Comprehensive evaluation of appendicular lean mass and sarcopenia on human health: evidence from the NHANES program

BACKGROUND: While accumulating points have been figured out the importance of muscle function, less clinical or epidemiological evidence have been provided. This study aimed to provide new evidence on the systemic effects of muscle mass on health condition, based on the National Health and Nutrition Examination Survey (NHANES) program. METHOD: All used data was acquired from 11 survey cycles (1999-2020) of the NHANES program. The mortality information of participants was derived from the National Death Index (NDI) website. The disease status of participants was obtained from questionnaire surveys. The metabolism-related index was obtained from examination data. Multiple regression methods, smooth curve fitting, and threshold effect models were used for association analyses. RESULT: In this large-scale study encompassing 46,733 participants, appendicular lean mass (ALM) demonstrated significant associations with multiple health outcomes: ALM exhibited L-shaped relationships with hyperuricemia and malignancy, inverse correlations with asthma, chronic obstructive pulmonary disease (COPD), rheumatoid arthritis (RA), nephrolithiasis, depression, and cancer-cause mortality, a positive correlation with bone mineral density (BMD), and notably, protective saturating effects against osteoarthritis (OA), all-cause mortality, and cardiovascular (CVD)-cause mortality. A significant inverse association was observed between sarcopenia and BMD, while positive correlations were identified between sarcopenia and COPD, asthma, OA, depression, and all-cause mortality. CONCLUSIONS: In this study, we explored the association between ALM or sarcopenia and multiple health outcomes, highlighting the widespread impact of ALM on systemic health condition. These findings provide new epidemiological evidence on how ALM or sarcopenia influence the health status among the U.S.