Association of smoking and alcohol consumption with the presence of sarcopenia at follow-up in community-dwelling people aged 40–74 years

Background: Evidence on the association of smoking and drinking with sarcopenia is scarce. This study aimed to examine the association between smoking levels/alcohol consumption and sarcopenia in community-dwelling middle-aged and older adults. Methods: This study consisted of 6,654 community-dwelling residents aged 40-74 years (mean age: 62.4 years, 54.8% women). At the baseline survey (2011-2014), demographic information, lifestyle habits (including smoking levels and alcohol consumption), physical characteristics, and medical history were obtained. Follow-up physical examinations were conducted in 2021 and 2022. Sarcopenia was diagnosed using modified AWGS 2019 criteria, with low muscle mass defined as the sex-specific 20th percentile of ALM/height². Results: Sarcopenia was present in 272/6654 cases (4.1%). Smoking levels were associated with higher odds of the presence of sarcopenia at follow-up (adjusted P for trend=0.0367), with the ≥20-cigarettes/day group having a higher OR than non-smokers (adjusted OR=1.95, 95% CI:1.17-3.24). Drinking levels were associated with lower odds of the presence of sarcopenia in women (adjusted P for trend=0.0013), but not in men (adjusted P for trend=0.9872). A subgroup analysis showed that smoking ≥20 cigarettes/day was associated with higher odds of the presence of sarcopenia than non-smoking (adjusted OR=2.20, 95%CI:1.17-4.16) in drinkers, but not in non-drinkers (P for interaction between levels of smoking and alcohol consumption = 0.0483). Conclusions: Higher smoking levels were associated with sarcopenia, particularly among individuals who smoked ≥20 cigarettes/day, and an interaction between smoking and alcohol consumption was suggested. However, caution is warranted in interpreting causality, as this study did not assess sarcopenia at baseline.