Background: Arterial stiffness has prognostic value for cardiovascular disease and increases with age. Skeletal muscle declines during ageing. There are a number of pathways common to arterial stiffness and muscle loss suggestive of a bi-directional relationship. Observational studies have examined the association between muscle loss and arterial stiffness. We aimed to quantitatively determine the relationship between lean tissue and arterial stiffness.
Methods: We conducted a systematic review and meta-analysis according to MOOSE guidelines. We searched MEDLINE and EMBASE for studies reporting correlations or associations between a measure of lean tissue and a measure of arterial stiffness. Meta-analysis was conducted using Fisher’s Z-transformed r-correlation (rZ) values and a pooled weighted rZ and 95% confidence intervals were calculated in an inverse-variance, random-effects model. Heterogeneity was assessed by the inconsistency index (I2). Study quality was assessed using a checklist using items from MOOSE.
Results: Of 1,195 unique records identified, 21 satisfied our inclusion/exclusion criteria totalling 8,558 participants with mean age 52±4years (range:23-74). Most studies reported a negative relationship between lean tissue and arterial stiffness. Eight studies had data eligible for meta-analysis as most studies did not report correlation or association statistics. Lean tissue was negatively associated with pulse wave velocity [rZ = -0.18 (95%CI: -0.26, -0.10); p<0.0001; I2=81%; n=4,440].
Conclusion: In conclusion, low lean mass is associated with arterial stiffness in adults. Studies were limited by cross-sectional design, heterogeneity and generalisability to other patient groups. Cardiovascular risk monitoring may be strengthened by screening for low muscle mass and maintaining muscle mass may be a primary prevention strategy.