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Sex-specific associations between cardiovascular risk factors and physical function: The Gambian Bone and Muscle Ageing Study

Sex-specific associations between cardiovascular risk factors and physical function: The Gambian Bone and Muscle Ageing Study
Sex-specific associations between cardiovascular risk factors and physical function: The Gambian Bone and Muscle Ageing Study

Background: In Sub-Saharan Africa, the prevalence of obesity, cardiovascular disease (CVD) and impaired physical function are increasing due to rapid urbanization. We investigated sex differences in associations between cardiac workload, arterial stiffness, peripheral vascular calcification (PVC) and physical function in Gambian adults. Methods: A total of 488 Gambians aged 40–75+ years were recruited (men: 239; and women: 249). Supine blood pressure and heart rate were measured to calculate rate pressure product and pulse pressure. Presence of PVC was determined from tibia peripheral quantitative computed tomography scans. Physical function was assessed by chair rise test (CRT), single two-legged jump (s2LJ) and hand grip strength (HGS). Body composition was measured by dual-energy x-ray absorptiometry; body size corrections were used to calculate fat mass index (FMI) and appendicular lean mass index (ALMI). Estimated glomerular filtration rate (eGFR) was measured from fasting blood samples. The relationship between rate pressure product, pulse pressure or presence of PVC (independent variable) with physical function parameters (dependent variable) was tested using linear regression. Sex-interactions were tested (p-int) adjusting for age, eGFR and ALMI/FMI. Results were expressed as mean differences between men and women with 95% confidence intervals. Mediation analyses used ALMI/FMI as mediator. Results: Women weighed less (54.7 kg ± 10.3 vs. 59.9 kg ± 10.3) and were shorter (157.8 cm ± 6.0 vs. 169.2 cm ± 7.0) compared with men (both P < 0.0001). Women had higher FMI (6.8 kg/m 2 ± 2.9 vs. 2.9 kg/m 2 ± 2.0, P < 0.0001) and eGFR (263.7 mL/min/1.73 m 2 ± 133.1 vs. 237.6 mL/min/1.73 m 2 ± 134.6), but lower ALMI (6.2 kg/m 2 ± 0.7 vs. 8.02 kg/m 2 ± 1.0, P < 0.0001) compared with men. There were significant mean differences between men and women in rate pressure product and s2LJ power (−1.08 [−1.21, −0.95]) and force (−0.57 [−0.63, −0.51]), only after adjusting for age, eGFR and FMI. There were significant mean differences in the associations between pulse pressure and CRT power (−0.28 [−0.31, −0.25]), s2LJ power (−1.07 [−1.20, −0.93]) and HGS (−11.94 [−13.35, −10.54]); these differences were greater after adjusting for age, eGFR and FMI, than ALMI. There were similar differences in the associations between PVC and physical function parameters. In men, FMI mediated the association between rate pressuree product and CRT power (P = 0.002), s2LJ force (P < 0.001) and s2LJ power (P = 0.001). ALMI did not mediate associations for either men or women. Conclusions: Multiple risk factors for CVD were associated with poorer physical function in men and were mediated by FMI. There is a need to identify strategies to slow/prevent the rising CVD burden and poor physical function in Sub-Saharan Africa.

The Gambia, ageing, cardiovascular, fat, hand grip strength, peripheral vascular calcification, physical function, pulse pressure
2190-5991
84-92
Zengin, Ayse
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Breasail, Micheal O.
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Parsons, Camille
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Jarjou, Landing M.
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Janha, Ramatoulie E.
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Prentice, Ann
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Cooper, Cyrus
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Ebeling, Peter R.
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Ward, Kate
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Zengin, Ayse
b2023a08-983d-45bc-ba35-02b5e08aaaa3
Breasail, Micheal O.
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Parsons, Camille
9730e5c3-0382-4ed7-8eaa-6932ab09ec15
Jarjou, Landing M.
ca2935b3-3c0d-4541-bff7-afd191cf502b
Janha, Ramatoulie E.
1a14cb0a-33f3-47f7-8da4-3f7e431d555e
Prentice, Ann
675810ad-8022-453c-b3a3-8afff0e1a920
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Ebeling, Peter R.
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Ward, Kate
39bd4db1-c948-4e32-930e-7bec8deb54c7

Zengin, Ayse, Breasail, Micheal O., Parsons, Camille, Jarjou, Landing M., Janha, Ramatoulie E., Prentice, Ann, Cooper, Cyrus, Ebeling, Peter R. and Ward, Kate (2023) Sex-specific associations between cardiovascular risk factors and physical function: The Gambian Bone and Muscle Ageing Study. Journal of Cachexia, Sarcopenia and Muscle, 14 (1), 84-92. (doi:10.1002/jcsm.13069).

Record type: Article

Abstract

Background: In Sub-Saharan Africa, the prevalence of obesity, cardiovascular disease (CVD) and impaired physical function are increasing due to rapid urbanization. We investigated sex differences in associations between cardiac workload, arterial stiffness, peripheral vascular calcification (PVC) and physical function in Gambian adults. Methods: A total of 488 Gambians aged 40–75+ years were recruited (men: 239; and women: 249). Supine blood pressure and heart rate were measured to calculate rate pressure product and pulse pressure. Presence of PVC was determined from tibia peripheral quantitative computed tomography scans. Physical function was assessed by chair rise test (CRT), single two-legged jump (s2LJ) and hand grip strength (HGS). Body composition was measured by dual-energy x-ray absorptiometry; body size corrections were used to calculate fat mass index (FMI) and appendicular lean mass index (ALMI). Estimated glomerular filtration rate (eGFR) was measured from fasting blood samples. The relationship between rate pressure product, pulse pressure or presence of PVC (independent variable) with physical function parameters (dependent variable) was tested using linear regression. Sex-interactions were tested (p-int) adjusting for age, eGFR and ALMI/FMI. Results were expressed as mean differences between men and women with 95% confidence intervals. Mediation analyses used ALMI/FMI as mediator. Results: Women weighed less (54.7 kg ± 10.3 vs. 59.9 kg ± 10.3) and were shorter (157.8 cm ± 6.0 vs. 169.2 cm ± 7.0) compared with men (both P < 0.0001). Women had higher FMI (6.8 kg/m 2 ± 2.9 vs. 2.9 kg/m 2 ± 2.0, P < 0.0001) and eGFR (263.7 mL/min/1.73 m 2 ± 133.1 vs. 237.6 mL/min/1.73 m 2 ± 134.6), but lower ALMI (6.2 kg/m 2 ± 0.7 vs. 8.02 kg/m 2 ± 1.0, P < 0.0001) compared with men. There were significant mean differences between men and women in rate pressure product and s2LJ power (−1.08 [−1.21, −0.95]) and force (−0.57 [−0.63, −0.51]), only after adjusting for age, eGFR and FMI. There were significant mean differences in the associations between pulse pressure and CRT power (−0.28 [−0.31, −0.25]), s2LJ power (−1.07 [−1.20, −0.93]) and HGS (−11.94 [−13.35, −10.54]); these differences were greater after adjusting for age, eGFR and FMI, than ALMI. There were similar differences in the associations between PVC and physical function parameters. In men, FMI mediated the association between rate pressuree product and CRT power (P = 0.002), s2LJ force (P < 0.001) and s2LJ power (P = 0.001). ALMI did not mediate associations for either men or women. Conclusions: Multiple risk factors for CVD were associated with poorer physical function in men and were mediated by FMI. There is a need to identify strategies to slow/prevent the rising CVD burden and poor physical function in Sub-Saharan Africa.

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Accepted/In Press date: 24 July 2022
e-pub ahead of print date: 8 November 2022
Published date: 1 February 2023
Additional Information: Funding Information: GamBAS is funded by the UK Medical Research Council (programmes U105960371 and U123261351) and the Department for International Development (DFID) under the MRC/DFID Concordat agreement. The UK Medical Research Council and DFID had no role in the design, analysis or writing of this article. Publisher Copyright: © 2022 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders.
Keywords: The Gambia, ageing, cardiovascular, fat, hand grip strength, peripheral vascular calcification, physical function, pulse pressure

Identifiers

Local EPrints ID: 469018
URI: http://eprints.soton.ac.uk/id/eprint/469018
ISSN: 2190-5991
PURE UUID: 885ee283-1a29-4e03-b352-d13465ee2fda
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Kate Ward: ORCID iD orcid.org/0000-0001-7034-6750

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Date deposited: 05 Sep 2022 16:42
Last modified: 30 Oct 2023 03:06

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Contributors

Author: Ayse Zengin
Author: Micheal O. Breasail
Author: Camille Parsons
Author: Landing M. Jarjou
Author: Ramatoulie E. Janha
Author: Ann Prentice
Author: Cyrus Cooper ORCID iD
Author: Peter R. Ebeling
Author: Kate Ward ORCID iD

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