
Women (n=14087)
|
Age (years)
|
61.53 ± 8.26
|
60.16 ± 8.06
|
59.60 ± 7.84
|
<0.0001
|
Height (cm)
|
157.73 ± 5.51
|
158.38 ± 5.24
|
158.63 ± 5.26
|
<0.0001
|
Weight (kg)
|
53.07 ± 5.93
|
60.74 ± 5.52
|
69.57 ± 7.74
|
<0.0001
|
BMI (kg/m2)
|
21.32 ± 2.05
|
24.21 ± 1.83
|
27.64 ± 2.66
|
<0.0001
|
ASMI (kg/m2)
|
6.77 ± 0.34
|
7.51 ± 0.18
|
8.41 ± 0.57
|
<0.0001
|
ASM (kg)
|
16.87 ± 1.51
|
18.87 ± 1.33
|
21.19 ± 2.05
|
<0.0001
|
SMM (kg)
|
34.63 ± 2.96
|
37.96 ± 2.68
|
41.81 ± 3.78
|
<0.0001
|
LAMM (kg)
|
2.21 ± 0.21
|
2.48 ± 0.19
|
2.79 ± 0.29
|
<0.0001
|
RAMM (kg)
|
2.21 ± 0.22
|
2.48 ± 0.20
|
2.79 ± 0.32
|
<0.0001
|
LLMM (kg)
|
6.23 ± 0.58
|
6.96 ± 0.53
|
7.82 ± 0.84
|
<0.0001
|
RLMM (kg)
|
6.22 ± 0.56
|
6.95 ± 0.51
|
7.79 ± 0.78
|
<0.0001
|
TMM (kg)
|
17.75 ± 1.51
|
19.10 ± 1.40
|
20.62 ± 1.79
|
<0.0001
|
BFP (%)
|
29.10 (26.00, 31.90)
|
31.90 (29.10, 34.30)
|
34.30 (31.50, 36.80)
|
<0.0001
|
baPWV (cm/s)
|
1587.00 (1375.50, 1867.00)
|
1558.00 (1362.00, 1812.00)
|
1557.00 (1378.00, 1789.00)
|
<0.0001
|
SBP (mmHg)
|
132.40 ± 20.17
|
135.19 ± 20.55
|
140.02 ± 20.44
|
<0.0001
|
DBP (mmHg)
|
76.45 ± 11.01
|
78.01 ± 11.03
|
80.57 ± 11.00
|
<0.0001
|
PP (mmHg)
|
57.99 ± 12.75
|
59.16 ± 13.06
|
61.58 ± 13.31
|
<0.0001
|
ABI
|
1.16 ± 0.10
|
1.18 ± 0.10
|
1.19 ± 0.11
|
<0.0001
|
MAP (%)
|
42.70 ± 3.43
|
42.53 ± 3.40
|
42.25 ± 3.55
|
<0.0001
|
UT (s)
|
155.00 (140.00, 173.00)
|
156.00 (142.00, 174.00)
|
158.00 (143.00, 176.00)
|
<0.0001
|
Values are mean ± SD or medians (25th and 75th percentile)
* Test for difference between tertiles was performed using the Kruskal–Wallis test for non-normally distributed continuous variables and ANOVA analysis for normally distributed continuous variables.
Abbreviations: BMI body mass index, SMM Total muscle mass, LAMM Left arm muscle mass, RAMM Right arm muscle mass, LLMM Left arm muscle mass, RLMM Right leg muscle mass, TMM Trunk muscle mass, BFP total body fat percentage, ASM appendicular skeletal muscle, ASMI appendicular skeletal muscle index, baPWV brachial-ankle pulse wave velocity, SBP systolic blood pressure, DBP diastolic blood pressure, PP Pulse pressure, ABI ankle brachial index, MAP mean artery pressure, UT upstroke time.
Table 3 Correlation between muscle mass indices and baPWV
|
Men (n=6390)
|
Women (n=14087)
|
|
r
|
p
|
r
|
p
|
ASMI (kg/m2)
|
-0.080
|
<0.0001
|
-0.054
|
<0.0001
|
ASM (kg)
|
-0.115
|
<0.0001
|
-0.112
|
<0.0001
|
SMM (kg)
|
-0.120
|
<0.0001
|
-0.114
|
<0.0001
|
LAMM (kg)
|
-0.106
|
<0.0001
|
-0.116
|
<0.0001
|
RAMM (kg)
|
-0.107
|
<0.0001
|
-0.115
|
<0.0001
|
LLMM (kg)
|
-0.114
|
<0.0001
|
-0.100
|
<0.0001
|
RLMM (kg)
|
-0.116
|
<0.0001
|
-0.111
|
<0.0001
|
TMM (kg)
|
-0.123
|
<0.0001
|
-0.114
|
<0.0001
|
Pearson’s correlation coefficient was calculated using bivariate correlation analysis.
The natural logarithm was applied for baPWV.
Abbreviations: baPWV brachial-ankle pulse wave velocity, ASMI appendicular skeletal muscle index, ASM appendicular skeletal muscle, SMM Total muscle mass, LAMM Left arm muscle mass, RAMM Right arm muscle mass, LLMM Left arm muscle mass, RLMM Right leg muscle mass, TMM Trunk muscle mass.
Table 4 Multiple linear regression for association between muscle mass indices and baPWV adjusted for potential confounders
|
Model 1
|
Model 2
|
R2
|
β (SE)
|
p
|
R2
|
β (SE)
|
p
|
Men
|
|
|
|
|
|
|
ASMI (kg/m2)
|
0.172
|
-0.040 (0.020)
|
0.0431
|
0.471
|
-0.208 (0.016)
|
<0.0001
|
ASM (kg)
|
0.173
|
-0.061 (0.016)
|
0.0002
|
0.473
|
-0.200 (0.016)
|
<0.0001
|
SMM (kg)
|
0.172
|
-0.053 (0.018)
|
0.0033
|
0.472
|
-0.232 (0.020)
|
<0.0001
|
LAMM (kg)
|
0.173
|
-0.062 (0.015)
|
<0.0001
|
0.471
|
-0.176 (0.015)
|
<0.0001
|
RAMM (kg)
|
0.174
|
-0.062 (0.015)
|
<0.0001
|
0.471
|
-0.164 (0.015)
|
<0.0001
|
LLMM (kg)
|
0.173
|
-0.057 (0.016)
|
0.0003
|
0.473
|
-0.198 (0.016)
|
<0.0001
|
RLMM (kg)
|
0.173
|
-0.058 (0.016)
|
0.0003
|
0.472
|
-0.198 (0.017)
|
<0.0001
|
TMM (kg)
|
0.172
|
-0.037 (0.020)
|
0.0676
|
0.469
|
-0.255 (0.025)
|
<0.0001
|
Women
|
|
|
|
|
|
|
ASMI (kg/m2)
|
0.288
|
0.001 (0.014)
|
0.9294
|
0.579
|
-0.245 (0.012)
|
<0.0001
|
ASM (kg)
|
0.288
|
-0.026 (0.012)
|
0.0266
|
0.579
|
-0.206 (0.013)
|
<0.0001
|
SMM (kg)
|
0.288
|
-0.006 (0.013)
|
0.6521
|
0.578
|
-0.244 (0.016)
|
<0.0001
|
LAMM (kg)
|
0.288
|
-0.041 (0.011)
|
0.0002
|
0.579
|
-0.178 (0.011)
|
<0.0001
|
RAMM (kg)
|
0.288
|
-0.040 (0.011)
|
0.0002
|
0.577
|
-0.155 (0.011)
|
<0.0001
|
LLMM (kg)
|
0.288
|
-0.017 (0.011)
|
0.1317
|
0.578
|
-0.187 (0.012)
|
<0.0001
|
RLMM (kg)
|
0.288
|
-0.022 (0.012)
|
0.0594
|
0.579
|
-0.203 (0.013)
|
<0.0001
|
TMM (kg)
|
0.288
|
0.025 (0.015)
|
0.0858
|
0.576
|
-0.259 (0.020)
|
<0.0001
|
Abbreviations: baPWV brachial-ankle pulse wave velocity, SMM Total muscle mass, ASMI appendicular skeletal muscle index, ASM appendicular skeletal muscle, LAMM Left arm muscle mass, RAMM Right arm muscle mass, LLMM Left arm muscle mass, RLMM Right leg muscle mass, TMM Trunk muscle mass.
Multiple linear regression. Model 1: adjusted for age. Model 2: further adjusted for BFP, SBP and DBP for the association between ASMI and baPWV, further adjusted for height, BFP, SBP and DBP for the association between ASM, SMM, LAMM, RAMM, LLMM, RLMM, TMM and baPWV.
Table 5 Multiple logistic regression for the association between muscle mass indices and arterial stiffness (0: baPWV≤1800, 1: baPWV>1800) adjusted for potential confounders
|
Model 1
|
Model 2
|
OR (95% CI)
|
p
|
OR (95% CI)
|
p
|
Men
|
|
|
|
|
ASMI (kg/m2)
|
0.942 (0.889, 0.997)
|
0.0391
|
0.731 (0.683, 0.783)
|
<0.0001
|
ASM (kg)
|
0.976 (0.960, 0.992)
|
0.0033
|
0.899 (0.878, 0.921)
|
<0.0001
|
SMM (kg)
|
0.989 (0.980, 0.998)
|
0.0220
|
0.941 (0.927, 0.955)
|
<0.0001
|
LAMM (kg)
|
0.818 (0.727, 0.919)
|
0.0007
|
0.480 (0.406, 0.568)
|
<0.0001
|
RAMM (kg)
|
0.819 (0.731, 0.919)
|
0.0006
|
0.510 (0.433, 0.599)
|
<0.0001
|
LLMM (kg)
|
0.941 (0.900, 0.983)
|
0.0067
|
0.755 (0.709, 0.805)
|
<0.0001
|
RLMM (kg)
|
0.941 (0.900, 0.984)
|
0.0078
|
0.757 (0.709, 0.808)
|
<0.0001
|
TMM (kg)
|
0.985 (0.965, 1.006)
|
0.1593
|
0.876 (0.844, 0.908)
|
<0.0001
|
Women
|
|
|
|
|
ASMI (kg/m2)
|
0.949 (0.899, 1.001)
|
0.0551
|
0.634 (0.594, 0.677)
|
<0.0001
|
ASM (kg)
|
0.974 (0.957, 0.992)
|
0.0037
|
0.844 (0.820, 0.869)
|
<0.0001
|
SMM (kg)
|
0.992 (0.982, 1.002)
|
0.1065
|
0.900 (0.886, 0.914)
|
<0.0001
|
LAMM (kg)
|
0.794 (0.699, 0.902)
|
0.0004
|
0.348 (0.286, 0.425)
|
<0.0001
|
RAMM (kg)
|
0.807 (0.714, 0.914)
|
0.0007
|
0.397 (0.329, 0.480)
|
<0.0001
|
LLMM (kg)
|
0.946 (0.903, 0.990)
|
0.0158
|
0.668 (0.621, 0.719)
|
<0.0001
|
RLMM (kg)
|
0.937 (0.893, 0.982)
|
0.0068
|
0.616 (0.573, 0.661)
|
<0.0001
|
TMM (kg)
|
1.001 (0.979, 1.023)
|
0.9587
|
0.795 (0.766, 0.826)
|
<0.0001
|
Abbreviations: baPWV brachial-ankle pulse wave velocity, SMM Total muscle mass, ASMI appendicular skeletal muscle index, ASM appendicular skeletal muscle, LAMM Left arm muscle mass, RAMM Right arm muscle mass, LLMM Left arm muscle mass, RLMM Right leg muscle mass, TMM Trunk muscle mass.
Multiple linear regression. Model 1: adjusted for age. Model 2: further adjusted for BFP, SBP and DBP for the association between ASMI and baPWV, further adjusted for height, BFP, SBP and DBP for the association between ASM, SMM, LAMM, RAMM, LLMM, RLMM, TMM and baPWV.