Sarcopenia and obesity may contribute to chronic disease. However, little is known about the association between sarcopenia, body roundness index (BRI), and cardiovascular disease (CVD). The aim of this study was to investigate the association of sarcopenia and BRI with CVD in middle-aged and older Chinese population.

Cohort study with an 8-year follow-up.

Data were derived from 4 waves of the China Health and Retirement Longitudinal Study, and 6152 participants aged 45 or above were included in the study.

Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. CVD was defined as the presence of physician-diagnosed heart disease, diabetes and/or stroke. The associations of BRI and sarcopenia with CVD risk were explored using Cox proportional hazards regression models.

The mean age of the participants was 58.3 (8.9) years, and 2936 (47.7%) were males. During the 8 years follow-up, 2385 cases (38.8%) with incident CVD were identified. Longitudinal results demonstrated that compared to neither sarcopenia or high BRI, both sarcopenia and high BRI (HR: 1.49, 95%CI: 1.08, 2.07) were associated with higher risk of CVD. In the subgroup analysis, individuals with both sarcopenia and high BRI were more likely to have new onset stroke (HR: 1.93, 95%CI: 1.12, 3.32) and increased risk of multimorbidity (HR: 2.15, 95% CI: 1.14, 4.04).

Coexistence of sarcopenia and high BRI was associated with higher risk of CVD. Early identification and intervention for sarcopenia and BRI not only allows the implementation of therapeutic strategies, but also provides an opportunity to mitigate the risk of developing CVD.