VARIOUS BODY COMPOSITION DISORDERS IN ELDERLY PATIENTS WITH ATHEROSCLEROSIS OF VASCULAR BEDS

Highlights

One third of elderly patients with coronary atherosclerosis have adverse musculoskeletal and fat profile. The most common type of disorder affecting muscle, fat and bone tissues includes an isolated osteopenia or sarcopenia, and less often a combination of disorders such as osteosarcopenia, sarcopenic and osteosarcopenic obesity.

Aim. To identify variants of body composition disorders (BCD) affecting muscle, fat and bone tissues in elderly patients with atherosclerosis of vascular beds.

Methods. The single-center cohort study included 720 patients with coronary artery disease. The inclusion criteria were: age 60 years and older with coronary atherosclerosis, selected for surgical myocardial revascularization. Among the variants of musculoskeletal and fat status disorders, osteopenic syndrome (osteopenia/osteoporosis), sarcopenia, osteosarcopenia, sarcopenic and osteosarcopenic obesity have been verified.

Results. The mean age of the patients was 68.7 (64.0; 74.0) years, males were the majority (67.1%). The average score on the SARC-F questionnaire did not differ significantly in the groups of patients with various BCD. 33.6% of patients with coronary atherosclerosis had BCD, including isolated osteopenia or osteoporosis (23.9%) and sarcopenia (3.2%), whereas combined disorders in the form of osteosarcopenia (2.9%), sarcopenic (2.1%) and osteosarcopenic obesity (1.5%) were somewhat less common. Male patients were 1.2 times more likely to not have BCD compared to female patients. The logistic regression analysis demonstrated statistical significance only in the group with the detected osteopenia. The risk of this type of disorder was associated with an increase in age (OR = 1.05, 95% CI: 1.04–1.08, p = 0.008) and a history of MI (OR = 2.4, 95% CI: 1.1–4.9, p = 0.018). At the same time, male gender was associated with a reduced risk of developing this condition (OR = 0.32, 95% CI: 0.2–0.5, p = 0.00001).

Conclusion. One third of elderly patients with coronary atherosclerosis had BCD. The overwhelming majority had isolated osteopenia or osteoporosis and sarcopenia, whereas combined disorders in the form of osteosarcopenia, sarcopenic and osteosarcopenic obesity were less common. SARC-F score did not differ significantly among the groups of examined patients with various BCD, thus reducing the diagnostic value of this tool in detecting musculoskeletal disorders in cardiac patients. The factors that increase the risk of osteopenia and osteoporosis include age and prior myocardial infarction, whereas male gender reduces this probability.

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