{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T22:33:53Z","timestamp":1793572433691,"version":"4.5.0"},"reference-count":60,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,3,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">To determine whether differences in body composition contribute to sex differences in cardiovascular disease (CVD) mortality, we investigated the relationship between components of body composition and CVD mortality in healthy men and women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Dual energy x\u2010ray absorptiometry body composition data from the National Health and Nutrition Examination Survey 1999\u20132004 and CVD mortality data from the National Health and Nutrition Examination Survey 1999\u20132014 were evaluated in 11\u00a0463 individuals 20\u00a0years of age and older. Individuals were divided into 4 body composition groups (low muscle mass\u2013low fat mass\u2014the referent; low muscle\u2013high fat; high muscle\u2013low fat, and high muscle\u2013high fat), and adjusted competing risks analyses were performed for CVD versus non\u2010CVD mortality. In women, high muscle\/high fat mass was associated with a significantly lower adjusted CVD mortality rate (hazard ratio [HR], 0.58; 95% CI, 0.39\u20130.86;\n                      <jats:italic>P<\/jats:italic>\n                      =0.01), but high muscle\/low fat mass was not. In men, both high muscle\u2013high fat (HR, 0.74; 95% CI, 0.53\u20131.04;\n                      <jats:italic>P<\/jats:italic>\n                      =0.08) and high muscle\u2013low fat mass (HR, 0.40; 95% CI, 0.21\u20130.77;\n                      <jats:italic>P<\/jats:italic>\n                      =0.01) were associated with lower CVD. Further, in adjusted competing risks analyses stratified by sex, the CVD rate in women tends to significantly decrease as normalized total fat increase (total fat fourth quartile: HR, 0.56; 95% CI, 0.34\u20130.94;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.03), whereas this is not noted in men.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Higher muscle mass is associated with lower CVD and mortality in men and women. However, in women, high fat, regardless of muscle mass level, appears to be associated with lower CVD mortality risk. This finding highlights the importance of muscle mass in healthy men and women for CVD risk prevention, while suggesting sexual dimorphism with respect to the CVD risk associated with fat mass.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.017511","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T05:04:31Z","timestamp":1614056671000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":56,"title":["Sex Differences in the Association of Body Composition and Cardiovascular Mortality"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9931-3407","authenticated-orcid":false,"given":"Preethi","family":"Srikanthan","sequence":"first","affiliation":[{"name":"Division of Endocrinology University of California Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara B.","family":"Horwich","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of California Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcella","family":"Calfon Press","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of California Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Gornbein","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine University of California Los Angeles CA"},{"name":"Department of Medicine and Computational Medicine University of California Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karol E.","family":"Watson","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of California Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e318282ab8f"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.39"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/JCN.0000000000000139"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.02.005"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.023005"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.01.033"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-016-0783-1"},{"key":"e_1_3_2_9_2","unstructured":"CDC . 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