Combined effect of skeletal muscle mass loss and elevated insulin resistance on heart failure risk in older adults: a community-based longitudinal cohort study
Authors' conclusion
Skeletal muscle mass loss and elevated IR act synergistically to increase the HF risk in older adults. Comprehensive management of muscle mass and IR might be a useful and effective strategy for preventing and controlling HF.
Study context
- Population
- Community-dwelling adults aged ≥60 years10,489 in trajectory analysis
- Participants
- 11,596 adults
- Exposure
- Higher vs lower ASMI and estimated glucose disposal rate (eGDR); dual ASMI and eGDR trajectory groups
- Outcome
- Incident HF
Methodological detailsprospective analysis, dual-trajectory analysis, restricted cubic splines
- Prospective analysis
- Dual-trajectory analysis
- Restricted cubic splines
Main finding
As reported in the abstract
Incident HF (prospective analysis)
Hazard ratio (95% CI)P value
Femaleper one SD AMSI increment; HF risk decreased by 32.3%
0.677(0.623–0.734)
Padj < 0.001Maleper one SD AMSI increment; HF risk decreased by 9.0%
0.910(0.831–0.996)
Padj = 0.003Femaleper one SD eGDR increment; HF risk decreased by 29.4%
0.706(0.647–0.770)
Padj < 0.001Maleper one SD eGDR increment; HF risk decreased by 26.8%
0.732(0.668–0.803)
Padj < 0.001Each row per its own increment, as printed
- Individuals who developed heart failure (HF) in the prospective analysis
- 1087
- Synergistic effect on HF risk per one SD ASMI and eGDR increment
- Padj < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Incident HF by dual ASMI and eGDR trajectory (dual-trajectory analysis)Group 5vs Group 4 | 1.908 (1.482–2.457) | Padj < 0.001 | |
| Incident HF by dual ASMI and eGDR trajectory (dual-trajectory analysis)Group 3vs Group 4 | 1.716 (1.296–2.273) | Padj < 0.001 | |
| 0.512Hazard ratio (log scale) |
- Incident HF by dual ASMI and eGDR trajectory (dual-trajectory analysis) — Individuals who developed HF
- 859 (8.85 per 1000 person-years)
Incident HF by dual ASMI and eGDR trajectory (dual-trajectory analysis)
- Five distinct dual ASMI and eGDR trajectories identified
Original publication
Combined effect of skeletal muscle mass loss and elevated insulin resistance on heart failure risk in older adults: a community-based longitudinal cohort study. Cardiovasc Diabetol. Published 9 April 2025. doi:10.
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