Skip to main content

Advertisement

SpringerLink
Log in

Low Relative Lean Mass is Associated with Increased Likelihood of Abdominal Aortic Calcification in Community-Dwelling Older Australians

  • Original Research
  • Published:
Calcified Tissue International Aims and scope Submit manuscript

Abstract

Age-related loss of skeletal muscle is associated with increased risk of functional limitation and cardiovascular (CV) mortality. In the elderly abdominal aortic calcification (AAC) can increase CV risk by altering aortic properties which may raise blood pressure and increase cardiac workload. This study investigated the association between low muscle mass and AAC in community-dwelling older Australians. Data for this cross-sectional analysis were drawn from a 2010 sub-study of the Melbourne Collaborative Cohort Study in the setting of community-dwelling older adults. Three hundred and twenty-seven participants [mean age = 71 ± 6 years; mean BMI = 28 ± 5 kg/m2; females n = 199 (62 %)] had body composition determined by dual-energy x-ray absorptiometry (DXA) and AAC determined by radiography. Participants were stratified into tertiles of sex-specific BMI-normalised appendicular lean mass (ALM). Those in the lowest tertile were considered to have low relative muscle mass. Aortic calcification score (ACS) was determined visually as the extent of calcification on the aortic walls between L1 and L4 vertebrae (range: 0–24). Severe AAC was defined as ACS ≥ 6. Prevalence of any AAC was highest in participants with low relative muscle mass (74 %) compared to the middle (65 %) and upper (53 %) tertiles (p trend = 0.006). The lower ALM/BMI tertile had increased odds (Odds ratio = 2.3; 95 % confidence interval: 1.1–4.6; p = 0.021) of having any AAC; and having more severe AAC (2.2; 1.2–4.0; p = 0.009) independent of CV risk factors, serum calcium and physical activity. AAC is more prevalent and severe in community-dwelling older adults with low relative muscle mass. Maintaining muscle mass could form part of a broader primary prevention strategy in reducing AAC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. World Health Statistics (2016) World Health Organization, 15 Jan 2016

  2. Rosenberg IH (1997) Sarcopenia: origins and clinical relevance. J Nutr 127:990s–991s

    CAS  PubMed  Google Scholar 

  3. Lee SW, Youm Y, Lee WJ, Choi W, Chu SH, Park YR, Kim HC (2015) Appendicular skeletal muscle mass and insulin resistance in an elderly korean population: the korean social life, health and aging project-health examination cohort. Diabetes Metab J 39:37–45

    Article  PubMed  PubMed Central  Google Scholar 

  4. Scott D, Park MS, Kim TN, Ryu JY, Hong HC, Yoo HJ, Baik SH, Jones G, Choi KM (2016) Associations of low muscle mass and the metabolic syndrome in Caucasian and Asian middle-aged and older adults. J Nutr Health Aging 20(3):248–255

    Article  CAS  PubMed  Google Scholar 

  5. Witteman JC, Kok FJ, van Saase JL, Valkenburg HA (1986) Aortic calcification as a predictor of cardiovascular mortality. Lancet 2:1120–1122

    Article  CAS  PubMed  Google Scholar 

  6. Asmar RG, Topouchian JA, Benetos A, Sayegh FA, Mourad JJ, Safar ME (1997) Non-invasive evaluation of arterial abnormalities in hypertensive patients. J Hypertens Suppl 15:S99–S107

    Article  CAS  PubMed  Google Scholar 

  7. Lang T, LeBlanc A, Evans H, Lu Y, Genant H, Yu A (2004) Cortical and trabecular bone mineral loss from the spine and hip in long-duration spaceflight. J Bone Miner Res 19:1006–1012

    Article  PubMed  Google Scholar 

  8. Chow JT, Khosla S, Melton LJ 3rd, Atkinson EJ, Camp JJ, Kearns AE (2008) Abdominal aortic calcification, BMD, and bone microstructure: a population-based study. J Bone Miner Res 23:1601–1612

    Article  PubMed  PubMed Central  Google Scholar 

  9. Roubenoff R (2003) Catabolism of aging: is it an inflammatory process? Curr Opin Clin Nutr Metab Care 6:295–299

    PubMed  Google Scholar 

  10. Taekema DG, Ling CH, Blauw GJ, Meskers CG, Westendorp RG, de Craen AJ, Maier AB (2011) Circulating levels of IGF1 are associated with muscle strength in middle-aged- and oldest-old women. Eur J Endocrinol 164:189–196

    Article  CAS  PubMed  Google Scholar 

  11. Demer LL, Tintut Y (2014) Inflammatory, metabolic, and genetic mechanisms of vascular calcification. Arterioscler Thromb Vasc Biol 34:715–723

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Jensky NE, Allison MA, Loomba R, Carnethon MR, de Boer IH, Budoff MJ, Burke GL, Criqui MH, Ix JH (2013) Null association between abdominal muscle and calcified atherosclerosis in community-living persons without clinical cardiovascular disease: the multi-ethnic study of atherosclerosis. Metabolism 62:1562–1569

    Article  CAS  PubMed  Google Scholar 

  13. Wassel CL, Laughlin GA, Saad SD, Araneta MR, Wooten W, Barrett-Connor E, Allison MA (2015) Associations of abdominal muscle area with 4-year change in coronary artery calcium differ by ethnicity among post-menopausal women. Ethn Dis 25:435–442

    Article  PubMed  PubMed Central  Google Scholar 

  14. Giles GG, English DR (2002) The Melbourne collaborative cohort study. IARC Sci Publ 156:69–70

    CAS  PubMed  Google Scholar 

  15. Khan B, Nowson CA, Daly RM, English DR, Hodge AM, Giles GG, Ebeling PR (2015) Higher dietary calcium intakes are associated with reduced risks of fractures, cardiovascular events, and mortality: a prospective cohort study of older men and women. J Bone Miner Res 30:1758–1766

    Article  CAS  PubMed  Google Scholar 

  16. Stewart AL, Mills KM, King AC, Haskell WL, Gillis D, Ritter PL (2001) CHAMPS physical activity questionnaire for older adults: outcomes for interventions. Med Sci Sports Exerc 33:1126–1141

    Article  CAS  PubMed  Google Scholar 

  17. Ireland P, Jolley D, Giles G, O’Dea K, Powles J, Rutishauser I, Wahlqvist ML, Williams J (1994) Development of the Melbourne FFQ: a food frequency questionnaire for use in an Australian prospective study involving an ethnically diverse cohort. Asia Pac J Clin Nutr 3:19–31

    CAS  PubMed  Google Scholar 

  18. Pink B (2008) Information paper: an introduction to socio-economic indexes for areas (SEIFA), 2006. Australian Bureau of Statistics (ABS), Canberra

    Google Scholar 

  19. Sakai Y, Ito H, Meno T, Numata M, Jingu S (2006) Comparison of body composition measurements obtained by two fan-beam DXA instruments. J Clin Densitom 9:191–197

    Article  PubMed  Google Scholar 

  20. Studenski SA, Peters KW, Alley DE, Cawthon PM, McLean RR, Harris TB, Ferrucci L, Guralnik JM, Fragala MS, Kenny AM, Kiel DP, Kritchevsky SB, Shardell MD, Dam TT, Vassileva MT (2014) The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci 69:547–558

    Article  PubMed  PubMed Central  Google Scholar 

  21. Barbat-Artigas S, Plouffe S, Pion CH, Aubertin-Leheudre M (2013) Toward a sex-specific relationship between muscle strength and appendicular lean body mass index? J Cachexia Sarcopenia Muscle 4:137–144

    Article  PubMed  PubMed Central  Google Scholar 

  22. Raggi P, Bellasi A (2007) Clinical assessment of vascular calcification. Adv. Chronic Kidney Dis 14:37–43

    Article  PubMed  Google Scholar 

  23. Kauppila LI, Polak JF, Cupples LA, Hannan MT, Kiel DP, Wilson PW (1997) New indices to classify location, severity and progression of calcific lesions in the abdominal aorta: a 25-year follow-up study. Atherosclerosis 132:245–250

    Article  CAS  PubMed  Google Scholar 

  24. Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, Garry PJ, Lindeman RD (1998) Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 147:755–763

    Article  CAS  PubMed  Google Scholar 

  25. Bischoff-Ferrari HA, Orav JE, Kanis JA, Rizzoli R, Schlogl M, Staehelin HB, Willett WC, Dawson-Hughes B (2015) Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older. Osteoporos Int 26:2793–2802

    Article  CAS  PubMed  Google Scholar 

  26. Golledge J, Jayalath R, Oliver L, Parr A, Schurgers L, Clancy P (2008) Relationship between CT anthropometric measurements, adipokines and abdominal aortic calcification. Atherosclerosis 197:428–434

    Article  CAS  PubMed  Google Scholar 

  27. Matsubara Y, Matsumoto T, Aoyagi Y, Tanaka S, Okadome J, Morisaki K, Shirabe K, Maehara Y (2015) Sarcopenia is a prognostic factor for overall survival in patients with critical limb ischemia. J Vasc Surg 61:945–950

    Article  PubMed  Google Scholar 

  28. Verbeke F, Van Biesen W, Honkanen E, Wikstrom B, Jensen PB, Krzesinski JM, Rasmussen M, Vanholder R, Rensma PL (2011) Prognostic value of aortic stiffness and calcification for cardiovascular events and mortality in dialysis patients: outcome of the calcification outcome in renal disease (CORD) study. Clin J Am Soc Nephrol CJASN 6:153–159

    Article  PubMed  Google Scholar 

  29. Coelho Junior HJ, Aguiar Sda S, Goncalves Ide O, Sampaio RA, Uchida MC, Moraes MR, Asano RY (2015) Sarcopenia is associated with high pulse pressure in older women. J Aging Res 2015:109824. doi:10.1155/2015/109824

    Article  PubMed  PubMed Central  Google Scholar 

  30. Aleman-Mateo H, Lopez Teros MT, Ramirez FA, Astiazaran-Garcia H (2014) Association between insulin resistance and low relative appendicular skeletal muscle mass: evidence from a cohort study in community-dwelling older men and women participants. J Gerontol A Biol Sci Med Sci 69:871–877

    Article  CAS  PubMed  Google Scholar 

  31. Rhee EJ, Kim JH, Park HJ, Park SE, Oh HG, Park CY, Lee WY, Oh KW, Park SW (2015) Increased risk for development of coronary artery calcification in insulin-resistant subjects who developed diabetes: 4-year longitudinal study. Atherosclerosis 245:132–138

    Article  PubMed  Google Scholar 

  32. Ong KL, McClelland RL, Rye KA, Cheung BM, Post WS, Vaidya D, Criqui MH, Cushman M, Barter PJ, Allison MA (2014) The relationship between insulin resistance and vascular calcification in coronary arteries, and the thoracic and abdominal aorta: the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 236:257–262

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Tarantino G, Costantini S, Finelli C, Capone F, Guerriero E, La Sala N, Gioia S, Castello G (2014) Is serum Interleukin-17 associated with early atherosclerosis in obese patients? J Transl Med 12:214

    Article  PubMed  PubMed Central  Google Scholar 

  34. Scott D, Trbojevic T, Skinner E, Clark RA, Levinger P, Haines TP, Sanders KM, Ebeling PR (2015) Associations of calf inter- and intra-muscular adipose tissue with cardiometabolic health and physical function in community-dwelling older adults. J Musculoskelet Neuronal Interact 15:350–357

    CAS  PubMed  Google Scholar 

  35. Canepa M, Ameri P, AlGhatrif M, Pestelli G, Milaneschi Y, Strait JB, Giallauria F, Ghigliotti G, Brunelli C, Lakatta EG, Ferrucci L (2014) Role of bone mineral density in the inverse relationship between body size and aortic calcification: results from the Baltimore longitudinal study of aging. Atherosclerosis 235:169–175

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Steitz SA, Speer MY, Curinga G, Yang HY, Haynes P, Aebersold R, Schinke T, Karsenty G, Giachelli CM (2001) Smooth muscle cell phenotypic transition associated with calcification: upregulation of Cbfa1 and downregulation of smooth muscle lineage markers. Circ Res 89:1147–1154

    Article  CAS  PubMed  Google Scholar 

  37. Lind L, Skarfors E, Berglund L, Lithell H, Ljunghall S (1997) Serum calcium: a new, independent, prospective risk factor for myocardial infarction in middle-aged men followed for 18 years. J Clin Epidemiol 50:967–973

    Article  CAS  PubMed  Google Scholar 

  38. Samelson EJ, Booth SL, Fox CS, Tucker KL, Wang TJ, Hoffmann U, Cupples LA, O’Donnell CJ, Kiel DP (2012) Calcium intake is not associated with increased coronary artery calcification: the Framingham Study. Am J Clin Nutr 96:1274–1280

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Endes S, Schaffner E, Caviezel S, Dratva J, Autenrieth CS, Wanner M, Martin B, Stolz D, Pons M, Turk A, Bettschart R, Schindler C, Kunzli N, Probst-Hensch N, Schmidt-Trucksass A (2016) Long-term physical activity is associated with reduced arterial stiffness in older adults: longitudinal results of the SAPALDIA cohort study. Age Ageing 45:110–115

    Article  PubMed  Google Scholar 

  40. Alkatan M, Machin DR, Baker JR, Akkari AS, Park W, Tanaka H (2016) Effects of swimming and cycling exercise intervention on vascular function in patients with osteoarthritis. Am J Cardiol 117:141–145

    Article  PubMed  Google Scholar 

  41. Miyachi M (2013) Effects of resistance training on arterial stiffness: a meta-analysis. Br J Sports Med 47:393–396

    Article  PubMed  Google Scholar 

  42. Scott D, Hayes A, Sanders KM, Aitken D, Ebeling PR, Jones G (2014) Operational definitions of sarcopenia and their associations with 5-year changes in falls risk in community-dwelling middle-aged and older adults. Osteoporos Int 25:187–193

    Article  CAS  PubMed  Google Scholar 

  43. Spence LA, Weaver CM (2013) Calcium intake, vascular calcification, and vascular disease. Nutr Rev 71:15–22

    Article  PubMed  Google Scholar 

Download references

Author Contributions

AJR performed data analysis and drafted the manuscript. DS contributed to manuscript development, data analysis and provided expert opinion. BK performed imaging, scored for calcification and collected data relating to other variables. NK independently performed calcification scoring. AH, DRE and GGG were responsible for the MCCS from which this study drew participants. PRE proposed the topic, contributed to manuscript development and provided expert opinion in drafting. All authors reviewed the final draft before submission.

Author information

Authors and Affiliations

  1. Bone and Muscle Health Research Group, Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Monash Medical Centre, 246 Clayton Road, Clayton, VIC, Australia

    Alexander J. Rodríguez, David Scott & Peter R. Ebeling

  2. Melbourne Medical School (Western Campus), University of Melbourne, St Albans, Australia

    David Scott, Belal Khan & Peter R. Ebeling

  3. Australian Institute for Musculoskeletal Science, St Albans, Australia

    David Scott & Peter R. Ebeling

  4. Department of Medicine, Max Super Specialty Hospital, Patparganj, Delhi, India

    Belal Khan

  5. Department of Radiology, Diwan Chand Satyapal Aggarwaal Diagnostic Imaging Research Centre, New Delhi, India

    Nayab Khan

  6. Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Australia

    Allison Hodge, Dallas R. English & Graham G. Giles

Authors
  1. Alexander J. Rodríguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Scott
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Belal Khan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nayab Khan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Allison Hodge
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dallas R. English
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Graham G. Giles
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Peter R. Ebeling
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alexander J. Rodríguez.

Ethics declarations

Conflict of interest

Alexander J. Rodríguez, David Scott, Belal Khan, Nayab Khan, Allison Hodge, Dallas R. English, Graham G. Giles and Peter R. Ebeling declare no competing interests. This work was supported by Monash University.

Human and Animal Rights and Informed Consent

This study complied with local ethical standards and was conducted in accordance with the guidelines outlined in the Helsinki Declaration.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 16 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rodríguez, A.J., Scott, D., Khan, B. et al. Low Relative Lean Mass is Associated with Increased Likelihood of Abdominal Aortic Calcification in Community-Dwelling Older Australians. Calcif Tissue Int 99, 340–349 (2016). https://doi.org/10.1007/s00223-016-0157-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00223-016-0157-z

Keywords

Search

Navigation