Background This study aimed to assess the association between obesity, sarcopenia, and sarcopenic obesity with hypertension and to explore the potential mediation of inflammation indicators and insulin resistance. Methods Data from the UK Biobank, a large-scale prospective cohort, were utilized. Obesity was defined using percentage of fat mass, while sarcopenia was defined as low muscle mass and low muscle strength. The primary outcome assessed was new-onset hypertension within a 5-year follow-up period. The association analysis was examined using a Cox regression model. Results A total of 183,091 participants were enrolled in this study. During 5 years of follow-up, 3812 (2.08%) developed hypertension. In the fully adjusted model, compared to men without these conditions, those with obesity, sarcopenia, and sarcopenic obesity had 2.32 times (95% CI, 2.12-2.55), 3.10 times (95% CI, 2.35-4.08), and 3.66 times (95% CI, 2.98-4.50) higher risks of developing hypertension, respectively. Women with obesity, sarcopenia, and sarcopenic obesity had 2.27 times (95% CI, 2.03-2.54), 2.93 times (95% CI, 1.95-4.39), and 4.04 times (95% CI, 3.32-4.91) higher risks of hypertension, respectively. Significant mediating effects of C-reactive protein, neutrophils, white blood cells, triglyceride-glucose index, and triglyceride to high-density lipoprotein cholesterol ratio were found, with mediations ranging from 6% to 13% for men and 2% to 21% for women in the association between sarcopenic obesity and hypertension. Conclusions Obesity, sarcopenia, and sarcopenic obesity significantly increased the risk of hypertension. Inflammation and insulin resistance appeared to mediate the association between sarcopenic obesity and hypertension.

中文翻译：

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肥胖、肌肉减少症、肌肉减少性肥胖和高血压：炎症和胰岛素抵抗的中介作用


背景 本研究旨在评估肥胖、肌肉减少症和肌肉减少性肥胖与高血压之间的关联，并探讨炎症指标和胰岛素抵抗的潜在中介作用。方法 利用来自英国生物样本库（一个大规模前瞻性队列）的数据。肥胖是使用脂肪量的百分比定义的，而肌肉减少症被定义为低肌肉量和低肌肉力量。评估的主要结局是 5 年随访期内新发高血压。使用 Cox 回归模型检查关联分析。结果 本研究共纳入 183,091 名参与者。在 5 年的随访中，3812 例 （2.08%） 患高血压。在完全调整的模型中，与没有这些情况的男性相比，肥胖、肌肉减少和肌肉减少性肥胖患者患高血压的风险分别高 2.32 倍 （95% CI，2.12-2.55） 、 3.10 倍 （95% CI，2.35-4.08） 和 3.66 倍 （95% CI，2.98-4.50） 。肥胖、肌肉减少症和肌肉减少性肥胖女性患高血压的风险分别高 2.27 倍 （95% CI，2.03-2.54） 、 2.93 倍 （95% CI，1.95-4.39） 和 4.04 倍 （95% CI，3.32-4.91）。发现 C 反应蛋白、中性粒细胞、白细胞、甘油三酯-葡萄糖指数和甘油三酯对高密度脂蛋白胆固醇比值的显着介导作用，在肌肉减少性肥胖与高血压之间的关联中，男性为 6%-13%，女性为 2%-21%。结论 肥胖、肌肉减少症和肌肉减少性肥胖显著增加高血压风险。炎症和胰岛素抵抗似乎介导了肌肉减少性肥胖与高血压之间的关联。