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Objectives To explore the complex associations of sarcopenia with lung function, and risks of incident respiratory disease (including its subtypes: chronic obstructive pulmonary disease COPD, asthma, and interstitial lung disease ILD), as well as to explore the potential inflammatory and metabolic pathways. Design Prospective cohort study. Setting and participants We assembled data from 317,628 adults enrolled in the UK Biobank. Measurements Sarcopenia status was defined using the European Working Group on Sarcopenia in Older People 2 criteria. Lung function was assessed via a spirometer. The incident respiratory disease was ascertained through linked hospital data over a median follow-up of 14 years. Results Both probable sarcopenia and confirmed/severe sarcopenia were consistently associated with poorer lung function and a higher risk of incident respiratory disease. For instance, compared with their non-sarcopenic counterparts, participants with probable sarcopenia exhibited a significantly higher risk (P < 0.001) of respiratory disease (hazard ratio HR = 1.30; 95% confidence interval CI: 1.26, 1.36), COPD (HR = 1.37; 95% CI: 1.24, 1.50), asthma (HR = 1.35; 95% CI: 1.23, 1.48), and ILD (HR = 1.74; 95% CI: 1.48, 2.04). Furthermore, inflammatory markers and metabolites partially mediated the associations between probable sarcopenia and incident respiratory disease, with C-reactive protein (5.2 %–12.9 %) and albumin (2.6%–8.0%) showing relatively higher mediation proportions. Conclusion Sarcopenia, even at the probable stage, was significantly associated with an increased risk of incident respiratory disease, and inflammatory and metabolic mechanisms may underlie these associations. Our findings highlight the importance of early prevention and management of sarcopenia for preserving respiratory health.
Cao et al. (Thu,) studied this question.