Abstract

Background: Few studies have examined sarcopenia's impact on peripheral arterial disease (PAD) prognosis. We aimed to investigate the impact of  sarcopenia on long-term mortality in community-dwelling patients with PAD.

Methods: Data were extracted from the NHANES 1999-2004. Participants ≥ 40 years old who had PAD defined by ankle-brachial index were eligible.  Participants were categorized as having low and normal muscle mass according to body mass index adjusted appendicular lean mass, measured by the  dualenergy X-ray absorptiometry. In the NHANES 1999-2002 cycle, knee extensor strength in participants aged ≥ 50 years was measured using a Kin Com MP dynamometer. All-cause and cardiovascular disease (CVD) mortality were compared between the two groups using the Cox proportional hazard analysis.

Results: A total of 623 participants, of which 27.4% had low muscle mass, were included. After adjustment, low muscle mass was significantly associated with an increased risk of all-cause mortality (aHR = 1.31, 95% CI: 1.03-1.65) and CVD mortality (aHR = 1.26, 95% CI: 0.68-2.35) than those without low muscle mass. According to the sub-analyses, lowmuscle strength alonewas not significantly associated with mortality. Reduced muscle mass combined with low muscle strength increased the risk of CVD mortality (aHR = 2.50, 95% CI: 1.12-5.60).

Conclusions: In adults with PAD, lowmuscle mass elevates the risk of all-cause mortality, while the combination of low muscle mass and reduced muscle strength strongly increases the risk of CVD mortality. These findings underscore the need to assess both muscle mass and strength in the management of PAD.