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Abstract: FR-PO1121

Cardiovascular-Kidney-Metabolic Syndrome and Physical Inactivity as Emerging Risk Factors for Sarcopenia in US Adults: A Nationwide Cohort Analysis

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1500 Health Maintenance, Nutrition, and Metabolism

Authors

  • Wang, Dingding, Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
  • Zhang, Meng, Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
  • Xie, Peichen, Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
  • Li, Bin, Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
  • Chen, Wei, Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
Background

Sarcopenia, a progressive loss of muscle mass and function, poses a major public health burden due to its association with increased morbidity, frailty, and mortality. While cardiovascular, metabolic, and kidney dysfunction are known contributors, the integrated impact of cardiovascular-kidney-metabolic (CKM) syndrome—a recently conceptualized multisystem disorder—on sarcopenia risk remains under-investigated. Furthermore, the modifying role of physical activity within this context is poorly understood.

Methods

We conducted a cross-sectional analysis of 4,193 adults from the 2011–2018 National Health and Nutrition Examination Survey (NHANES). Sarcopenia was defined using validated criteria for muscle mass and strength. CKM syndrome was staged from 0 to 4 based on clinical parameters, and physical activity was quantified via metabolic equivalent of task (MET) scores. Multivariable logistic regression evaluated the independent and joint associations of CKM stage and physical activity with sarcopenia, adjusting for sociodemographic and clinical confounders. Subgroup and interaction analyses assessed effect modification.

Results

The weighted prevalence of sarcopenia was 7.2%. Individuals with sarcopenia were disproportionately represented in advanced CKM stages (Stage 3: 5% vs. 1%; Stage 4: 8% vs. 3%, sarcopenia vs. non-sarcopenia). A dose-response association was observed: Stage 2 vs. 0-1: OR=1.58 (95% CI: 1.03-2.43); Stages 3-4 vs. 0-1: OR=3.51 (95% CI: 1.54-8.01). Physical inactivity independently elevated sarcopenia risk (OR=2.16; 95% CI: 1.56-3.00). Notably, joint exposure to physical inactivity and advanced CKM (Stages 3-4) conferred a synergistically elevated risk (OR=7.62; 95% CI: 3.02-19.21), suggesting multiplicative interaction. Significant interaction by marital status (P for interaction = 0.038) suggests social support may influence susceptibility.

Conclusion

Advanced CKM stage and physical inactivity are independent and synergistic predictors of sarcopenia, underscoring the importance of early detection and intervention in populations with cardiometabolic-renal comorbidity. These findings advance our understanding of sarcopenia’s multifactorial etiology and support integrated lifestyle and risk-stage–based strategies to mitigate muscle loss and disability in high-risk groups.

Funding

  • Government Support – Non-U.S.

Digital Object Identifier (DOI)