노인 건강검진 수검자에서 골격근량과 사망률의 관계

• Published in: The Korean journal of medicine Vol. 85; no. 2; pp. 167 - 173
• Main Authors: 정희원, Hee Won Jung, 김선욱, Sun Wook Kim, 진호준, Ho Jun Chin, 김철호, Cheol Ho Kim, 김광일, Kwang Il Kim
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.08.2013
• Subjects: Aged; Mortality; Sarcopenia; Skeletal muscle; 내과학
• ISSN: 1738-9364; 2289-0769
• DOI: 10.3904/kjm.2013.85.2.167

Background/Aims: A U-shaped relationship between body mass index (BMI) and mortality has been reported. However, controversy exists as to whether skeletal muscle mass affects mortality in healthy older adults. We evaluated the independent association of BMI or appendicular skeletal muscle mass (ASM) with mortality in elderly people. Methods: A total of 4,261 consecutive subjects older than 65 years who underwent health examinations at Seoul National University Gangnam Center between 2005 and 2009 were included in the analysis. ASM, ASM/height² and ASM/weight were estimated by bioelectrical impedance analysis. Sarcopenia was defined as a relative skeletal muscle mass of 1-2 SD below (class I) or more than 2 SD below (class II) the gender-specific mean for healthy young adults. BMI was grouped into five groups (A-E). Results: During the follow-up period (27.2 ± 13.5 months), 63 subjects died. The subjects who died were significantly older and had a male predominance, increased levels of inflammatory markers and poor nutritional statuses. In a fully adjusted Cox proportional hazards model, BMI was not associated with mortality. However, class I sarcopenia (HR 2.11, 95% CI 1.17 3.79) and class II sarcopenia (HR 3.47, 95% CI 1.62-7.43), defined by ASM/height², were related to all-cause mortality. This association was not observed when sarcopenia was defined by ASM/weight. Class II sarcopenia defined by ASM/height² was associated with cancer-related mortality (HR 5.73, 95% CI 2.22-14.78), but not with cardiovascular mortality (HR 1.56, 95% CI 0.17 14.27). Conclusions: This study indicates that lower skeletal muscle mass is a risk marker for cancer-related and all cause mortality in Korean elderly people. (Korean J Med 2013;85:167-173)