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Godziuk K, Prado CM, Woodhouse LJ, Forhan M. The impact of sarcopenic obesity on knee and hip osteoarthritis: a scoping review. BMC Musculoskelet Disord 2018; 19:271. [PMID: 30055599 PMCID: PMC6064616 DOI: 10.1186/s12891-018-2175-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/10/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The progressive, debilitating nature of knee and hip osteoarthritis can result in severe, persistent pain and disability, potentially leading to a need for total joint arthroplasty (TJA) in end-stage osteoarthritis. TJA in adults with obesity is associated with increased surgical risk and prolonged recovery, yet classifying obesity only using body mass index (BMI) precludes distinction of obesity phenotypes and their impact on surgical risk and recovery. The sarcopenic obesity phenotype, characterized by high adiposity and low skeletal muscle mass, is associated with higher infection rates, poorer function, and slower recovery after surgery in other clinical populations, but not thoroughly investigated in osteoarthritis. The rising prevalence and impact of this phenotype demands further attention in osteoarthritis treatment models of care, particularly as osteoarthritis-related pain, disability, and current treatment practices may inadvertently be influencing its development. METHODS A scoping review was used to examine the extent of evidence of sarcopenic obesity in adults with hip or knee osteoarthritis. Medline, CINAHL, Web of Science and EMBASE were systematically searched from inception to December 2017 with keywords and subject headings related to obesity, sarcopenia and osteoarthritis. RESULTS Eleven studies met inclusion criteria, with indications that muscle weakness, low skeletal muscle mass or sarcopenia are present alongside obesity in this population, potentially impacting therapeutic outcomes, and TJA surgical risk and recovery. CONCLUSIONS Consideration of sarcopenic obesity should be included in osteoarthritis patient assessments.
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Affiliation(s)
- Kristine Godziuk
- Faculty of Rehabilitation Medicine, University of Alberta, 8205 – 114 Street, 2-64 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - Carla M. Prado
- Division of Human Nutrition, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, AB Canada
| | - Linda J. Woodhouse
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB Canada
| | - Mary Forhan
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB Canada
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Van Aller C, Lara J, Stephan BCM, Donini LM, Heymsfield S, Katzmarzyk PT, Wells JCK, Prado CM, Siervo M. Sarcopenic obesity and overall mortality: Results from the application of novel models of body composition phenotypes to the National Health and Nutrition Examination Survey 1999-2004. Clin Nutr 2018; 38:264-270. [PMID: 29499977 DOI: 10.1016/j.clnu.2018.01.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 01/05/2018] [Accepted: 01/12/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND/OBJECTIVES There is no consensus on the definition of sarcopenic obesity (SO), resulting in inconsistent associations of SO with mortality risk. We aim to evaluate association of dual energy x-ray absorptiometry (DXA) SO models with mortality risk in a US adult population (≥50 years). SUBJECTS/METHODS The study population consisted of 3577 participants aged 50 years and older from the 1999-2004 National Health and Nutrition and Examination Survey with mortality follow-up data through December 31, 2011. Difference in survival time in people with and without SO defined by three body composition DXA models (Model 1: body composition phenotype model; Model 2: Truncal Fat Mass (TrFM)/Appendicular Skeletal Muscle Mass (ASM) ratio model; Model 3: Fat Mass (FM)/Fat Free Mass (FFM) ratio). The differences between the models were assessed by the acceleration failure time model, and expressed as time ratios (TR). RESULTS Participants age 50-70 years with SO had a significantly decreased survival time, according to the body composition phenotype model (TR: 0.92; 95% CI: 0.87-0.97), and TrFM/ASM ratio model (TR: 0.88; 95% CI: 0.81-0.95). The FM/FFM ratio model did not detect significant differences in survival time. Participants with SO aged 70 years and older did not have a significantly decreased survival time, according to all three models. CONCLUSIONS A SO phenotype increases mortality risk in people of age 50-70 years, but not in people aged 70 years and older. The application of the body composition phenotype and the TrFM/ASM ratio models may represent useful diagnostic approaches to improve the prediction of disease and mortality risk.
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Affiliation(s)
- Carla Van Aller
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK
| | - Jose Lara
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, UK
| | - Blossom C M Stephan
- Institute of Health and Society, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK
| | - Lorenzo Maria Donini
- Department of Experimental Medicine- Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University of Rome, 00185 Rome, Italy
| | | | | | - Jonathan C K Wells
- Childhood Nutrition Research Centre, Institute of Child Health, University College of London, 30 Guilford Street, WC1N 1EH, London, UK
| | - Carla M Prado
- Department of Agriculture, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Mario Siervo
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK.
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Perri A, Ilacqua A, Valenti M, Aversa A. Effects of nutraceuticals on sexual satisfaction and lower urinary tract symptoms in a cohort of young-old men. Phytother Res 2017; 32:284-289. [PMID: 29168235 DOI: 10.1002/ptr.5971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 09/27/2017] [Accepted: 10/09/2017] [Indexed: 11/08/2022]
Abstract
The aim of this study was to evaluate the effects of nutraceuticals containing multiple supplemental facts (Virherbe®/Rekupros®) on sexual satisfaction and lower urinary tract symptoms (LUTS) in young-old men. In an open-label trial, 40 males (mean age 66 ± 13) with sexual disturbances and mild LUTS but without cognitive/motor impairment and clinical hypogonadism were enrolled. Sexual desire (SD; IIEF-SD domain) and satisfaction (Global Assessment Question; GAQ), the capacity to perform daily activities (evaluated by 6-min walking test [6MWT]), and International Prostate Symptoms Scores (IPSS) were evaluated before and after oral administration of 2 capsules/day of each supplement for 8 weeks. The difference from baseline for SD was +2.6 (p < .05) and -4.2 points for IPSS (p < .05), with significance in subscales of urinary streaming/nocturia (p < .01), respectively; 6MWT increased from 507 ± 44 versus 527 ± 58 meters (p < .001). GAQ scale-responses showed overall improvement in overall 75% population, with a significant improvement in QoL (p < .01). These changes returned to baseline at 1-month withdrawal follow-up. No adverse events were reported. These supplemental facts improved sexual desire, satisfaction with sex life, physical performance, and LUTS in young-old men, suggesting that they may be effective in patients in whom standard treatments are not suitable.
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Affiliation(s)
- Anna Perri
- "Kidney and Transplantation" Research Center, Department of Nephrology, Dialysis and Transplantation, Annunziata Hospital, Cosenza, Italy
| | - Alessandro Ilacqua
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Marina Valenti
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Johnson Stoklossa CA, Sharma AM, Forhan M, Siervo M, Padwal RS, Prado CM. Prevalence of Sarcopenic Obesity in Adults with Class II/III Obesity Using Different Diagnostic Criteria. J Nutr Metab 2017; 2017:7307618. [PMID: 28421144 PMCID: PMC5380855 DOI: 10.1155/2017/7307618] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 02/12/2017] [Indexed: 12/20/2022] Open
Abstract
Background/Objective. Sarcopenic obesity (SO) is a hidden condition of reduced lean soft tissue (LST) in context of excess adiposity. SO is most commonly reported in older adults and both its risk and prevalence increase with age. A variety of body composition indices and cut points have been used to define this condition, leading to conflicting prevalence and risk prediction. Here, we investigate variability in the prevalence of SO in an adult sample of individuals with class II/III obesity (BMI ≥ 35 kg/m2) using different diagnostic criteria. Methods. SO definitions were identified from a literature review of studies using dual-energy X-ray absorptiometry (DXA) to assess LST. Demographics, anthropometrics, and body composition (by DXA) were measured in n = 120, 86% female (46.9 ± 11.1 years). Results. LST was extremely variable in individuals, even with similar body sizes, and observed across the age spectrum. The prevalence of SO ranged from 0 to 84.5% in females and 0 to 100% in males, depending upon the definition applied, with higher prevalence among definitions accounting for measures of body size or fat mass. Conclusion. SO is present, yet variable, in adults with class II/III obesity. Accounting for body mass or fat mass may identify a higher number of individuals with SO, although risk prediction remains to be studied.
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Affiliation(s)
| | - Arya M. Sharma
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Mary Forhan
- Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada
| | - Mario Siervo
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle on Tyne, UK
| | - Raj S. Padwal
- Department of Medicine, University of Alberta, Alberta Diabetes Institute, Edmonton, AB, Canada
| | - Carla M. Prado
- Department of Agriculture, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
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Sammarco R, Marra M, Di Guglielmo ML, Naccarato M, Contaldo F, Poggiogalle E, Donini LM, Pasanisi F. Evaluation of Hypocaloric Diet With Protein Supplementation in Middle-Aged Sarcopenic Obese Women: A Pilot Study. Obes Facts 2017; 10:160-167. [PMID: 28528340 PMCID: PMC5644943 DOI: 10.1159/000468153] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 02/28/2017] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the efficacy of a nutritional program, which is characterized by a different modulation of proteins, in adult patients with sarcopenic obesity. METHODS We studied 18 obese women aged 41-74 years. Obesity was diagnosed as fat mass > 34.8% and sarcopenia was defined when lean body mass was <90% of the subject's ideal fat free mass. All subjects were randomly assigned to different nutritional interventions: Hypocaloric diet plus placebo (A) and hypocaloric high-protein diet (1.2-1.4 g / kg body weight reference / day) (B). Anthropometric measurements, body composition, resting energy expenditure, handgrip test, Short Physical Performance Battery (SPPB), and SF-36 questionnaire were evaluated at baseline and after 4 months. RESULTS Weight significantly decreased in both groups. Women with high-protein diet preserved lean body mass compared to low-calorie diet and improved significantly muscle strength; SPPB score did not change in both groups. SF-36 test showed a significant change for general health after 4 months in group B. CONCLUSIONS In our study, sarcopenic obese patients with high-protein diet showed an improvement in muscle strength. Furthermore, dietary protein enrichment may represent a protection from the risk of sarcopenia following a hypocaloric diet.
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Affiliation(s)
- Rosa Sammarco
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Maurizio Marra
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
- *Dr. Maurizio Marra, BSc, PhD, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Pansini 5, 80131 Naples, Italy,
| | | | - Marianna Naccarato
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Franco Contaldo
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
- Interuniversity Centre for Obesity and Eating Disorders (CISRODCA), Federico II University of Naples, Naples, Italy
| | - Eleonora Poggiogalle
- Food Science and Human Nutrition Research Unit, Food Science and Endocrinology Section, Medical Pathophysiology, Experimental Medicine Department, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Maria Donini
- Food Science and Human Nutrition Research Unit, Food Science and Endocrinology Section, Medical Pathophysiology, Experimental Medicine Department, Sapienza University of Rome, Rome, Italy
| | - Fabrizio Pasanisi
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
- Interuniversity Centre for Obesity and Eating Disorders (CISRODCA), Federico II University of Naples, Naples, Italy
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Fatty Liver Index Associates with Relative Sarcopenia and GH/ IGF- 1 Status in Obese Subjects. PLoS One 2016; 11:e0145811. [PMID: 26741958 PMCID: PMC4711804 DOI: 10.1371/journal.pone.0145811] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 12/09/2015] [Indexed: 02/06/2023] Open
Abstract
Introduction Recently the association between hepatic steatosis and sarcopenia has been described. GH/IGF-1 axis has been postulated to play a role in linking fatty liver and low muscle mass. The aim of our study was to explore the association between fatty liver index, sarcopenic obesity, insulin sensitivity, and GH/IGF-1 status. Methods 427 subjects [age: 45.65±13.94 years, BMI: 36.92±6.43 kg/m2] were enrolled. Participants were divided into three groups: fatty liver index (FLI) <20, 20≥FLI<60, and FLI≥60. Body composition was assessed by DXA. The truncal fat mass (TrFM) to appendicular skeletal muscle (ASM) ratio was used as an indicator of sarcopenic obesity. ISI-Matsuda index was used. Results BMI, fat mass, and the TrFM/ASM ratio were higher in subjects with FLI≥60. GH, IGF-1 and ISI-Matsuda were lower in the high FLI group (all p<0.05). A significantly positive correlation between FLI and TrFM/ ASM ratio (r = 0.221, p<0.001) was found, whereas FLI levels were negatively correlated with ISI- Matsuda (r = -0.335, p<0.001), GH (r = -0.200, p = 0.006), and IGF- 1 levels (r = -0.157, p = 0.028). Stepwise linear regression analysis showed that GH levels were significantly negatively correlated with FLI, while the TrFM/ ASM ratio was positively associated with FLI, after adjustment for age, BMI, total fat mass, truncal fat mass, fat- free mass, and ISI- Matsuda. Conclusions Impairment of GH/IGF-1 axis seems to be associated to the risk of the development of sarcopenic obesity and ectopic fat deposition in the liver. Metabolic and hormonal derangements as determinants of ectopic fat deposition and body composition deserve to be evaluated in obese subjects.
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Poggiogalle E, Lubrano C, Sergi G, Coin A, Gnessi L, Mariani S, Lenzi A, Donini LM. Sarcopenic Obesity and Metabolic Syndrome in Adult Caucasian Subjects. J Nutr Health Aging 2016; 20:958-963. [PMID: 27791227 DOI: 10.1007/s12603-015-0638-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Recently metabolic aspects linked to sarcopenic obesity (SO) were investigated. Extant studies involved especially older people from Asian or White-mixed American cohorts. THE AIMS OF OUR STUDY WERE to explore the prevalence of sarcopenia in Caucasian adult obese subjects using two different indices of sarcopenia, and to investigate the relationship among SO, metabolic syndrome (MS), inflammation, and serum albumin concentrations. DESIGN Cross- sectional study. SUBJECTS/METHODS The study was performed from 2011 to 2014 in a hospitalized care setting. Inclusion criteria were: age>18 and <65 years, BMI≥30 Kg/m2. Fat mass (FM) and fat-free mass (FFM) were assessed by DXA. Appendicular skeletal muscle mass (ASMM) was calculated. Sarcopenia was defined as ASMM/height2 or ASMM/weight <2SD than the sex-specific mean of a young population. The cutoffs were ASMM/h2<6.54 Kg/m2 for men and 4.82 Kg/m2 for women, and ASMM/weight<0.2827 for men and 0.2347 for women. ISI-Matsuda was calculated. MS was diagnosed (NCEP-ATPIII). RESULTS 727 subjects (age: 45.72±13.56 years, BMI: 37.74±5.82 kg/m2) were enrolled. The prevalence of SO was 1.0% or 34.8% in men and 0.6% or 50.1% in women, using ASMM/height2 ratio or ASMM/weight. Subjects with SO based on ASMM/height2 were scarce, only data relying on ASMM/weight were considered. Subjects with SO had higher BMI, waist circumference, FM, and lower FFM and ASMM than nonsarcopenic obese individuals (all p<0.05). ISI-Matsuda was lower and hs-CRP levels were higher in subjects with SO (all p<0.05). MS was more prevalent in subjects with SO than nonsarcopenic obese subjects (47.6% vs 34.3%, p<0.001). ASMM/weight was decreased in subjects with MS (0.2522±0.0410 vs 0.2423±0.0352, p=0.001). CONCLUSION SO is associated with MS and low- grade inflammation in adult Caucasian subjects. Metabolic profile evaluation should be recommended in subjects with SO.
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Affiliation(s)
- E Poggiogalle
- Dr Eleonora Poggiogalle, MD, "Sapienza" University of Rome, Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Piazzale Aldo Moro, 5- 00185 Rome, Italy, phone: +39 064991 0996, fax: +39 06 4991 0699, email address:
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Abstract
Sarcopenic obesity (SO) refers to the copresence of sarcopenia and obesity. In this condition, a disproportion exists between the amount of lean mass relative to fat mass. Research on SO is important because the presence of both sarcopenia and obesity may have important health consequences. However, SO research has been hampered by the disparate number of definitions of SO. Various definitions of sarcopenia include ratios of appendicular mass to height(2) or body weight, measures of muscle strength, or physical function. More recent definitions incorporate all 3. Obesity is usually defined by high body mass index, but some studies have relied on percent body fat or visceral fat. Depending on the definition, the prevalence of SO ranges from 0% to 41% in older populations. The loss of lean mass and increase in fat mass with advancing age may share common etiologic pathways. Declines in physical activity can lead to poor muscle strength, lower muscle mass, and increased fat infiltration; all of which could lead to increases in fat mass. The increases in fat mass and accompanying increases in adipokines and inflammation may further adversely affect muscle quality. SO has been related to an increased risk of mobility disability, above and beyond sarcopenia, or obesity alone. Additional research is needed to further our understanding of the pathophysiology of SO and its consequences. Interventions aimed at reducing SO may improve physical function as well as reduce disability and death.
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Affiliation(s)
- Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
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Migliaccio S, Greco EA, Wannenes F, Donini LM, Lenzi A. Adipose, bone and muscle tissues as new endocrine organs: role of reciprocal regulation for osteoporosis and obesity development. Horm Mol Biol Clin Investig 2015; 17:39-51. [PMID: 25372729 DOI: 10.1515/hmbci-2013-0070] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 02/14/2014] [Indexed: 02/07/2023]
Abstract
The belief that obesity is protective against osteoporosis has recently been revised. In fact, the latest epidemiologic and clinical studies show that a high level of fat mass, but also reduced muscle mass, might be a risk factor for osteoporosis and fragility fractures. Furthermore, increasing evidence seems to indicate that different components such as myokines, adipokines and growth factors, released by both fat and muscle tissues, could play a key role in the regulation of skeletal health and in low bone mineral density and, thus, in osteoporosis development. This review considers old and recent data in the literature to further evaluate the relationship between fat, bone and muscle tissue.
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