Muscle quality index is associated with advanced stages in patients with cardiovascular-kidney-metabolic syndrome: A cross-sectional study.
Level 4 - case-series / case-control
Cross-sectional observational study using NHANES survey data
PubMed 42332509 · doi:10.1097/MD.0000000000049366
What was done
Analyzed cross-sectional data from 2,012 participants in the 2011–2014 National Health and Nutrition Examination Survey (NHANES). Muscle quality index (MQI) was calculated as the ratio of handgrip strength to appendicular skeletal muscle mass. Advanced cardiovascular-kidney-metabolic (CKM) syndrome was defined as stages 3 to 4 using American Heart Association criteria. Multivariable logistic regression, restricted cubic spline analysis, and stratified interaction analyses were used to assess the relationship between MQI and advanced CKM syndrome.
What was found
Advanced CKM syndrome was present in 4.7% of participants. Higher MQI was associated with lower odds of advanced CKM syndrome (odds ratio = 0.54 per unit increase, 95% CI: 0.29–0.99). A threshold effect was identified at MQI = 2.66, with stronger inverse associations below this value. Significant effect modifications were observed by sex (P-interaction = 0.0083) and income (P-interaction < 0.0001), where the inverse association was present only in males and participants in the highest-income group.
Why it matters
This study suggests that preserving composite muscle quality (strength relative to mass) rather than muscle mass alone may be relevant to advanced multisystem cardiovascular-kidney-metabolic dysfunction, particularly in specific demographic subgroups.
Limits
The cross-sectional design cannot establish temporality or causality. The low prevalence of advanced CKM syndrome (4.7%, approximately 95 cases) led to wide confidence intervals approaching the null. Findings were not generalizable across sexes or income levels, with no significant associations observed in females or lower-income groups. Unmeasured confounding from physical activity patterns, dietary factors, or medication use was not fully accounted for in the abstract.
Cited by
- supports Having high-quality skeletal muscle makes it significantly harder to develop metabolic disorders.