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Nishida C, Iemitsu M, Kurihara T, Kishigami K, Miyachi M, Sanada K. Differences in sarcopenia indices in elderly Japanese women and their relationships with obesity classified according to waist circumference, BMI, and body fat percentage. J Physiol Anthropol 2024; 43:22. [PMID: 39354553 PMCID: PMC11446072 DOI: 10.1186/s40101-024-00370-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 09/02/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND Sarcopenic obesity (SO) is defined as a decrease in lean body mass and an increase in body fat mass (BFM) due to aging. Detecting SO in elderly women is important from the perspective of extending healthy life expectancy. While various indices of SO are currently used, there is no global consensus regarding diagnostic criteria for SO. This study aimed to examine the relationship between obesity indices (waist circumference (WC), body mass index (BMI), and body fat percentage (BFP)) and sarcopenia indices (total body muscle mass (TBM), appendicular lean mass (ALM), skeletal mass index (SMI)), and physical function (gait speed (GS), handgrip strength (HGS)). METHODS Subjects were 170 community-dwelling healthy elderly women aged 65-79 years (mean: 72.7 ± 5.78 years) who underwent measurements for WC, BMI, and BFP. A WC of ≥ 90cm was defined as the obese group, BMI was determined as weight (kg) divided by height squared (m2) and a cutoff of ≥ 25 kg/m2 was used to define the obesity group. BFM was measured using the bioelectrical impedance analysis (BIA) method and BFP was calculated from body weight and a cutoff of ≥ 30% was used to define the obesity group. TBM and ALM (kg) were measured using the BIA method, ALM (kg) was corrected for height (m2) to obtain SMI (kg/m2). Physical function was assessed by GS and HGS, which were measured by the 5-m walk test and a digital grip strength meter, respectively. RESULTS When obesity was assessed using BMI, WC and BFP, obese individuals had higher TBM, ALM and SMI, and lower GS among the sarcopenia indicators. HGS did not differ significantly between the non-obese and obese groups. CONCLUSION Our findings suggest HGS is thought to reflect muscle strength without being affected by obesity indices, suggesting that it may be useful in detecting possible sarcopenia in obese individuals.
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Affiliation(s)
- Chihiro Nishida
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji Higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Motoyuki Iemitsu
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji Higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Toshiyuki Kurihara
- Faculty of Science, Yamaguchi University, 3003 Yoshida, Yamaguchi, 753-8512, Japan
| | - Keiko Kishigami
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji Higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Motohiko Miyachi
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Kiyoshi Sanada
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji Higashi, Kusatsu, Shiga, 525-8577, Japan.
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Ishii K, Ogawa W, Kimura Y, Kusakabe T, Miyazaki R, Sanada K, Satoh-Asahara N, Someya Y, Tamura Y, Ueki K, Wakabayashi H, Watanabe Y, Yamada M, Arai H. Diagnosis of sarcopenic obesity in Japan: Consensus statement of the Japanese Working Group on Sarcopenic Obesity. Geriatr Gerontol Int 2024; 24:997-1000. [PMID: 39253949 DOI: 10.1111/ggi.14978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 08/11/2024] [Accepted: 08/21/2024] [Indexed: 09/11/2024]
Abstract
Sarcopenic obesity is the co-existence of obesity and sarcopenia in individuals aged 40-75 years. The Japanese Working Group on Sarcopenic Obesity has developed diagnostic criteria tailored for the Japanese population, considering their unique characteristics compared with European populations. Our algorithm consists of two steps: screening and diagnosis. The screening of obesity mandates using waist circumference and/or body mass index (BMI) based on national standards, while screening for sarcopenia involves the "finger ring test" in addition to the Asian Working Group for Sarcopenia 2019 criteria. The final diagnosis of sarcopenia involves handgrip strength for low muscle strength, the five-times chair stand test for low physical function, and limb skeletal muscle mass (corrected for BMI) for low muscle mass. Obesity is assessed by visceral fat area or body fat percentage. Sarcopenic obesity is then categorized into Stage I, with muscle weakness/loss of function, loss of muscle mass, and obesity; or Stage II, which includes complications. Further clinical validation is needed to refine the consensus and age range. Geriatr Gerontol Int 2024; 24: 997-1000.
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Affiliation(s)
- Kojiro Ishii
- Faculty of Health and Sports Science, Doshisha University, Kyotanabe, Japan
| | - Wataru Ogawa
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yutaka Kimura
- Health Science Center, Kansai Medical University, Hirakata, Japan
| | - Toru Kusakabe
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Ryo Miyazaki
- Faculty of Human Sciences, Shimane University, Matsue, Japan
| | - Kiyoshi Sanada
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Noriko Satoh-Asahara
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Yuki Someya
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Faculty of Health and Sports Science, Juntendo University, Chiba, Japan
| | - Yoshifumi Tamura
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kohjiro Ueki
- Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Yuya Watanabe
- Faculty of Sport Study, Biwako Seikei Sport College, Otsu, Japan
| | - Minoru Yamada
- Faculty of Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
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Vangelov B, Smee RI, Bauer J. Sarcopenic obesity in patients with head and neck cancer is predictive of critical weight loss during radiotherapy. Br J Nutr 2024:1-8. [PMID: 39344001 DOI: 10.1017/s0007114524001880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
The impact of computed tomography-defined sarcopenia on outcomes in head and neck cancer has been well described. Sarcopenic obesity (SO) (depleted muscle mass combined with obesity) may pose a more serious risk than either condition alone. We investigated SO and its impact on survival and critical weight loss (≥ 5 %) in patients with head and neck cancer who received curative radiotherapy (± other modalities). Retrospective analysis of computed tomography cross-sectional muscle at cervical (C3), thoracic (T2) and lumbar (L3) regions was conducted. Patients were grouped by BMI and sarcopenia status based on established thresholds. A total of 413 patients were included for analysis, the majority having oropharyngeal carcinoma (52 %), and 56 % received primary concurrent chemoradiotherapy. The majority of the cohort (65 %) was overweight or obese (BMI ≥ 25 kg/m2). Sarcopenia was found in 43 %, with 65 % having SO (n 116), equating to 28 % of the whole cohort. Critical weight loss was experienced by 58 % (n 238). A significantly higher proportion of patients with SO experienced critical weight loss (n 70 v. 19, P < 0·001) and were four times more likely to do so during treatment (OR 4·1; 95 % CI 1·5, 7·1; P = 0·002). SO was not found to impact on overall or cancer-specific survival; however, in patients with sarcopenia, those with SO had better overall survival (median 9·1 v. 7·0 years; 95 % CI 5·2, 16·8; P = 0·021). SO at the time of presentation in patients with head and neck cancer is predictive of critical weight loss during treatment, and muscle evaluation can be useful in identifying patients at nutritional risk regardless of BMI and obvious signs of wasting.
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Affiliation(s)
- Belinda Vangelov
- Department of Radiation Oncology, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital and Community Health Services, Randwick, NSW 2031, Australia
| | - Robert I Smee
- Department of Radiation Oncology, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital and Community Health Services, Randwick, NSW 2031, Australia
- School of Clinical Medicine (Randwick Campus), Faculty of Medicine and Health, University of New South Wales, Randwick, NSW 2031, Australia
- Department of Radiation Oncology, Tamworth Base Hospital, Tamworth, NSW 2340, Australia
| | - Judith Bauer
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
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Li H, Su W, Zheng Z, Li J, Wang S, Chen Z, Zhang Y, Huang B, Lyu F, Yan F, Huang C, Lin M, Shi X, Li X. The coexistence of low muscle mass and obesity evaluated by dual energy X-ray absorptiometry, rather than low muscle mass or obesity alone, is associated with macrovascular but not microvascular complications in patients with type 2 diabetes mellitus. Diabetes Obes Metab 2024. [PMID: 39344849 DOI: 10.1111/dom.15978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 08/30/2024] [Accepted: 09/09/2024] [Indexed: 10/01/2024]
Abstract
AIM The prevalence of the coexistence of low muscle mass and obesity is increasing, particularly with a rising trend observed in patients diagnosed with type 2 diabetes mellitus (T2DM). However, the association between the coexistence of low muscle mass and obesity and diabetic complications remains unclear. This study aimed to investigate these associations in patients with T2D. MATERIALS AND METHODS A retrospective study was conducted, including 2387 hospitalized patients with T2DM. Data on demographic characteristics, biochemical parameters, diabetic complications and body composition was from electronic health records. The participants were categorized as control, low muscle mass, obesity and the coexistence of the low muscle mass and obesity groups according to the body compositions evaluated by dual-energy X-ray absorptiometry. Multiple logistic regression models were applied to assess the associations between the pattern of body composition and complications of diabetes. RESULTS After adjustment for potential confounders, compared with patients in the control group, the odds ratios [95% confidence intervals (CIs)] of macrovascular complications of diabetes were 0.62 (95% CI, 0.27-1.39) for those in the low muscle mass group, 1.12 (95% CI, 0.59-2.11) in the obesity group, and 2.43 (95% CI, 1.16-5.07) in the coexistence of the low muscle mass and obesity group, respectively; the odds ratios (95% CIs) of microvascular complications of diabetes were 0.86 (95% CI, 0.52-1.43) for those in the low muscle mass group, 0.82 (95% CI, 0.53-1.26) in the obesity group, and 1.21 (95% CI, 0.69-2.15) in the coexistence of the low muscle mass and obesity group, respectively. CONCLUSION According to our findings, the coexistence of low muscle mass and obesity, rather than low muscle mass or obesity alone, was significantly associated with a higher prevalence of macrovascular complications in hospitalized patients with T2DM. This association was not observed for diabetic microvascular complications.
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Affiliation(s)
- Han Li
- Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, and Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China
| | - Weijuan Su
- Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, and Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China
| | - Zeyu Zheng
- Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, and Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China
| | - Jia Li
- Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, and Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China
| | - Shunhua Wang
- Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, and Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China
| | - Zheng Chen
- Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, and Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China
| | - Yuxian Zhang
- Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, and Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China
| | - Bingkun Huang
- Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, and Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China
| | - Fuping Lyu
- Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, and Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China
| | - Fangfang Yan
- Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, and Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China
| | - Caoxin Huang
- Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, and Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China
| | - Mingzhu Lin
- Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, and Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China
| | - Xiulin Shi
- Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, and Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China
| | - Xuejun Li
- Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, and Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China
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Prado CM, Phillips SM, Gonzalez MC, Heymsfield SB. Muscle matters: the effects of medically induced weight loss on skeletal muscle. Lancet Diabetes Endocrinol 2024:S2213-8587(24)00272-9. [PMID: 39265590 DOI: 10.1016/s2213-8587(24)00272-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Revised: 08/17/2024] [Accepted: 08/20/2024] [Indexed: 09/14/2024]
Affiliation(s)
- Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - M Cristina Gonzalez
- Post-graduate program in Nutrition and Food, Federal University of Pelotas, Pelotas, Brazil; Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA.
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Wu H, Chen X, Shi Z, Liu J, Meng Z, Zheng C, Zhou C. The L-shaped relationship between composite dietary antioxidant index and sarcopenic obesity in elderly adults: a cross-sectional study. Front Nutr 2024; 11:1428856. [PMID: 39285866 PMCID: PMC11403637 DOI: 10.3389/fnut.2024.1428856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/12/2024] [Indexed: 09/19/2024] Open
Abstract
Background This study aimed to examine the associations of the Composite Dietary Antioxidant Index (CDAI) with sarcopenic obesity (SO) using the National Health and Nutrition Examination Survey (NHANES) database. Methods Data were gathered from NHANES between 2001 and 2004. To examine the relationship between CDAI and the occurrence of SO, multiple logistic regression analyses were performed. Subgroup analyses were performed to demonstrate the stability of the results. Restricted cubic splines were utilized to examine the non-linear correlations. Results A total of 2,333 elderly individuals were included in the study. In the multivariate logistic regression crude model, we revealed an odds ratio (OR) of 0.928 [95% confidence interval (CI), 0.891-0.965, p < 0.001] for the correlation between CDAI and SO. The ORs were 0.626 (95% CI, 0.463-0.842) and 0.487 (95% CI, 0.354-0.667) for CDAI tertiles 2 and 3, respectively (p for trend <0.001), after full adjustment. The subgroup analysis findings demonstrated a reliable and enduring connection between CDAI and SO across various subgroups. However, the strength of the correlation between CDAI and SO was significantly affected by diabetes (p for interaction = 0.027). Moreover, restricted cubic spline analysis revealed an L-shaped relationship. Conclusion The present study identified an L-shaped correlation between CDAI and SO in elderly participants' demographics. The implications of these findings were significant for future studies and the formulation of dietary guidelines.
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Affiliation(s)
- He Wu
- Department of Emergency, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiyi Chen
- Department of Cardiovascular and Thoracic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhengqing Shi
- Department of Anorectal Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jieyu Liu
- Department of Anorectal Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ziqi Meng
- Department of Anorectal Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chenguo Zheng
- Department of Anorectal Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- Zhejiang Inheritance and Innovation Team of Traditional Chinese Medicine Devoting to the Diagnosis and Treatment of Anorectal Diseases, Wenzhou, China
| | - Chongjun Zhou
- Department of Anorectal Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- Zhejiang Inheritance and Innovation Team of Traditional Chinese Medicine Devoting to the Diagnosis and Treatment of Anorectal Diseases, Wenzhou, China
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Ma X, Tian M, Liu J, Tong L, Ding W. Impact of high fat and low lean mass phenotype on bone mineral content: A cross-sectional study of Chinese adolescent population. Bone 2024; 186:117170. [PMID: 38880171 DOI: 10.1016/j.bone.2024.117170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/30/2024] [Accepted: 06/13/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND AND OBJECTIVE Research on body composition phenotypes and bone health in adolescents is limited. Hence, this study aimed to analyze the relationship between different body composition phenotypes, bone mineral content, and bone metabolism markers in Chinese adolescents. METHODS In this cross-sectional study, 1852 adolescents aged 12 to 18 years were selected from six schools in Yinchuan City between 2017 and 2020 using stratified cluster random sampling. The participant's body composition and bone mineral content (BMC) were measured using bioelectrical impedance analysis (BIA). Serum bone metabolic markers (OC, CTX, and Ca) were measured. Based on their FMI and LMI, individuals were categorized into four body composition phenotypes: low fat mass-low lean mass (LFMI-LLMI), low fat mass-high lean mass (LFMI-HLMI), high fat mass-high lean mass (HFMI-HLMI), high fat mass-low lean mass (HFMI-LLMI). RESULTS There was a statistically significant difference between the four different body composition phenotypes with BMC, CTX and Ca in boys (all P < 0.05), similar conclusions were found in girls, except the OC and CTX. After adjusting for age, gender, smoking, drinking, and others, compared with the LFMI-HLMI reference group, the two high FMI groups (HFMI-LLMI and HFMI-HLMI) had a greater negative correlation with BMC, while the low BMC risk of the HFMI-LLMI group was the highest (OR = 33.28; 95%CI: 11.12-99.63; P < 0.001). The correlation between BMC of different body composition phenotypes in boys was greater than that in girls. HFMI-HLMI is a risk phenotype negatively associated with Ca content (β = -0.12; 95%CI: -0.19 to -0.04; P < 0.05). Regardless of body composition level, BMC was always negatively correlated with fat mass (LLMI: β = -0.27; 95%CI: -0.32-0.21; HLMI: β = -0.52, 95%CI: -0.65-0.40) and positively correlated with lean mass (LFMI: β =0.24; 95%CI: 0.20-0.28; HFMI: β =0.23, 95%CI:0.13-0.33) (all P < 0.001). The fat mass showed different correlations with OC and CTX in girls and boys based on LLMI or HLMI (all P < 0.05). CONCLUSION HFMI-LLMI is a risk phenotype of low BMC in Chinese adolescents, and the relationship between fat mass and bone metabolism markers is affected by lean body mass and gender.
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Affiliation(s)
- Xiaoyan Ma
- School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan 750004, China
| | - Mei Tian
- School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan 750004, China
| | - Jianxi Liu
- School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan 750004, China
| | - Lingling Tong
- School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan 750004, China
| | - Wenqing Ding
- School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan 750004, China.
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Mirzai S, Carbone S, Batsis JA, Kritchevsky SB, Kitzman DW, Shapiro MD. Sarcopenic Obesity and Cardiovascular Disease: An Overlooked but High-Risk Syndrome. Curr Obes Rep 2024; 13:532-544. [PMID: 38753289 PMCID: PMC11306598 DOI: 10.1007/s13679-024-00571-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2024] [Indexed: 08/09/2024]
Abstract
PURPOSE OF REVIEW Sarcopenic obesity (SO), defined as the coexistence of excess fat mass and reduced skeletal muscle mass and strength, has emerged as an important cardiovascular risk factor, particularly in older adults. This review summarizes recent findings on the diagnosis, prevalence, health impacts, and treatment of SO. RECENT FINDINGS Growing evidence suggests SO exacerbates cardiometabolic risk and adverse health outcomes beyond either condition alone; however, the heterogeneity in diagnostic criteria and the observational nature of most studies prohibit the evaluation of a causal relationship. This is concerning given that SO is increasing with the aging population, although that is also difficult to assess accurately given wide-ranging prevalence estimates. A recent consensus definition proposed by the European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity provides a framework of standardized criteria to diagnose SO. Adopting uniform diagnostic criteria for SO will enable more accurate characterization of prevalence and cardiometabolic risk moving forward. Although current management revolves around diet for weight loss coupled with resistance training to mitigate further muscle loss, emerging pharmacologic therapies have shown promising results. As the global population ages, diagnosing and managing SO will become imperative to alleviate the cardiovascular burden.
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Affiliation(s)
- Saeid Mirzai
- Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Salvatore Carbone
- Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - John A Batsis
- Division of Geriatric Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stephen B Kritchevsky
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Dalane W Kitzman
- Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Michael D Shapiro
- Center for Prevention of Cardiovascular Disease, Medical Center Blvd, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA.
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Gortan Cappellari G, Zanetti M, Donini LM, Barazzoni R. Detecting sarcopenia in obesity: emerging new approaches. Curr Opin Clin Nutr Metab Care 2024; 27:402-409. [PMID: 39022899 PMCID: PMC11309345 DOI: 10.1097/mco.0000000000001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
PURPOSE OF REVIEW Sarcopenic obesity is a likely common, but certainly underestimated obesity phenotype, with an important negative clinical impact. Its definition and diagnosis have however remained elusive until recently. RECENT FINDINGS Substantial progress has been recently made in sarcopenic obesity diagnostic tools, with the first international consensus proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO). Very encouraging results emerge from initial implementation of the ESPEN-EASO algorithm. In addition, even more recent progress in global consensus on sarcopenia conceptual definition is likely to further enhance consistency in sarcopenic obesity identification. The latter Global Leadership Initiative on Sarcopenia (GLIS) initiative also adopted a new definition of muscle specific strength. Its inclusion in sarcopenia diagnostic constructs opens the possibility of its potential evaluation in sarcopenic obesity, also considering the emerging positive impact of obesity treatment and fat loss on muscle functional parameters. SUMMARY New consensus tools for sarcopenic obesity diagnosis are likely to improve awareness, understanding, identification and treatment of this under-recognized obesity phenotype.
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Affiliation(s)
- Gianluca Gortan Cappellari
- Department of Medical, Surgical and Health Sciences – University of Trieste
- Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste
| | - Michela Zanetti
- Department of Medical, Surgical and Health Sciences – University of Trieste
- Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste
| | | | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences – University of Trieste
- Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste
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Carvalho ES, Silva LGA, Zullo SA, Damião R. Prevalence of sarcopenic obesity in women and its association with level of independent physical activity combined with sedentary behavior. Menopause 2024:00042192-990000000-00374. [PMID: 39190339 DOI: 10.1097/gme.0000000000002426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
OBJECTIVE This study aimed to determine the prevalence of sarcopenic obesity and its association with the level of physical activity, alone and combined with sedentary behavior. METHODS A cross-sectional study was performed. The sample was composed of 317 women aged between 24 and 59 years. Sarcopenic obesity was determined by the coexistence of sarcopenia (reduced muscle mass and strength) and obesity (% fat). Dual-energy x-ray absorption was used to evaluate muscle mass and % fat, with cutoff points of <15 kg and <31.71%, respectively. Strength was assessed by the handgrip test, with a cutoff point of <21.68 kg. Levels of physical activity and sedentary behavior were assessed using the long version of the International Physical Activity Questionnaire. Individuals who did not achieve 150 minutes per week of physical activity were considered insufficiently active. The cutoff point for sedentary behavior was determined based on the 75th percentile (480 min/wk), considering excessive sedentary behavior (≥75th percentile) and low/moderate sedentary behavior (<75th percentile). RESULTS The prevalence of sarcopenic obesity was 7.9% (95% CI, 4.9-10.8). Sarcopenic obesity was associated with the general physical activity level (odds ratio, 3.96; 95% CI, 1.32-11.8) and being insufficiently active together with low/moderate sedentary behavior (odds ratio, 4.88; 95% CI, 1.49-16.0). CONCLUSIONS There was the presence of sarcopenic obesity in adult women which was associated with the level of general physical activity, alone and combined with sedentary behavior.
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Batitucci G, Abud GF, Ortiz GU, Belisário LF, Travieso SG, de Lima Viliod MC, Venturini ACR, de Freitas EC. Sarcobesity: New paradigms for healthy aging related to taurine supplementation, gut microbiota and exercise. Ageing Res Rev 2024; 101:102460. [PMID: 39173917 DOI: 10.1016/j.arr.2024.102460] [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: 04/06/2024] [Revised: 07/16/2024] [Accepted: 08/15/2024] [Indexed: 08/24/2024]
Abstract
Enigmatic sarcopenic obesity is still a challenge for science and adds to the global public health burden. The progressive accumulation of body fat combined with a dysfunctional skeletal muscle structure and composition, oxidative stress, mitochondrial dysfunction, and anabolic resistance, among other aggravating factors, together represent the seriousness and complexity of treating the metabolic disorder of sarcobesity in aging. For this reason, further studies are needed that encourage the support of therapeutic management. It is along these lines that we direct the reader to therapeutic approaches that demonstrate important, but still obscure, outcomes in the physiological conditions of sarcobesity, such as the role of taurine in modulating inflammatory and antioxidant mechanisms in muscle and adipose tissue, as well as the management of gut microbiota, able to systemically re-establish the structure and function of the gut-muscle axis, in addition to the merits of physical exercise as an instrument to improve muscular health and lifestyle quality.
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Affiliation(s)
- Gabriela Batitucci
- School of Medical Sciences, Obesity and Comorbidities Research Center, University of Campinas - UNICAMP, Campinas, Sao Paulo, Brazil
| | - Gabriela Ferreira Abud
- Department of Health Sciences, Ribeirao Preto Medical School, University of São Paulo - FMRP/USP, Ribeirao Preto, Sao Paulo, Brazil
| | - Gabriela Ueta Ortiz
- Department of Health Sciences, Ribeirao Preto Medical School, University of São Paulo - FMRP/USP, Ribeirao Preto, Sao Paulo, Brazil
| | - Lucas Fernandes Belisário
- Laboratory of Exercise Physiology and Metabolism, School of Physical Education and Sports of Ribeirao Preto, University of Sao Paulo - EEFERP/USP, Ribeirao Preto, Brazil
| | - Sofia Germano Travieso
- Department of Health Sciences, Ribeirao Preto Medical School, University of São Paulo - FMRP/USP, Ribeirao Preto, Sao Paulo, Brazil
| | - Marcela Coffacci de Lima Viliod
- Laboratory of Exercise Physiology and Metabolism, School of Physical Education and Sports of Ribeirao Preto, University of Sao Paulo - EEFERP/USP, Ribeirao Preto, Brazil
| | - Ana Cláudia Rossini Venturini
- Laboratory of Exercise Physiology and Metabolism, School of Physical Education and Sports of Ribeirao Preto, University of Sao Paulo - EEFERP/USP, Ribeirao Preto, Brazil
| | - Ellen Cristini de Freitas
- Department of Health Sciences, Ribeirao Preto Medical School, University of São Paulo - FMRP/USP, Ribeirao Preto, Sao Paulo, Brazil; Laboratory of Exercise Physiology and Metabolism, School of Physical Education and Sports of Ribeirao Preto, University of Sao Paulo - EEFERP/USP, Ribeirao Preto, Brazil.
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12
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Chen J, Jia S, Guo C, Fan Z, Yan W, Dong K. Research Progress on the Effect and Mechanism of Exercise Intervention on Sarcopenia Obesity. Clin Interv Aging 2024; 19:1407-1422. [PMID: 39139211 PMCID: PMC11319865 DOI: 10.2147/cia.s473083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 08/02/2024] [Indexed: 08/15/2024] Open
Abstract
With the increasingly severe situation of obesity and population aging, there is growing concern about sarcopenia obesity (SO). SO refers to the coexistence of obesity and sarcopenia, which imposes a heavier burden on individuals and society compared to obesity or sarcopenia alone. Therefore, comprehending the pathogenesis of SO and implementing effective clinical interventions are vital for its prevention and treatment. This review uses a comprehensive literature search and analysis of PubMed, Web of Science, and CNKI databases, with search terms including "Sarcopenic obesity", "exercise", "cytokines", "inflammation", "mitochondrial quality control", and "microRNA", covering relevant studies published up to July 2024. The results indicate that the pathogenesis of SO is complex, involving mechanisms like age-related changes in body composition, hormonal alterations, inflammation, mitochondrial dysfunction, and genetic and epigenetic factors. Regarding exercise interventions for SO, aerobic exercise can reduce fat mass, resistance exercise can increase skeletal muscle mass and strength, and combined exercise can achieve both, making it the optimal intervention for SO. The potential mechanisms by which exercise may prevent and treat SO include regulating cytokine secretion, inhibiting inflammatory pathways, improving mitochondrial quality, and mediating microRNA expression. This review emphasizes the effectiveness of exercise interventions in mitigating sarcopenic obesity through comprehensive analysis of its multifactorial pathogenesis and the mechanistic insights into exercise's therapeutic effects. Understanding these mechanisms informs targeted therapeutic strategies aimed at alleviating the societal and individual burdens associated with SO.
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Affiliation(s)
- Jun Chen
- School of Graduate, Wuhan Sport University, Wuhan, 430079, People’s Republic of China
| | - Shaohui Jia
- School of Sports Medicine, Wuhan Sport University, Wuhan, 430079, People’s Republic of China
| | - Chenggen Guo
- School of Sports Training, Wuhan Sport University, Wuhan, 430079, People’s Republic of China
| | - Zhiwei Fan
- School of Graduate, Wuhan Sport University, Wuhan, 430079, People’s Republic of China
| | - Weiyi Yan
- School of Graduate, Wuhan Sport University, Wuhan, 430079, People’s Republic of China
| | - Kunwei Dong
- School of Arts, Wuhan Sport University, Wuhan, 430079, People’s Republic of China
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13
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Collazo-Castiñeira P, Sánchez-Izquierdo M, Reiter LJ, Bauer S, Cruz-Jentoft AJ, Schoufour JD, Weijs PJM, Eglseer D. Analysis of behavioral change techniques used in exercise and nutritional interventions targeting adults around retirement age with sarcopenic obesity in a systematic review. Arch Gerontol Geriatr 2024; 123:105437. [PMID: 38653002 DOI: 10.1016/j.archger.2024.105437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/27/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Sarcopenic obesity significantly burdens health and autonomy. Strategies to intervene in or prevent sarcopenic obesity generally focus on losing body fat and building or maintaining muscle mass and function. For a lifestyle intervention, it is important to consider psychological aspects such as behavioral change techniques (BCTs) to elicit a long-lasting behavioral change. PURPOSE The study was carried out to analyze BCTs used in exercise and nutritional interventions targeting community-dwelling adults around retirement age with sarcopenic obesity. METHODS We conducted an analysis of articles cited in an existing systematic review on the effectiveness of exercise and nutritional interventions on physiological outcomes in community-dwelling adults around retirement age with sarcopenic obesity. We identified BCTs used in these studies by applying a standardized taxonomy. RESULTS Only nine BCTs were identified. Most BCTs were not used intentionally (82 %), and those used derived from the implementation of lifestyle components, such as exercise classes ("instructions on how to perform a behavior," "demonstration of the behavior," "behavioral practice/rehearsal," and "body changes"). Only two studies used BCTs intentionally to reinforce adherence in their interventions. CONCLUSIONS Few studies integrated BCTs in lifestyle interventions for community-dwelling persons around retirement age with sarcopenic obesity. Future studies on interventions to counteract sarcopenic obesity should include well-established BCTs to foster adherence and, therefore, their effectiveness.
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Affiliation(s)
- Paula Collazo-Castiñeira
- Geriatric Unit, Hospital Universitario Ramón y Cajal (IRYCIS), Ctra. de Colmenar Viejo, km. 9,100, 28034 Madrid, Spain; Psychology Department, Universidad Pontificia Comillas, C. Universidad Comillas, 3-5 28049 Madrid, Spain
| | - Macarena Sánchez-Izquierdo
- Psychology Department, Universidad Pontificia Comillas, C. Universidad Comillas, 3-5 28049 Madrid, Spain
| | - Lea Joanne Reiter
- Medical University of Graz, Institute of Nursing Science, Neue Stiftingtalstraße 6 West, P/06, 8010, Graz, Austria
| | - Silvia Bauer
- Medical University of Graz, Institute of Nursing Science, Neue Stiftingtalstraße 6 West, P/06, 8010, Graz, Austria
| | - Alfonso J Cruz-Jentoft
- Geriatric Unit, Hospital Universitario Ramón y Cajal (IRYCIS), Ctra. de Colmenar Viejo, km. 9,100, 28034 Madrid, Spain
| | - Josje D Schoufour
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Dr. Meurerhuis, Dokter Meurerlaan 8, 1067 SM, Amsterdam, the Netherlands
| | - Peter J M Weijs
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Dr. Meurerhuis, Dokter Meurerlaan 8, 1067 SM, Amsterdam, the Netherlands; Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - Doris Eglseer
- Medical University of Graz, Institute of Nursing Science, Neue Stiftingtalstraße 6 West, P/06, 8010, Graz, Austria.
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14
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Volkert D, Delzenne N, Demirkan K, Schneider S, Abbasoglu O, Bahat G, Barazzoni R, Bauer J, Cuerda C, de van der Schueren M, Doganay M, Halil M, Lehtisalo J, Piccoli GB, Rolland Y, Sengul Aycicek G, Visser M, Wickramasinghe K, Wirth R, Wunderle C, Zanetti M, Cederholm T. Nutrition for the older adult - Current concepts. Report from an ESPEN symposium. Clin Nutr 2024; 43:1815-1824. [PMID: 38970937 DOI: 10.1016/j.clnu.2024.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 06/18/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND & AIMS In view of the global demographic shift, a scientific symposium was organised by the European Society for Clinical Nutrition and Metabolism (ESPEN) to address nutrition-related challenges of the older population and provide an overview of the current state of knowledge. METHODS Eighteen nutrition-related issues of the ageing global society were presented by international experts during the symposium and summarised in this report. RESULTS Anorexia of ageing, dysphagia, malnutrition, frailty, sarcopenia, sarcopenic obesity, and the metabolic syndrome were highlighted as major nutrition-related geriatric syndromes. Great progress has been made in recent years through standardised definitions of some but not all syndromes. Regarding malnutrition, the GLIM approach has shown to be suitable also in older adults, justifying its continuous implementation. For anorexia of ageing, a consensus definition is still required. Intervention approaches should be integrated and person-centered with the aim of optimizing intrinsic capacity and maintaining functional capacity. Landmark studies like EFFORT and FINGER have impressively documented the potential of individualised and multifactorial interventions for functional and health benefits. Combining nutritional intervention with physical training seems particularly important whereas restrictive diets and drug treatment should generally be used with caution because of undesirable risks. Obesity management in older adults should take into account the risk of promoting sarcopenia. CONCLUSIONS In the future, even more individualised approaches like precision nutrition may enable better nutritional care. Meanwhile all stakeholders should focus on a better implementation of currently available strategies and work closely together to improve nutritional care for older adults.
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Affiliation(s)
- D Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany.
| | - N Delzenne
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Brussels, Belgium.
| | - K Demirkan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, Ankara, Turkiye.
| | - S Schneider
- Gastroenterology and Nutrition, CHU de Nice, Université Côte d'Azur, Nice, France.
| | - O Abbasoglu
- Department of Clinical Nutrition, Hacettepe University, Ankara, Turkiye.
| | - G Bahat
- Department of Internal Medicine, Division of Geriatrics, Medical Faculty, Istanbul University, Istanbul, Turkiye.
| | - R Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Italy.
| | - J Bauer
- Center for Geriatric Medicine, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Germany.
| | - C Cuerda
- Department of Medicine, Universidad Complutense, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - M de van der Schueren
- Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, The Netherlands; Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands.
| | - M Doganay
- Department of Surgery and Surgical Oncology, University of Health Sciences, Gulhane Medical Faculty, Ankara, Turkiye.
| | - M Halil
- Department of Internal Medicine, Division of Geriatrics, Medical Faculty, Hacettepe University, Ankara, Turkiye.
| | - J Lehtisalo
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
| | - G B Piccoli
- Nephrologie, Centre Hospitalier Le Mans, Le Mans, France.
| | - Y Rolland
- IHU HealthAge, Centre Hospitalo-Universitaire de Toulouse, France; Centre for Epidemiology and Research in POPulation Health, CERPOP UMR 1295, Toulouse, France.
| | | | - M Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam and the Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - K Wickramasinghe
- Special Initiative on Noncommunicable Diseases and Innovation, WHO Regional Office for Europe, Copenhagen, Denmark.
| | - R Wirth
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Herne, Germany.
| | - C Wunderle
- Medical University Department, Division of General Internal and Emergency Medicine, Cantonal Hospital Aarau, Aarau, Switzerland.
| | - M Zanetti
- Geriatric Clinic, Department of Medical Sciences, University of Trieste, Italy.
| | - T Cederholm
- Department of Clinical Nutrition & Metabolism, Uppsala University and Theme Inflammation & Aging, Karolinska University Hospital, Stockholm, Sweden.
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15
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Bufano A, Cartocci A, Benenati N, Ciuoli C, Simon Batzibal M, Bombardieri A, Iraci Sareri G, Sannino I, Tirone A, Voglino C, Vuolo G, Castagna MG. New specific skeletal muscle mass index cut-offs for the assessment of sarcopenia in patients with severe obesity. Front Endocrinol (Lausanne) 2024; 15:1369584. [PMID: 39036048 PMCID: PMC11258000 DOI: 10.3389/fendo.2024.1369584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/11/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Bioelectrical impedance analysis (BIA) is the most used tool in clinical practice to evaluate body composition in patients with obesity. The skeletal muscle index (SMI) defined by BIA has been proposed for the identification of sarcopenia, but there are currently no univocal cutoffs for this condition. In this study, we aimed: 1) to determine the prevalence of sarcopenia in patients with severe obesity using the current cutoffs of SMI; 2) to define new specific cutoffs; 3) to validate the new cutoffs; and 4) to re-determine the prevalence of sarcopenia. Methods A total of 300 patients, 74% women and 26% men (mean age = 42.6 ±; 9 years), with morbid obesity (mean BMI = 46.7 ±; 6.5 kg/m2) followed by the Unit of Endocrinology from January 2014 to December 2020 were retrospectively evaluated. SMI was calculated as the skeletal muscle mass normalized for squared height through the BIA equation by Janssen et al. Results The prevalence of sarcopenic obesity calculated using the cutoff points reported by De Rosa et al. (7.3 kg/h2 for women and 9.5 kg/h2 for men) was 2.3%. The prevalence of sarcopenia was calculated using the new cutoffs: with the cutoff obtained from the standard deviation method (8.2 kg/h2 for women and 10.2 kg/h2 for men), a prevalence of 14.7% was observed, whereas the prevalence reached 47.6% when using the cutoff calculated through the K-means unsupervised cluster (9.2 kg/h2 for women and 11.3 kg/h2 for men). The new cutoffs were validated with a second sample consisting of 300 patients with morbid obesity (BMI = 44.9 ±; 6.7 kg/m2): the rate of sarcopenic patients was still higher than that observed in the training cohort (56%). After the matching procedure (by BMI and age), the rates of sarcopenic patients were similar in both groups (50.2% in the validation group and 53% in the training group, p = 0.6). Conclusion The new cutoffs calculated with cluster analysis could better identify sarcopenia in morbidly obese patients. However, further studies are needed to validate these cutoffs in different patient cohorts.
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Affiliation(s)
- Annalisa Bufano
- Department of Medicine, Surgery and Neuroscience, Unità Operativa Complessa (UOC) Endocrinology, University of Siena, Siena, Italy
| | | | - Nicoletta Benenati
- Department of Medicine, Surgery and Neuroscience, Unità Operativa Complessa (UOC) Endocrinology, University of Siena, Siena, Italy
| | - Cristina Ciuoli
- Department of Medicine, Surgery and Neuroscience, Unità Operativa Complessa (UOC) Endocrinology, University of Siena, Siena, Italy
| | - Maria Simon Batzibal
- Department of Medicine, Surgery and Neuroscience, Unità Operativa Complessa (UOC) Endocrinology, University of Siena, Siena, Italy
| | - Alessio Bombardieri
- Department of Medicine, Surgery and Neuroscience, Unità Operativa Complessa (UOC) Endocrinology, University of Siena, Siena, Italy
| | - Gabriele Iraci Sareri
- Department of Medicine, Surgery and Neuroscience, Unità Operativa Complessa (UOC) Endocrinology, University of Siena, Siena, Italy
| | - Ida Sannino
- Department of Medicine, Surgery and Neuroscience, Unità Operativa Complessa (UOC) Endocrinology, University of Siena, Siena, Italy
| | - Andrea Tirone
- Department of Surgical Sciences, Bariatric Surgery Unit, University of Siena, Siena, Italy
| | - Costantino Voglino
- Department of Surgical Sciences, Bariatric Surgery Unit, University of Siena, Siena, Italy
| | - Giuseppe Vuolo
- Department of Surgical Sciences, Bariatric Surgery Unit, University of Siena, Siena, Italy
| | - Maria Grazia Castagna
- Department of Medicine, Surgery and Neuroscience, Unità Operativa Complessa (UOC) Endocrinology, University of Siena, Siena, Italy
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16
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Guimarães NS, Reis MG, Tameirão DR, de Castro Cezar NO, Leopoldino AAO, Magno LAV. Factors associated with sarcopenic obesity in Brazilian adults and older people: Systematic review and meta-analysis of observational studies. Geriatr Gerontol Int 2024; 24:661-674. [PMID: 38868920 DOI: 10.1111/ggi.14918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 05/02/2024] [Accepted: 05/22/2024] [Indexed: 06/14/2024]
Abstract
AIM Sarcopenic obesity (SO) is characterized by the coexistence of the loss of muscle mass and function with excess adipose tissue. Its prevalence has increased concomitantly with population aging, becoming one of the most significant challenges for public health, threatening the quality of life and the physical and mental health of the elderly population. METHODS This study estimated the prevalence and factors associated with SO among adults and the elderly in Brazil's macro-regions, utilizing MEDLINE, Embase, Web of Science, and the Virtual Health Library databases. Primary outcomes included SO prevalence overall and by subgroups, with secondary outcomes identifying associated factors. RESULTS A systematic review of 33 studies with 10 266 participants up to July 2023 showed a 17% prevalence of SO (95% confidence interval: 13-21%), using a random effects meta-analysis. The Central-West region had the highest occurrence (27%). Dual-energy X-ray absorptiometry (26%) and bioimpedance (6%) were the top diagnostic methods. Protective factors were chronic kidney disease and healthy lifestyles; risk factors included socioeconomic status, functionality, lifestyle, biochemical parameters, and comorbidities such as osteoarthritis and apnea. CONCLUSIONS The prevalence of SO in Brazil is significant, emerging as a critical public health problem. It is essential to direct attention to changes in prevalence rates in the coming years, given the rising obesity trends and the absolute increase in the elderly population. Geriatr Gerontol Int 2024; 24: 661-674.
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Affiliation(s)
- Nathalia Sernizon Guimarães
- Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Department of Nutrition, Research Observatory in Epidemiology, Nutrition and Health (OPeNS), Belo Horizonte, Brazil
| | - Marcela Gomes Reis
- Department of Nutrition, Research Observatory in Epidemiology, Nutrition and Health (OPeNS), Belo Horizonte, Brazil
- Postgraduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Diego Ribeiro Tameirão
- Department of Nutrition, Research Observatory in Epidemiology, Nutrition and Health (OPeNS), Belo Horizonte, Brazil
- Postgraduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Luiz Alexandre Viana Magno
- Postgraduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
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Aguas-Ayesa M, Yárnoz-Esquiroz P, Perdomo CM, Olazarán L, Vegas-Aguilar IM, García-Almeida JM, Gómez-Ambrosi J, Frühbeck G. Revisiting the beyond BMI paradigm in excess weight diagnosis and management: A call to action. Eur J Clin Invest 2024; 54:e14218. [PMID: 38629697 DOI: 10.1111/eci.14218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 06/06/2024]
Abstract
Adolphe Quételet, a 19th-century Belgian sociologist and statistician, pioneered the incorporation of statistics into social sciences. He initiated the development of anthropometry since he was interested in identifying the proportions of the 'ideal man'. He devised a ratio between weight and height, originally termed the Quételet Index, and today widely known and used as the body mass index or BMI. In 1835, he demonstrated that a normal curve accommodates the distribution of human traits articulating his reasoning on human variance around the average. Quételet's long-lasting legacy of the establishment of a simple measure to classify people's weight relative to an ideal for their height endures today with minor variations having dramatically influenced public health agendas. While being very useful, the limitations of the BMI are well known. Thus, revisiting the beyond BMI paradigm is a necessity in the era of precision medicine with morphofunctional assessment representing the way forward via incorporation of body composition and functionality appraisal. While healthcare systems were originally designed to address acute illnesses, today's demands require a radical rethinking together with an original reappraisal of our diagnosis and treatment approaches from a multidimensional perspective. Embracing new methodologies is the way forward to advance the field, gain a closer look at the underlying pathophysiology of excess weight, keep the spotlight on improving diagnostic performance and demonstrate its clinical validity. In order to provide every patient with the most accurate diagnosis together with the most appropriate management, a high degree of standardization and personalization is needed.
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Affiliation(s)
- Maite Aguas-Ayesa
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain
| | - Patricia Yárnoz-Esquiroz
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Carolina M Perdomo
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain
| | - Laura Olazarán
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Isabel M Vegas-Aguilar
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
- Institute of Biomedical Research in Malaga (IBIMA)-Bionand Platform, Málaga, Spain
| | - José Manuel García-Almeida
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
- Institute of Biomedical Research in Malaga (IBIMA)-Bionand Platform, Málaga, Spain
- Department of Endocrinology and Nutrition, Quironsalud Málaga Hospital, Málaga, Spain
- Department of Medicine and Dermatology, Faculty of Medicine, University of Malaga, Málaga, Spain
| | - Javier Gómez-Ambrosi
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gema Frühbeck
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
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Nascimento GM, Longo GZ, Valmorbida A, Ferreira FG, Trindade EBSDM. Prevalence of body composition phenotypes and their associations with glycemic, lipidic, and inflammatory biomarkers: a population-based study. CAD SAUDE PUBLICA 2024; 40:e00109823. [PMID: 38896593 PMCID: PMC11178369 DOI: 10.1590/0102-311xen109823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 06/21/2024] Open
Abstract
We aimed to verify the prevalence of body composition phenotypes and the association of glycemic, lipidic, and inflammatory biomarkers with such phenotypes. This is a cross-sectional, population-based study, with 720 participants aged 20 to 59 years. Body composition was assessed by dual-energy X-ray absorptiometry. Obesity was defined as body fat percentage ≥ 25% in males and ≥ 32% in females and sarcopenia by appendicular muscle mass index < 7.0kg/m2 in males and < 5.5kg/m2 in females. Sarcopenic obesity (SO) was defined as the presence of both sarcopenia and obesity. The prevalence of obesity, sarcopenia, and SO were 62.5%, 4.5%, and 6.2%, respectively. The association between biomarkers and phenotypes was verified using multinomial logistic regression models adjusted for confounding factors. The models showed that increased glycemia (OR = 3.39; 95%CI: 1.83-6.27), total cholesterol (TC) (OR = 2.24; 95%CI: 1.35-3.70), LDL-c (OR = 1.01; 95%CI: 1.00-1.02), VLDL-c (OR = 1.04; 95%CI: 1.02-1.06), non-HDL-c (OR = 1.02; 95%CI: 1.01-1.03), triglycerides (Tg) (OR = 3.66; 95%CI: 2.20-6.06), and decreased HDL-c (OR = 0.97; 95%CI: 0.95-0.98) were significantly associated with the obesity phenotype. Increased HOMA-IR (OR = 3.94; 95%CI: 1.69-9.21), LDL-c (OR = 1.01; 95%CI: 1.00-1.02), non-HDL-c (OR = 1.01; 95%CI: 1.00-1.02), and hs-CRP (OR = 2.42; 95%CI: 1.04-5.66) were independently associated with SO phenotype. Our findings indicate that increased glycemia, TC, Tg, LDL-c, VLDL-c, non-HDL-c, and decreased HDL-c may be indicators of the obesity phenotype and that increased hs-CRP, HOMA-IR, LDL-c, and non-HDL-c appear to be indicators of the SO phenotype. Those parameters may be used as additional markers for screening.
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Liu C, Liu T, Deng L, Zhang Q, Song M, Shi J, Liu C, Xie H, Chen Y, Lin S, Zheng X, Zhang H, Barazzoni R, Shi H. Sarcopenic Obesity and Outcomes for Patients With Cancer. JAMA Netw Open 2024; 7:e2417115. [PMID: 38874924 PMCID: PMC11179127 DOI: 10.1001/jamanetworkopen.2024.17115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/16/2024] [Indexed: 06/15/2024] Open
Abstract
Importance The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) have recently proposed a consensus definition and diagnostic criteria for sarcopenic obesity (SO). Objective To implement the ESPEN-EASO diagnostic algorithm to investigate the prevalence of SO and its association with outcomes in patients with solid tumor cancers, with particular regard to associations among SO, overall survival (OS), and patient quality of life (QoL). Design, Setting, and Participants This prospective cohort study included patients diagnosed with solid tumor starting in May 7, 2013, with the last follow-up on June 30, 2022. Patients with solid tumors were categorized into SO and non-SO groups according to ESPEN-EASO criteria. The primary outcome was OS and the secondary outcomes included patient QoL and risk of intensive care unit (ICU) admission. Data were analyzed from June to December 2023. Results A total of 6790 patients were included in the study (mean [SD] age, 59.64 [10.77] years; 3489 were female [51.4%]). The prevalence of SO was 4.36% (296 of 6790) in the whole cohort and 14.98% (296 of 1976) in the subgroup with obesity. SO prevalence increased with age. During a median (IQR) follow-up period of 6.83 (5.67-7.04) years, 2103 patients died. Cox regression analysis indicated that SO was independently associated with lower OS (hazard ratio [HR], 1.54; 95% CI, 1.23-1.92), which was observed in both men (HR, 1.51; 95% CI, 1.09-2.10) and women (HR, 1.53; 95% CI, 1.12-2.07). SO was also associated with poorer QoL and higher risk of ICU admission (odds ratio, 2.39; 95% CI, 1.06-5.29). Among the diagnostic components of SO, low hand grip strength (HGS) was the only SO component associated with poor OS (HR, 1.15; 95% CI, 1.04-1.28). Conclusions and Relevance This cohort study of SO found that SO was significantly associated with lower OS, poorer QoL, and higher risk of ICU admission. Weak HGS, 1 of the diagnostic conditions, was the only component of SO associated with OS. The ESPEN-EASO algorithm appears to be an applicable tool to identify cancer-associated SO, which represents a major clinical complication and factor associated with risk for poor outcomes in these patients.
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Affiliation(s)
- Chenan Liu
- Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Tong Liu
- Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Li Deng
- Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Qi Zhang
- Department of Genetics, Yale University School of Medicine, New Haven
| | - Mengmeng Song
- Cardiovascular Research Institute, University of California, San Francisco
| | - Jinyu Shi
- Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Chenning Liu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Hailun Xie
- Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Yue Chen
- Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Shiqi Lin
- Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Xin Zheng
- Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Heyang Zhang
- Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Hanping Shi
- Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
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20
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Zhang N, Qu X, Zhou H, Kang L. Mapping Knowledge Landscapes and Emerging Trends of Sarcopenic Obesity in Older Adults: A Bibliometric Analysis From 2004 to 2023. Cureus 2024; 16:e62300. [PMID: 38873392 PMCID: PMC11170931 DOI: 10.7759/cureus.62300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2024] [Indexed: 06/15/2024] Open
Abstract
Background The prevalence of obesity in combination with sarcopenia, the age-related loss of muscle mass and strength or physical function, is on the rise among adults aged 65 years and older. A significant portion of this demographic now falls under the classification of sarcopenic obesity, a high-risk geriatric syndrome predominantly seen in an aging population vulnerable to compounded complications from both sarcopenia and obesity. It is essential to promptly evaluate the impact of academic research in this field, taking into account factors such as geographical regions, authors, journals, and institutions. Furthermore, exploring current topics and identifying potential areas that could inspire future researchers to conduct additional studies is crucial for advancing overall health in this population. Methodology A search was conducted in the Web of Science Core Collection database to identify English language articles and reviews focusing on sarcopenic obesity in older adults, published between January 1, 2004, and December 31, 2023. Bibliometric analysis was performed using VOSviewer (v.1.6.18) and CiteSpace (v.6.1.R2). Results A total of 985 original English-language articles were collected, consisting of 783 articles and 202 reviews. The volume of research publications in this field has shown significant growth since 2012. The United States leads in contributions, with 239 articles (24.3% of the total) and the highest number of citations at 18,403, along with the highest total link strength. The University of Melbourne in Australia stands out with 25 published articles (2.5% of the total). University of Verona in Italy has the most citations at 9,405, and Monash University in Australia has the highest total link strength at 53. Among prolific authors, John A. Batsis from Duke University is the most productive with 24 articles (2.4% of the total). The journal "Nutrients" has the most articles on sarcopenic obesity in older adults, publishing 54 articles (5.5% of the total). Key topics in this area include sarcopenia, obesity, sarcopenic obesity, and elderly. Recent interventions focus on "nutrition" and "exercise" for sarcopenic obesity in older adults. Conclusions Research on sarcopenic obesity in older adults has seen significant growth on a global scale from 2004 to 2023, indicating a promising area for further study with potential benefits from current advancements. Although academic inquiries have shed light on various aspects of sarcopenic obesity in older adults, there remains a noticeable dearth of clinical research and evidence-based medicine on the effective management of this condition in elderly individuals. Future studies could focus on developing tailored interventions for older adults with sarcopenic obesity.
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Affiliation(s)
- Ning Zhang
- Department of Geriatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, CHN
| | - Xuan Qu
- Department of Geriatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, CHN
| | - Haokang Zhou
- Department of Internal Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, CHN
| | - Lin Kang
- Department of Geriatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, CHN
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21
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Yildiz BO, Boguszewski CL, da Silva Boguszewski MC, Busetto L, Celik O, Fuleihan GEH, Goulis DG, Hammer GD, Haymart MR, Kaltsas G, Law JR, Lim AYL, Luger A, Macut D, McGowan B, McClung M, Miras AD, Patti ME, Peeters RP, Pignatelli D, Saeed H, Sipos J, Stratakis CA, Tsoli M, van der Lely AJ, Witchel SF, Yazici D. EndoBridge 2023: highlights and pearls. Hormones (Athens) 2024; 23:183-204. [PMID: 38619812 DOI: 10.1007/s42000-024-00549-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 03/06/2024] [Indexed: 04/16/2024]
Abstract
EndoBridge 2023 took place on October 20-22, 2023, in Antalya, Turkey. Accredited by the European Council, the 3-day scientific program of the 11th Annual Meeting of EndoBridge included state-of-the-art lectures and interactive small group discussion sessions incorporating interesting and challenging clinical cases led by globally recognized leaders in the field and was well attended by a highly diverse audience. Following its established format over the years, the program provided a comprehensive update across all aspects of endocrinology and metabolism, including topics in pituitary, thyroid, bone, and adrenal disorders, neuroendocrine tumors, diabetes mellitus, obesity, nutrition, and lipid disorders. As usual, the meeting was held in English with simultaneous translation into Russian, Arabic, and Turkish. The abstracts of clinical cases presented by the delegates during oral and poster sessions have been published in JCEM Case Reports. Herein, we provide a paper on highlights and pearls of the meeting sessions covering a wide range of subjects, from thyroid nodule stratification to secondary osteoporosis and from glycemic challenges in post-bariatric surgery to male hypogonadism. This report emphasizes the latest developments in the field, along with clinical approaches to common endocrine issues. The 12th annual meeting of EndoBridge will be held on October 17-20, 2024 in Antalya, Turkey.
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Affiliation(s)
- Bulent Okan Yildiz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hacettepe University School of Medicine, 06100, Hacettepe, Ankara, Turkey.
| | - Cesar Luiz Boguszewski
- Department of Internal Medicine, Endocrine Division (SEMPR), University Hospital, Federal University of Parana, Curitiba, Brazil
| | | | - Luca Busetto
- Department of Medicine, University of Padova, Padova, Italy
| | - Ozlem Celik
- Department of Endocrinology and Metabolism, School of Medicine, Acibadem University, Istanbul, Turkey
| | - Ghada El-Hajj Fuleihan
- Division of Endocrinology, Deparment of Medicine at the American University of Beirut, Beirut, Lebanon
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Gary D Hammer
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, MI, USA
| | - Megan R Haymart
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, MI, USA
| | - Gregory Kaltsas
- First Department of Propaedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Jennifer R Law
- Division of Pediatric Endocrinology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Amanda Yuan Ling Lim
- Imperial College Healthcare NHS Trust, London, UK
- Division of Endocrinology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Anton Luger
- Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Djuro Macut
- Institute of Endocrinology, University of Belgrade, Belgrade, Serbia
| | - Barbara McGowan
- Guy's and St Thomas Hospital and King's College London, London, UK
| | | | | | | | - Robin P Peeters
- Department of Internal Medicine, Academic Center for Thyroid Disease, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Duarte Pignatelli
- Department of Endocrinology, Centro Hospitalar e Universitário de S. João, Porto, Portugal
| | | | - Jennifer Sipos
- Division Endocrinology, Diabetes and Metabolism, Ohio State University, Columbus, OH, USA
| | | | - Marina Tsoli
- Academic Scholar Fellow at 1st Department of Propaedeutic and Internal Medicine, Laiko Hospital, Athens, Greece
| | - A J van der Lely
- Pituitary Center Rotterdam and Division of Endocrinology, Department of Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Selma F Witchel
- Division of Pediatric Endocrinology, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dilek Yazici
- Division of Endocrinology, Department of Internal Medicine, School of Medicine, Koç University, Istanbul, Turkey
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22
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Cancello R, Brenna E, Soranna D, Zambon A, Villa V, Castelnuovo G, Donini LM, Busetto L, Capodaglio P, Brunani A. Sarcopenia Prevalence among Hospitalized Patients with Severe Obesity: An Observational Study. J Clin Med 2024; 13:2880. [PMID: 38792422 PMCID: PMC11122386 DOI: 10.3390/jcm13102880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Sarcopenic obesity (SO) is the combination of excess fat, skeletal muscle and muscular strength/function deficit. The ESPEN/EASO have proposed new diagnostic criteria, but the SO prevalence in patients with severe obesity remains to be established. The aim of this study was to establish the SO prevalence in a large cohort of inpatients with obesity, considering sex, age, BMI, type, and number of concomitant diseases. Methods: Patient data of both genders aged between 18 and 90 years with a body mass index (BMI) of ≥30 kg/m2 underwent hospital evaluation including bioelectrical impedance analysis (BIA) and handgrip strength (HS). QoL scores were obtained by the Psychological General Well-Being Index questionnaire. The study was approved by the institutional Ethic Committee. Results: Among the 3858 patients, 444 (11.51%) exhibited a strength deficit, while 3847 (99.71%) had skeletal muscle mass deficit. The prevalence of SO was then 11.48%, with higher rates in women (12.39%), in individuals aged >70 years (27%), and in those reporting a 'poor' QoL (12.6%). No significant difference in SO prevalence was found when stratifying by BMI (30-40 kg/m2 vs. >40 kg/m2, p = 0.1710). In SO patients, osteoarticular diseases (57%), hypertension/heart failure (38%), type 2 diabetes mellitus (34%), and obstructive sleep apnea (32%) were the more frequent comorbidities. Conclusions: The application of ESPEN/EASO-SO criteria in a cohort of inpatients with severe obesity revealed 11.48% SO prevalence, which was associated with age (particularly > 70 years), gender (women), but not BMI, as determinants. Disease staging and QoL screening may improve the identification of SO high-risk patients.
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Affiliation(s)
- Raffaella Cancello
- Obesity Unit, Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, 20121 Milan, Italy;
| | - Ettore Brenna
- Biostatistic Unit, IRCCS Istituto Auxologico Italiano, 20121 Milan, Italy; (E.B.); (D.S.); (A.Z.)
| | - Davide Soranna
- Biostatistic Unit, IRCCS Istituto Auxologico Italiano, 20121 Milan, Italy; (E.B.); (D.S.); (A.Z.)
| | - Antonella Zambon
- Biostatistic Unit, IRCCS Istituto Auxologico Italiano, 20121 Milan, Italy; (E.B.); (D.S.); (A.Z.)
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, 20126 Milan, Italy
| | - Valentina Villa
- Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, 20824 Piancavallo-Verbania, Italy; (V.V.); (G.C.)
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, 20824 Piancavallo-Verbania, Italy; (V.V.); (G.C.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy
| | | | - Luca Busetto
- Department of Medicine, University of Padova, 35122 Padova, Italy;
| | - Paolo Capodaglio
- Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Turin, 10126 Turin, Italy;
- Laboratory of Biomechanics, Rehabilitation and Ergonomics, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo-Verbania, Italy
| | - Amelia Brunani
- Laboratory of Biomechanics, Rehabilitation and Ergonomics, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo-Verbania, Italy
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23
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Prado CM, Batsis JA, Donini LM, Gonzalez MC, Siervo M. Sarcopenic obesity in older adults: a clinical overview. Nat Rev Endocrinol 2024; 20:261-277. [PMID: 38321142 DOI: 10.1038/s41574-023-00943-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 02/08/2024]
Abstract
Sarcopenic obesity is characterized by a concurrent decline in muscle mass and function, along with increased adipose tissue. Sarcopenic obesity is a growing concern in older adults owing to significant health consequences, including implications for mortality, comorbidities and risk of developing geriatric syndromes. A 2022 consensus statement established a new definition and diagnostic criteria for sarcopenic obesity. The pathophysiology of this condition involves a complex interplay between muscle, adipose tissue, hormonal changes, inflammation, oxidative stress and lifestyle factors, among others. Sarcopenic obesity is treated with a range of management approaches, such as lifestyle interventions, exercise, nutrition and medical therapies. Emerging therapies that were developed for treating other conditions may be relevant to sarcopenic obesity, including novel pharmacological agents and personalized approaches such as precision medicine. In this Review, we synthesize the current knowledge of the clinical importance of sarcopenic obesity, its assessment and diagnosis, along with current and emerging management strategies.
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Affiliation(s)
- Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.
| | - John A Batsis
- Division of Geriatric Medicine, School of Medicine, and Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lorenzo M Donini
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - M Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Pelotas, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Mario Siervo
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Curtin Dementia Centre of Excellence, enAble Institute, Curtin University, Perth, Western Australia, Australia
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24
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Akgul YSS, Akin S, Cengiz BE, Kocaslan D, Ozer NT. Body composition assessment for sarcopenic obesity and 3-year mortality in older adults: A comparison study. JPEN J Parenter Enteral Nutr 2024; 48:460-468. [PMID: 38400558 DOI: 10.1002/jpen.2613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND There is no universally accepted definition of sarcopenic obesity (SO), and its prevalence is ambiguous. This study aimed to investigate the prevalence of SO in older adults based on different definitions and determine which predicts all-cause mortality. METHODS This prospective longitudinal follow-up study included outpatients aged ≥60 years. SO was defined by sarcopenia definition based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria plus obesity. Three different methods were used to define obesity. Body mass index (BMI) ≥ 30 kg/m2, waist circumference (WC) ≥ 102 cm for men and ≥88.0 cm for women, and body fat percentage (BF%) ≥ 37.3% for men and ≥51.1% for women. Different definitions of SO and their mortality predictions were compared. RESULTS The median age of the 584 patients in the study was 70.0 (interquartile range, 66.0-76.0) years. The prevalence of sarcopenia was 38.5% (47.5% in men and 35.7% in women). The prevalence of SO based on BMI, WC, and BF% was 15.3%, 16.4%, and 10.5%, respectively. The mortality rate was 6.7%. SO based on BMI (odds ratio [OR], 2.73; 95% CI, 1.12-17.9; P = 0.024) and BF% (OR, 1.43; 95% CI, 1.19-3.02; P = 0.007) were significantly associated with 3-year mortality after adjusting for the confounding variables of age, sex, and number of comorbidities. SO based on WC was not associated with mortality (OR, 0.78; 95% CI, 0.07-1.27; P = 0.104). CONCLUSION The use of BF% and BMI for defining SO is appropriate in outpatient older adults.
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Affiliation(s)
- Yavuz Sultan Selim Akgul
- Division of Geriatrics, Department of Internal Medicine, Erciyes School of Medicine, Erciyes University, Kayseri, Türkiye
| | - Sibel Akin
- Division of Geriatrics, Department of Internal Medicine, Erciyes School of Medicine, Erciyes University, Kayseri, Türkiye
| | - Burcu Eren Cengiz
- Division of Geriatrics, Department of Internal Medicine, Erciyes School of Medicine, Erciyes University, Kayseri, Türkiye
| | - Derya Kocaslan
- Division of Geriatrics, Department of Internal Medicine, Erciyes School of Medicine, Erciyes University, Kayseri, Türkiye
| | - Nurhayat Tugra Ozer
- Department of Nutrition and Dietetic, Faculty of Health Science, Agri Ibrahim Cecen University, Agri, Türkiye
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25
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Boppre G, Diniz-Sousa F, Veras L, Bezerra A, Devezas V, Preto J, Santos-Sousa H, Oliveira J, Fonseca H. Impact of a Multicomponent Exercise Training Program on Muscle Strength After Bariatric Surgery: A Randomized Controlled Trial. Obes Surg 2024; 34:1704-1716. [PMID: 38532144 PMCID: PMC11031478 DOI: 10.1007/s11695-024-07173-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE This study examined the benefits of an 11-months multicomponent exercise program (MEP) on muscular strength (MS) after bariatric surgery. METHODS Of the 84 randomized patients, 41 participants from the exercise group (EG) and 20 participants from the control group (CG) were included in the analysis. The EG received supervised MEP for 11 months, starting 1-month post-bariatric surgery (BS) in addition to standard medical care, while the CG received medical care recommendations only. Knee and trunk MS was assessed by isokinetic dynamometry pre-surgery, 1-, 6-, and 12-month post-surgery, while body composition was assessed by dual-energy X-ray absorptiometry. RESULTS The MEP did not significantly impact absolute MS in the dominant knee and trunk regions at 6- and 12-month post-BS. However, relative MS showed significant improvements. At 6-month post-BS, knee flexion at 60°/s relative to body weight (BW) increased significantly (p = 0.047), as did knee extension at 180°/s relative to BW (p = 0.009), and knee extension at 60°/s relative to total lean mass (p=0.040). At 12-month post-BS, knee flexion at 60°/s relative to BW also significantly improved (p=0.038). CONCLUSION While absolute MS was not significantly improved with MEP, this study found significant enhancements in relative MS, particularly in dominant knee flexion post-MEP participation. Further research should explore different exercise intensities and frequencies to optimize postoperative MS recovery post-BS. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov (NCT02843048).
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Affiliation(s)
- Giorjines Boppre
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal.
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
| | - Florêncio Diniz-Sousa
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Lucas Veras
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Andrea Bezerra
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Vitor Devezas
- General Surgery Department, São João Medical Center, Porto, Portugal
| | - John Preto
- General Surgery Department, São João Medical Center, Porto, Portugal
| | - Hugo Santos-Sousa
- General Surgery Department, São João Medical Center, Porto, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Hélder Fonseca
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
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Luo Y, Wang Y, Tang S, Xu L, Zhao X, Han M, Liu Y, Xu Y, Han B. Prevalence of sarcopenic obesity in the older non-hospitalized population: a systematic review and meta-analysis. BMC Geriatr 2024; 24:357. [PMID: 38649825 PMCID: PMC11036751 DOI: 10.1186/s12877-024-04952-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/05/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Sarcopenic obesity emerges as a risk factor for adverse clinical outcomes in non-hospitalized older adults, including physical disabilities, metabolic diseases, and even mortality. In this systematic review and meta-analysis, we investigated the overall SO prevalence in non-hospitalized adults aged ≥ 65 years and assessed the sociodemographic, clinicobiological, and lifestyle factors related to SO. METHODS We searched the PubMed, Embase, Cochrane Library, and Web of Science databases for studies reporting the prevalence of SO from database inception to October 2023. Two researchers independently screened the literature, evaluated the study quality, and extracted the data. Both fixed- and random-effects models were used in the meta-analysis to estimate the pooled SO prevalence and perform subgroup analyses. Publication and sensitivity bias analyses were performed to test the robustness of the associations. RESULTS Among 46 studies eligible for review and a total of 71,757 non-hospitalized older adults, the combined prevalence of SO was 14% (95% CI:11-17%, I2 = 99.5%, P < 0.01). Subgroup analysis according to lifestyle factors demonstrated that the SO prevalence was 17% (95% CI: 8-29%, I2 = 99.5%, P < 0.01) in older adults without exercise habits. Regarding clinicobiological factors, older adults with a history of falls (15% [95% CI: 10-22%, I2 = 82%, P < 0.01]), two or more chronic diseases (19% [95% CI: 10-29%, I2 = 97%, P < 0.01]), functional impairment (33% [95% CI: 29-37%, I2 = 0%, P = 0.95]), cognitive impairment (35% [95% CI: 9-65%, I2 = 83%, P = 0.02]), osteoporosis (20% [95% CI: 8-35%, I2 = 96%, P < 0.01]), high fasting glucose level (17% [95% CI: 1-49%, I2 = 98%, P < 0.01]), or the use of antipsychotics (13% [95% CI: 2-28%, I2 = 0%, P = 0.32]) exhibited a higher SO prevalence. CONCLUSION SO prevalence is high among non-hospitalized older adults, especially those with functional and cognitive impairments. Thus, SO is a potential problem for the aging population; implementation of planned interventions in the community is needed to reduce the prevalence and adverse outcomes of SO.
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Affiliation(s)
- Yuhong Luo
- School of Nursing, Capital Medical University, Beijing, China
- Xuanwu Hospital, Capital Medical University, No 45., Changchun Street, Xicheng District, 100055, Beijing, China
| | - Yanqiu Wang
- School of Nursing, Capital Medical University, Beijing, China
- Xuanwu Hospital, Capital Medical University, No 45., Changchun Street, Xicheng District, 100055, Beijing, China
| | - Shuao Tang
- School of Nursing, Capital Medical University, Beijing, China
- Xuanwu Hospital, Capital Medical University, No 45., Changchun Street, Xicheng District, 100055, Beijing, China
| | - Ludan Xu
- School of Nursing, Capital Medical University, Beijing, China
- Xuanwu Hospital, Capital Medical University, No 45., Changchun Street, Xicheng District, 100055, Beijing, China
| | - Xinyu Zhao
- School of Nursing, Capital Medical University, Beijing, China
- Xuanwu Hospital, Capital Medical University, No 45., Changchun Street, Xicheng District, 100055, Beijing, China
| | - Mengya Han
- School of Nursing, Capital Medical University, Beijing, China
- Xuanwu Hospital, Capital Medical University, No 45., Changchun Street, Xicheng District, 100055, Beijing, China
| | - Yuhua Liu
- School of Nursing, Capital Medical University, Beijing, China
- Xuanwu Hospital, Capital Medical University, No 45., Changchun Street, Xicheng District, 100055, Beijing, China
| | - Yan Xu
- School of Nursing, Capital Medical University, Beijing, China
- Xuanwu Hospital, Capital Medical University, No 45., Changchun Street, Xicheng District, 100055, Beijing, China
| | - Binru Han
- School of Nursing, Capital Medical University, Beijing, China.
- Xuanwu Hospital, Capital Medical University, No 45., Changchun Street, Xicheng District, 100055, Beijing, China.
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Mwala NN, Borkent JW, van der Meij BS, de van der Schueren MAE. Challenges in identifying malnutrition in obesity; An overview of the state of the art and directions for future research. Nutr Res Rev 2024:1-10. [PMID: 38576127 PMCID: PMC7616526 DOI: 10.1017/s095442242400012x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
(Protein-energy) malnutrition in individuals living with obesity presents complex diagnostic challenges due to the distinctive physiological characteristics of obesity. This narrative review critically examines the identification of malnutrition within the population with obesity, distinguishing malnutrition in obesity from related conditions such as sarcopenic obesity. While noting some shared features, the review highlights key differences between these conditions. The review also highlights the limitations of current malnutrition screening tools, which are not designed for individuals living with obesity. These tools primarily rely on anthropometric measurements, neglecting (among others) nutrient intake assessment, which hinders accurate malnutrition detection. Additionally, this review discusses limitations in existing diagnostic criteria, including the Global Leadership Initiative on Malnutrition (GLIM) criteria, when applied to individuals living with obesity. Challenges include the identification of appropriate cut-off values for phenotypic criteria (unintentional weight loss, low body mass index and muscle mass) and aetiological criteria such as reduced food intake and inflammation for the population with obesity. Overall, this review emphasises the need for modified screening tools and diagnostic criteria to recognise and assess malnutrition in obesity, leading to improved clinical outcomes and overall wellbeing.
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Affiliation(s)
- Natasha Nalucha Mwala
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
- Department of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Jos W Borkent
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
- Department of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Barbara S van der Meij
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
- Department of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
- Bond University Nutrition and Dietetics Research Group, Bond University, Gold Coast, Australia
| | - Marian A E de van der Schueren
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
- Department of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
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Uchida S, Sohda M, Tateno K, Watanabe T, Shibasaki Y, Nakazawa N, Kuriyama K, Sano A, Yokobori T, Sakai M, Ogawa H, Shirabe K, Saeki H. Usefulness of the preoperative inflammation-based prognostic score and the ratio of visceral fat area to psoas muscle area on predicting survival for surgically resected adenocarcinoma of the esophagogastric junction. Esophagus 2024; 21:157-164. [PMID: 38112929 DOI: 10.1007/s10388-023-01034-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Sarcopenic obesity is associated with gastrointestinal cancer prognosis through systemic inflammation. However, in patients with adenocarcinoma of the esophagogastric junction (AEG), the relationship between the inflammation-based prognostic score (IBPS), muscle loss, visceral fat mass, and prognosis has not been sufficiently evaluated. We investigated the prognostic value of the preoperative IBPS and the visceral fat area ratio to the psoas muscle area (V/P ratio) in patients with AEG undergoing surgery. METHODS We retrospectively analyzed 92 patients with AEG who underwent surgery. The prognostic value of the preoperative neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio, systemic inflammation response index, C-reactive protein-to-albumin ratio, prognostic nutritional index, modified Glasgow Prognostic Score, and V/P ratio at the third lumbar vertebra was investigated using univariate and multivariate survival analyses. RESULTS Multivariate analysis revealed that a high pathological stage (p = 0.0065), high PLR (p = 0.0421), and low V/P ratio (p = 0.0053) were independent prognostic factors for poor overall survival (OS). When restricted to patients with body mass index (BMI) ≥ 25 kg/m2, a high V/P ratio was a poor prognostic factor (p = 0.0463) for OS. Conversely, when restricted to patients with BMI < 25 kg/m2, a low V/P ratio was a poor prognostic factor (p = 0.0021) for OS. CONCLUSIONS Both PLR and V/P ratios may be useful prognostic biomarkers in surgical cases of AEG. V/P ratio and BMI may provide an accurate understanding of the muscle and fat mass's precise nature and may help predict AEG prognosis.
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Affiliation(s)
- Shintaro Uchida
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Makoto Sohda
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan.
| | - Kohei Tateno
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Takayoshi Watanabe
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Yuta Shibasaki
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Nobuhiro Nakazawa
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Kengo Kuriyama
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Akihiko Sano
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Takehiko Yokobori
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Makoto Sakai
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Hiroomi Ogawa
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Ken Shirabe
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Hiroshi Saeki
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
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Benz E, Pinel A, Guillet C, Capel F, Pereira B, De Antonio M, Pouget M, Cruz-Jentoft AJ, Eglseer D, Topinkova E, Barazzoni R, Rivadeneira F, Ikram MA, Steur M, Voortman T, Schoufour JD, Weijs PJM, Boirie Y. Sarcopenia and Sarcopenic Obesity and Mortality Among Older People. JAMA Netw Open 2024; 7:e243604. [PMID: 38526491 DOI: 10.1001/jamanetworkopen.2024.3604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
Importance Sarcopenia and obesity are 2 global concerns associated with adverse health outcomes in older people. Evidence on the population-based prevalence of the combination of sarcopenia with obesity (sarcopenic obesity [SO]) and its association with mortality are still limited. Objective To investigate the prevalence of sarcopenia and SO and their association with all-cause mortality. Design, Setting, and Participants This large-scale, population-based cohort study assessed participants from the Rotterdam Study from March 1, 2009, to June 1, 2014. Associations of sarcopenia and SO with all-cause mortality were studied using Kaplan-Meier curves, Cox proportional hazards regression, and accelerated failure time models fitted for sex, age, and body mass index (BMI). Data analysis was performed from January 1 to April 1, 2023. Exposures The prevalence of sarcopenia and SO, measured based on handgrip strength and body composition (BC) (dual-energy x-ray absorptiometry) as recommended by current consensus criteria, with probable sarcopenia defined as having low handgrip strength and confirmed sarcopenia and SO defined as altered BC (high fat percentage and/or low appendicular skeletal muscle index) in addition to low handgrip strength. Main Outcome and Measure The primary outcome was all-cause mortality, collected using linked mortality data from general practitioners and the central municipal records, until October 2022. Results In the total population of 5888 participants (mean [SD] age, 69.5 [9.1] years; mean [SD] BMI, 27.5 [4.3]; 3343 [56.8%] female), 653 (11.1%; 95% CI, 10.3%-11.9%) had probable sarcopenia and 127 (2.2%; 95% CI, 1.8%-2.6%) had confirmed sarcopenia. Sarcopenic obesity with 1 altered component of BC was present in 295 participants (5.0%; 95% CI, 4.4%-5.6%) and with 2 altered components in 44 participants (0.8%; 95% CI, 0.6%-1.0%). An increased risk of all-cause mortality was observed in participants with probable sarcopenia (hazard ratio [HR], 1.29; 95% CI, 1.14-1.47) and confirmed sarcopenia (HR, 1.93; 95% CI, 1.53-2.43). Participants with SO plus 1 altered component of BC (HR, 1.94; 95% CI, 1.60-2.33]) or 2 altered components of BC (HR, 2.84; 95% CI, 1.97-4.11) had a higher risk of mortality than those without SO. Similar results for SO were obtained for participants with a BMI of 27 or greater. Conclusions and Relevance In this study, sarcopenia and SO were found to be prevalent phenotypes in older people and were associated with all-cause mortality. Additional alterations of BC amplified this risk independently of age, sex, and BMI. The use of low muscle strength as a first step of both diagnoses may allow for early identification of individuals at risk for premature mortality.
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Affiliation(s)
- Elizabeth Benz
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Alexandre Pinel
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
| | - Christelle Guillet
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
| | - Frederic Capel
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
| | - Bruno Pereira
- Unit of Biostatistics, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Marie De Antonio
- Unit of Biostatistics, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Melanie Pouget
- Department of Clinical Nutrition, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | | | - Doris Eglseer
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Eva Topinkova
- Department of Geriatrics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Rocco Barazzoni
- Department of Medical, Technological and Translational Sciences, University of Trieste, Ospedale di Cattinara, Trieste, Italy
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marinka Steur
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Josje D Schoufour
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Peter J M Weijs
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
- Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Amsterdam Public Health Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Yves Boirie
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
- Department of Clinical Nutrition, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
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Jurdana M, Cemazar M. Sarcopenic obesity in cancer. Radiol Oncol 2024; 58:1-8. [PMID: 38378031 PMCID: PMC10878777 DOI: 10.2478/raon-2024-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/04/2023] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Sarcopenic obesity is a relatively new term. It is a clinical condition characterized by sarcopenia (loss of muscle mass and function) and obesity (increase in fat mass) that mainly affects older adults. As the incidence of sarcopenia and obesity increases worldwide, sarcopenic obesity is becoming a greater problem also in cancer patients. In fact, sarcopenic obesity is associated with poorer treatment outcomes, longer hospital stays, physical disability, and shorter survival in several cancers. Oxidative stress, lipotoxicity, and systemic inflammation, as well as altered expression of skeletal muscle anti-inflammatory myokines in sarcopenic obesity, are also associated with carcinogenesis. CONCLUSIONS Reported prevalence of sarcopenic obesity in cancer varies because of heterogeneity in definitions and variability in diagnostic criteria used to estimate the prevalence of sarcopenia and obesity. Therefore, the aim of this review is to describe the definitions, prevalence, and diagnostic criteria as well as the mechanisms that cancer has in common with sarcopenic obesity.
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Affiliation(s)
- Mihaela Jurdana
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Maja Cemazar
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
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31
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Mazurkiewicz Ł, Czernikiewicz K, Grygiel-Górniak B. Immunogenetic Aspects of Sarcopenic Obesity. Genes (Basel) 2024; 15:206. [PMID: 38397196 PMCID: PMC10888391 DOI: 10.3390/genes15020206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
Sarcopenic obesity (SO) is a combination of obesity and sarcopenia, with diagnostic criteria defined as impaired skeletal muscle function and altered body composition (e.g., increased fat mass and reduced muscle mass). The mechanism of SO is not yet perfectly understood; however, the pathogenesis includes aging and its complications, chronic inflammation, insulin resistance (IR), and hormonal changes. Genetic background is apparent in the pathogenesis of isolated obesity, which is most often polygenic and is characterized by the additive effect of various genetic factors. The genetic etiology has not been strictly established in SO. Still, many data confirm the existence of pathogenic gene variants, e.g., Fat Mass and Obesity Associated Gene (FTO), beta-2-adrenergic receptor (ADRB2) gene, melanocortin-4 receptor (MC4R) and others with obesity. The literature on the role of these genes is scarce, and their role has not yet been thoroughly established. On the other hand, the involvement of systemic inflammation due to increased adipose tissue in SO plays a significant role in its pathophysiology through the synthesis of various cytokines such as monocyte chemoattractant protein-1 (MCP-1), IL-1Ra, IL-15, adiponectin or CRP. The lack of anti-inflammatory cytokine (e.g., IL-15) can increase SO risk, but further studies are needed to evaluate the exact mechanisms of implications of various cytokines in SO individuals. This manuscript analyses various immunogenetic and non-genetic factors and summarizes the recent findings on immunogenetics potentially impacting SO development.
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Affiliation(s)
| | | | - Bogna Grygiel-Górniak
- Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland
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32
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Eitmann S, Matrai P, Hegyi P, Balasko M, Eross B, Dorogi K, Petervari E. Obesity paradox in older sarcopenic adults - a delay in aging: A systematic review and meta-analysis. Ageing Res Rev 2024; 93:102164. [PMID: 38103840 DOI: 10.1016/j.arr.2023.102164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
The prognostic significance of obesity in sarcopenic adults is controversial. This systematic review and meta-analysis aimed to investigate the effect of additional obesity on health outcomes in sarcopenia. MEDLINE, EMBASE, Scopus and CENTRAL were systematically searched for studies to compare health outcomes of adults with sarcopenic obesity (SO) to those of sarcopenic non-obese (SNO) adults. We also considered the methods of assessing obesity. Of 15060 records screened, 65 papers were included (100612 participants). Older community-dwelling SO adults had 15% lower mortality risk than the SNO group (hazard ratio, HR: 0.85, 95% confidence interval 0.76, 0.94) even when obesity was assessed by measurement of body composition. Additionally, meta-regression analysis revealed a significant negative linear correlation between the age and the HR of all-cause mortality in SO vs. SNO community-dwelling adults, but not in severely ill patients. Compared with SNO, SO patients presented lower physical performance, higher risk for metabolic syndrome, but similar cognitive function, risk of falls and cardiovascular diseases. Age-related obesity, SO and later fat loss leading to SNO represent consecutive phases of biological aging. Additional obesity could worsen the health state in sarcopenia, but above 65 years SO represents a biologically earlier phase with longer life expectancy than SNO.
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Affiliation(s)
- Szimonetta Eitmann
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary
| | - Peter Matrai
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary
| | - Peter Hegyi
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary; Centre for Translational Medicine, Semmelweis University, 26 Ulloi street, H-1085 Budapest, Hungary; Division of Pancreatic Diseases, Semmelweis University, 23-26 Baross street, H-1085 Budapest, Hungary
| | - Marta Balasko
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary
| | - Balint Eross
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary; Centre for Translational Medicine, Semmelweis University, 26 Ulloi street, H-1085 Budapest, Hungary; Division of Pancreatic Diseases, Semmelweis University, 23-26 Baross street, H-1085 Budapest, Hungary
| | - Kira Dorogi
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary
| | - Erika Petervari
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary.
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33
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Tam K, Wong-Pack M, Liu T, Adachi J, Lau A, Ma J, Papaioannou A, Rodrigues IB. Risk Factors and Clinical Outcomes Associated With Sarcopenia in Rheumatoid Arthritis: A Systematic Review and Meta-analysis. J Clin Rheumatol 2024; 30:18-25. [PMID: 37092889 DOI: 10.1097/rhu.0000000000001980] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
ABSTRACT Sarcopenia is underrecognized in patients with rheumatoid arthritis (RA). Risk factors of sarcopenia and its impact on outcomes in RA patients are relatively unknown. We conducted a systematic review to identify factors and outcomes associated with sarcopenia in RA. We conducted this review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. We searched PubMed, Embase, CINAHL, and Web of Science databases by combining the following search concepts: (1) RA and (2) sarcopenia. Articles were included if they included RA patients, assessed for sarcopenia using a consensus working group definition, and assessed for clinical outcomes. Meta-analysis was performed using studies that shared the same sarcopenia definition and consistency in reporting patient or disease variables. Our search identified 3602 articles. After removal of duplicates, title and abstract screen, and full-text review, 16 articles were included for final analysis. All studies had observational study designs. The pooled prevalence of sarcopenia ranged from 24% to 30%, depending on the criteria for sarcopenia used. Factors associated with sarcopenia included higher 28-joint Disease Activity Scale scores (+0.39; 95% confidence interval, +0.02 to +0.77) and baseline methotrexate use (odds ratio, 0.70; 95% confidence interval, 0.51-0.97). Baseline glucocorticoid use had a positive correlation with sarcopenia in multiple studies. Several studies found lower bone mineral density and higher incidence of falls and fractures in patients with sarcopenia. Sarcopenia is prevalent in RA, and it may be associated with higher RA disease activity, lower bone mineral density, and increased falls and fractures. Therefore, early screening of sarcopenia in RA patients is important to incorporate into clinical rheumatology practice.
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Affiliation(s)
- Keith Tam
- From the Department of Rheumatology, McMaster University, Hamilton
| | | | | | | | | | - Jinhui Ma
- GERAS Centre for Aging Research, Hamilton Health Sciences
| | | | - Isabel B Rodrigues
- Division of Geriatric Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Wannamethee SG, Atkins JL. Sarcopenic Obesity and Cardiometabolic Health and Mortality in Older Adults: a Growing Health Concern in an Ageing Population. Curr Diab Rep 2023; 23:307-314. [PMID: 37566368 PMCID: PMC10640508 DOI: 10.1007/s11892-023-01522-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE OF REVIEW Sarcopenic obesity (SO) is a growing public health problem in older adults. Whether SO confers higher risk of cardiometabolic disease and mortality than obesity or sarcopenia alone is still a matter of debate. We focus on recent findings on SO and cardiometabolic health and mortality in older adults. RECENT FINDINGS SO is associated with increased mortality compared to non-sarcopenic obesity, but similar mortality risk compared to sarcopenia without obesity. SO is associated with a higher risk of cardiovascular disease (CVD), diabetes, and physical disability than obesity or sarcopenia alone. SO, in the presence of diabetes, is associated with the highest risk of CVD and chronic kidney disease. A definition and diagnostic criteria for SO has recently been proposed (ESPEN and EASO). SO is associated with more adverse outcomes overall than sarcopenia or obesity alone. Future research is required to assess the impact of the new SO definition on health outcomes.
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Affiliation(s)
- Sasiwarang Goya Wannamethee
- Department Primary Care and Population Health, University College London, Royal Free Campus, London, NW32PF, UK.
| | - Janice L Atkins
- Epidemiology and Public Health Group, Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, St Luke's Campus, Exeter, EX1 2LU, Devon, UK
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Maheshwari V, Basu S. Sarcopenic Obesity Burden, Determinants, and Association With Risk of Frailty, Falls, and Functional Impairment in Older Adults With Diabetes: A Propensity Score Matching Analysis. Cureus 2023; 15:e49601. [PMID: 38161911 PMCID: PMC10755084 DOI: 10.7759/cureus.49601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Sarcopenic obesity (SO) is a medical and functional state characterized by the coexistence of excessive adipose tissue and sarcopenia inside an individual. Recent epidemiological studies suggest a rising prevalence of SO in patients with diabetes mellitus (DM) probably due to the conducive environment resulting from adipose tissue dysfunction and muscle wasting accelerated by insulin resistance, chronic inflammation, and altered protein metabolism. Individuals with SO may have higher risk of experiencing falls, frailty, and disabilities due to compromised musculoskeletal integrity, gait abnormalities, and reduced functional capacity. The primary study objective was to determine the prevalence and predictors of SO among older adults with a history of DM. The secondary objective was to assess the association of falls, frailty, and functional disability with SO in patients with DM. METHODOLOGY This cross-sectional study analyzed data from the nationally representative Longitudinal Aging Study in India (LASI) Wave 1, focusing on individuals aged 60 and above, with an emphasis on diabetes. SO was assessed using the Asian Working Group for Sarcopenia criteria. Propensity score matching (PSM), logistic regression, and mediation analysis were used to explore relationships between diabetes, SO, and health outcomes (falls, frailty, and disabilities). RESULTS Among 31,902 participants aged 60 and above, 14.26% had diabetes, and 17.67% of those with diabetes exhibited SO. Female gender (aOR = 2.63) and urban residence (aOR = 1.40) were significantly associated with higher odds of SO in individuals with diabetes. PSM analysis revealed a 9.0% higher likelihood of SO in older adults with DM than those without DM. SO was further linked to increased risk of falls, frailty, and various levels of activities of daily living (ADL) and instrumental activities of daily living (IADL) disabilities, with significant mediation effects ranging from 3.67% to 45.81%. CONCLUSIONS Diabetes substantially increases the risk of SO and associated functional disability with the risk of falls in older adults. Standard diabetes care should integrate health promotion especially nutrition to mitigate the risk of SO-linked functional disability and falls.
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Affiliation(s)
- Vansh Maheshwari
- Indian Institute of Public Health - Delhi, Public Health Foundation of India, New Delhi, IND
| | - Saurav Basu
- Indian Institute of Public Health - Delhi, Public Health Foundation of India, New Delhi, IND
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Weng XF, Liu SW, Li M, Zhang Y, Zhang YC, Liu CF, Zhu JT, Hu H. Relationship between sarcopenic obesity and cognitive function in patients with mild to moderate Alzheimer's disease. Psychogeriatrics 2023; 23:944-953. [PMID: 37652079 DOI: 10.1111/psyg.13015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 08/16/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Previous research has linked sarcopenic obesity (SO) to cognitive function; however, the relationship between cognitive performance and SO Alzheimer's disease (AD) patients remains unclear. This study aimed to investigate their relationship in AD patients. METHODS One hundred and twenty mild to moderate AD patients and 56 normal controls were recruited. According to sarcopenia or obesity status, AD patients were classified into subgroups: normal, obesity, sarcopenia, and SO. Body composition, demographics, and sarcopenia parameters were assessed. Cognitive performance was evaluated using neuropsychological scales. RESULTS Among the 176 participants, the prevalence of SO in the moderate AD group was higher than in the normal control group. The moderate AD group had the lowest appendicular skeletal muscle mass index (ASMI) and the highest percentage of body fat (PBF). Hypertension and diabetes were more prevalent in the SO group than in the normal group among the subgroups. The sarcopenia and SO groups exhibited worse global cognitive function compared to the normal and obesity groups. Partial correlation analysis revealed that ASMI, PBF, and visceral fat area were associated with multiple cognitive domains scores. In logistic regression analysis, after adjusting for confounders, obesity was not found to be associated with AD. However, sarcopenia (odds ratio (OR) = 5.35, 95% CI: 1.27-22.46) and SO (OR = 5.84, 95% CI: 1.26-27.11) were identified as independent risk factors for AD. CONCLUSIONS SO was associated with cognitive dysfunction in AD patients. Moreover, the impact of SO on cognitive decline was greater than that of sarcopenia. Early identification and intervention for SO may have a positive effect on the occurrence and progression of AD.
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Affiliation(s)
- Xiao-Fen Weng
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Geriatric Medicine, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Shan-Wen Liu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Meng Li
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yu Zhang
- School of Life Sciences and Technology, Changchun University of Science and Technology, Changchun, China
| | - Ying-Chun Zhang
- Department of Ultrasonography, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Chun-Feng Liu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jiang-Tao Zhu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Hua Hu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
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Wang Z, Zhou X, Deng M, Yin Y, Li Y, Zhang Q, Bian Y, Miao J, Li J, Hou G. Clinical impacts of sarcopenic obesity on chronic obstructive pulmonary disease: a cross-sectional study. BMC Pulm Med 2023; 23:394. [PMID: 37853348 PMCID: PMC10585792 DOI: 10.1186/s12890-023-02702-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Sarcopenia and obesity are two abnormal body composition phenotypes, and sarcopenic obesity (SO) is characterized by both low skeletal muscle mass (sarcopenia) and high adiposity (obesity). SO negatively influences the clinical status of patients with chronic obstructive pulmonary disease (COPD). However, the studies exploring the prevalence and clinical effects of SO in COPD patients are limited. Our study aimed to elucidate the prevalence and impact of SO on COPD patients. METHODS In this cross-sectional study, the pulmonary function, St. George's Respiratory Questionnaire, exercise tolerance, body composition, and serum levels of resistin and TNF-α were assessed in 198 COPD patients. The clinical value of serum resistin and TNF-α for predicting SO in patients with COPD was evaluated. RESULTS In the 198 patients with COPD, the prevalence rates of sarcopenia, obesity, and SO in COPD patients were 27.27%, 29.8%, and 9.6%, respectively. Patients with SO experienced more severe symptoms of dyspnea and worse health related quality of life. The expression of resistin increased in patients with SO compared to other patients. The AUC value of serum resistin level for predicting SO was 0.870 (95% CI: 0.799-0.940). BMI (OR: 1.474, 95% CI: 1.124-1.934) and resistin (OR: 1.001, 95% CI: 1.000-1.002) levels were independent risk factors of SO in patients with COPD in Multivariate analysis. CONCLUSION The prevalence rates of SO in COPD patients was 9.6%. COPD accompanied by SO is significantly associated with worse pulmonary function and poor physical performance. Serum resistin may be a potential adjunct for predicting SO in COPD patients.
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Affiliation(s)
- Zilin Wang
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoming Zhou
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College, Fuwai Hospital, Chinese Academy of Medical Sciences, Disease, Beijing, China
| | - Mingming Deng
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Yan Yin
- Department of Pulmonary and Critical Care Medicine, First Hospital of China Medical University, Shenyang, China
| | - Yanxia Li
- Respiratory Department, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qin Zhang
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Yiding Bian
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jinrui Miao
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Jiaye Li
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Gang Hou
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
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Qu Q, Guo Q, Sun J, Lu X, Cheang I, Zhu X, Yao W, Li X, Zhang H, Zhou Y, Liao S, Gao R. Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate. BMC Geriatr 2023; 23:619. [PMID: 37789259 PMCID: PMC10546679 DOI: 10.1186/s12877-023-04326-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND The influence of sarcopenic obesity (SO) on overall survival in older adults with hypertension has not been addressed. The aim of this study was to investigate the prevalence and mortality predictive value of various body composition phenotypes, focusing mainly on SO, in older adults with hypertension. METHODS We included 1105 hypertensive patients aged ≥ 60 years from the National Health and Nutrition Examination Survey 1999-2004. Sarcopenia was broadly defined based on low lean mass (LLM; as measured by dual-energy X-ray absorptiometry), and was defined using appendicular lean mass (ALM) divided by height squared (ALM/height2), weight (ALM/weight), and body mass index (BMI; ALM/BMI), respectively. Obesity was defined as BMI ≥ 30 kg/m2, body fat percentage ≥ 30/42%, or waist circumference ≥ 102/88 cm. The prevalence of LLM with obesity was estimated according to each ALM index (ALMI). Multivariable Cox regression analysis and sensitivity analysis were used to examine the association between various body composition phenotypes and all-cause mortality. RESULTS In older adults with hypertension, the prevalence of LLM with obesity by the ALM/height2 index (9.8%) was lower relative to the ALM/weight (11.7%) and ALM/BMI indexes (19.6%). After a median follow-up of 15.4 years, 642 deaths occurred. In the fully adjusted models, LLM with obesity was significantly associated with a higher risk of all-cause mortality (hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.14-2.49, P = 0.008; HR 1.48, 95% CI 1.04-2.10, P = 0.028; HR 1.30, 95% CI 1.02-1.66, P = 0.037; respectively) compared with the normal body phenotype, with no statistical differences found in individuals with LLM or obesity alone. Sensitivity analysis confirmed the robustness of the results. CONCLUSIONS The prevalence of LLM with obesity markedly differed in older adults with hypertension according to the 3 different ALMIs, varying from 9.8%, 11.7%, to 19.6%. Patients with both LLM and obesity had a higher risk of all-cause mortality. Further large, prospective, cohort studies are warranted to validate these findings and uncover underlying mechanisms.
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Affiliation(s)
- Qiang Qu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qixin Guo
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Jinyu Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xinyi Lu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Iokfai Cheang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xu Zhu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Wenming Yao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xinli Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Haifeng Zhang
- Department of Cardiology, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, 26 Daoqian Street, Suzhou, 215002, China
- Department of Cardiology, Jiangsu Province Hospital, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yanli Zhou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Shengen Liao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
| | - Rongrong Gao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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Aguas-Ayesa M, Yárnoz-Esquíroz P, Olazarán L, Gómez-Ambrosi J, Frühbeck G. Precision nutrition in the context of bariatric surgery. Rev Endocr Metab Disord 2023; 24:979-991. [PMID: 36928810 PMCID: PMC10020075 DOI: 10.1007/s11154-023-09794-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 03/17/2023]
Abstract
Bariatric surgery (BS) is the most effective long-term treatment for severe obesity. This review summarizes the main nutritional deficiencies before and after BS, as well as current dietary and supplementation recommendations to avoid them. Likewise, we have reviewed all those aspects that in recent years have been shown to be related to postoperative weight loss (WL) and its subsequent maintenance, such as hormonal changes, dietary patterns, changes in food preference, adherence to recommendations and follow-up, genetic factors and microbiota, among others. Despite all the knowledge, nutritional deficiencies and weight regain after BS are frequent. It is essential to continue studying in this field in order to establish more precise recommendations according to the individual characteristics of patients. It is also a major objective to understand more deeply the role of the factors involved in WL and its maintenance. This will allow the development of precision treatments and nutrition for patients with obesity, optimizing their benefit after BS.
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Affiliation(s)
- Maite Aguas-Ayesa
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, 31008, Pamplona, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 31008, Pamplona, Spain.
| | - Patricia Yárnoz-Esquíroz
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, 31008, Pamplona, Spain
- Navarra Institute for Health Research, 31008, IdiSNA, Pamplona, Spain
| | - Laura Olazarán
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, 31008, Pamplona, Spain
- Navarra Institute for Health Research, 31008, IdiSNA, Pamplona, Spain
| | - Javier Gómez-Ambrosi
- Navarra Institute for Health Research, 31008, IdiSNA, Pamplona, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 31008, Pamplona, Spain
- Metabolic Research Laboratory, Clínica Universidad de Navarra, 31008, Pamplona, Spain
| | - Gema Frühbeck
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, 31008, Pamplona, Spain.
- Navarra Institute for Health Research, 31008, IdiSNA, Pamplona, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 31008, Pamplona, Spain.
- Metabolic Research Laboratory, Clínica Universidad de Navarra, 31008, Pamplona, Spain.
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Salmón-Gómez L, Catalán V, Frühbeck G, Gómez-Ambrosi J. Relevance of body composition in phenotyping the obesities. Rev Endocr Metab Disord 2023; 24:809-823. [PMID: 36928809 PMCID: PMC10492885 DOI: 10.1007/s11154-023-09796-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
Obesity is the most extended metabolic alteration worldwide increasing the risk for the development of cardiometabolic alterations such as type 2 diabetes, hypertension, and dyslipidemia. Body mass index (BMI) remains the most frequently used tool for classifying patients with obesity, but it does not accurately reflect body adiposity. In this document we review classical and new classification systems for phenotyping the obesities. Greater accuracy of and accessibility to body composition techniques at the same time as increased knowledge and use of cardiometabolic risk factors is leading to a more refined phenotyping of patients with obesity. It is time to incorporate these advances into routine clinical practice to better diagnose overweight and obesity, and to optimize the treatment of patients living with obesity.
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Affiliation(s)
- Laura Salmón-Gómez
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Irunlarrea 1, Pamplona, 31008, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
| | - Victoria Catalán
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Irunlarrea 1, Pamplona, 31008, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Pamplona, Spain
| | - Gema Frühbeck
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Irunlarrea 1, Pamplona, 31008, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Pamplona, Spain
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Javier Gómez-Ambrosi
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Irunlarrea 1, Pamplona, 31008, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain.
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Pamplona, Spain.
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Fonfría-Vivas R, Pérez-Ros P, Barrachina-Igual J, Pablos-Monzó A, Martínez-Arnau FM. Assessing quality of life with SarQol is useful in screening for sarcopenia and sarcopenic obesity in older women. Aging Clin Exp Res 2023; 35:2069-2079. [PMID: 37442906 PMCID: PMC10520098 DOI: 10.1007/s40520-023-02488-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Health-related quality of life (HRQoL) may be impaired in the presence of sarcopenia. Since a specific quality of life questionnaire became available for sarcopenia (SarQol), cutoffs to screen for this condition have been proposed, prompting the need to assess them in different populations. Due to the lack of consensus on diagnostic criteria, the tool has not yet been analyzed in screening for sarcopenic obesity. AIM Our aim is to measure the SarQoL's metric properties and establish a cutoff in QoL assessments that could be used along the diagnostic pathway for sarcopenia and sarcopenic obesity in community-dwelling older women. METHODS This cross-sectional study assessed women aged ≥ 70 years using the SarQol, sarcopenia criteria (EWGSOP2) and sarcopenic obesity criteria (ESPEN/EASO). Cutoffs for the SarQol were defined with a receiver-operating characteristics (ROC) curve, and sensitivity and specificity were analyzed. RESULTS Of the 95 included women (mean age 76.0 years, standard deviation [SD] 5.7), 7.3% (n = 7) were classified as having sarcopenic obesity, 22.1% (n = 21) as having sarcopenia, and 70.5% (n = 67) as not having sarcopenia. The total SarQol score was higher in women without sarcopenia (66.5 SD 16.2) versus those with sarcopenia (56.6 SD 15.6) and sarcopenic obesity (45.1 SD 7.9). A cutoff of ≤ 60 points is proposed for sarcopenia screening (area under the ROC curve [AUC] 0.67; 95% confidence interval [CI] 0.53-0.80; sensitivity 61.9%; specificity 62%), and ≤ 50 points for sarcopenic obesity (AUC 0.85; 95% CI 0.74-0.95; sensitivity 71.4%; specificity 76.9%). CONCLUSIONS Quality of life is compromised in women with sarcopenia and especially in those with sarcopenic obesity. The SarQol could be useful in screening for these conditions, providing insight into health-related quality of life in older people with sarcopenia.
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Affiliation(s)
- Rosa Fonfría-Vivas
- Department of Nursing, Universitat de València, Av. Menendez Pelayo 19, 46010, Valencia, Spain
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Menéndez I Pelayo, 19, 46010, Valencia, Spain
| | - Pilar Pérez-Ros
- Department of Nursing, Universitat de València, Av. Menendez Pelayo 19, 46010, Valencia, Spain.
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Menéndez I Pelayo, 19, 46010, Valencia, Spain.
| | - Joaquín Barrachina-Igual
- Faculty of Physical Activity and Sport Sciences, Universidad Católica de Valencia San Vicente Mártir, Ramiro de Maetzu 14, 46900, Torrent, Valencia, Spain
| | - Ana Pablos-Monzó
- Faculty of Physical Activity and Sport Sciences, Universidad Católica de Valencia San Vicente Mártir, Ramiro de Maetzu 14, 46900, Torrent, Valencia, Spain
| | - Francisco M Martínez-Arnau
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Menéndez I Pelayo, 19, 46010, Valencia, Spain
- Department of Physiotherapy, Universitat de Valencia, Gascó Oliag 5, 46010, Valencia, Spain
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Şahin MEH, Akbaş F, Yardimci AH, Şahin E. The effect of sarcopenia and sarcopenic obesity on survival in gastric cancer. BMC Cancer 2023; 23:911. [PMID: 37770828 PMCID: PMC10537530 DOI: 10.1186/s12885-023-11423-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Sarcopenic obesity arises from increased muscle catabolism triggered by inflammation and inactivity. Its significance lies in its role in contributing to morbidity and mortality in gastric cancer. This study aims to explore the potential correlation between sarcopenia, sarcopenic obesity, and gastric cancer, as well as their effect on survival. MATERIALS AND METHODS This retrospective study included 162 patients aged ≥ 18 years who were diagnosed with stomach cancer. Patient age, gender, diagnostic laboratory results, and cancer characteristics were documented. Sarcopenia was assessed using the skeletal muscle index (SMI) (cm2/m2), calculated by measuring muscle mass area from a cross-sectional image at the L3 vertebra level of computed tomography (CT). RESULTS Among the 162 patients, 52.5% exhibited sarcopenia (with cut-off limits of 52.4 cm2/m2 for males and 38.5 cm2/m2 for females), and 4.9% showed sarcopenic obesity. Average skeletal muscle area (SMA) was 146.8 cm2; SMI was 50.6 cm2/m2 in men and 96.9 cm2 and 40.6 cm2/m2 in women, respectively. Sarcopenia significantly reduced mean survival (p = 0.033). There was no association between sarcopenic obesity and mortality (p > 0.05), but mortality was higher in sarcopenic obesity patients (p = 0.041). Patient weight acted as a protective factor against mortality, supporting the obesity paradox. Tumor characteristics, metabolic parameters, and concurrent comorbidities did not significantly impact sarcopenia or mortality. CONCLUSION Sarcopenia is more prevalent in the elderly population and is linked to increased mortality in gastric cancer patients. Paradoxically, higher body mass index (BMI) was associated with improved survival. Computed tomography offers a practical and reliable method for measuring muscle mass and distinguishing these distinctions. TRIAL REGISTRATION This study was approved by Istanbul Training and Research Hospital Clinical Research Ethics Committee of the University of Health Sciences (29.05.2020/2383).
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Affiliation(s)
| | - Feray Akbaş
- Department of Internal Medicine, University of Health Sciences, İstanbul Training and Research Hospital, 34098, Fatih, Istanbul, Turkey
| | - Aytul Hande Yardimci
- Aytul Hande Yardimci, Department of Radiology, University of Health Sciences, Başakşehir Cam and Sakura City Hospital, 34480, Başakşehir, Istanbul, Turkey
| | - Eren Şahin
- Faculty of Medicine, Department of Medical Oncology, Akdeniz University, 07070, Konyaaltı, Antalya, Turkey
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Scott D, Blyth F, Naganathan V, Le Couteur DG, Handelsman DJ, Waite LM, Hirani V. Sarcopenia prevalence and functional outcomes in older men with obesity: Comparing the use of the EWGSOP2 sarcopenia versus ESPEN-EASO sarcopenic obesity consensus definitions. Clin Nutr 2023; 42:1610-1618. [PMID: 37481869 DOI: 10.1016/j.clnu.2023.07.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND & AIMS The potential for older adults with obesity to also have sarcopenia, and the health consequences of 'sarcopenic obesity', may be underappreciated by health professionals. The primary aim of this secondary analysis of a prospective cohort study of older men was to explore the prevalence and functional outcomes of sarcopenic obesity based on different consensus definitions. METHODS 1416 community-dwelling men aged ≥70 years were classified into sarcopenia categories according to the European Working Group on Sarcopenia in Older People (EWGSOP2) definition, and sarcopenic obesity categories according to the European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity (ESPEN-EASO) definition. Descriptive analyses determined prevalence of sarcopenia in obese and non-obese older men. Multivariable analyses compared associations with functional outcomes including activity of daily living (ADL) and instrumental activity of daily living (IADL) disability and 12-month incident falls. RESULTS According to the EWGSOP2 definition, 12.6% of men had confirmed sarcopenia but only 0.3% of men had sarcopenia and obesity (BMI ≥30 kg/m2). Conversely, 9.6% of men had sarcopenic obesity according to the ESPEN-EASO definition. Notably, no men with a BMI ≥32 kg/m2 were classified as having EWGSOP2-confirmed sarcopenia, despite the fact that 60.8% of all men with BMI ≥32 kg/m2 had low muscle strength. Due to low numbers (N = 4) of obese older men with EWGSOP2-confirmed sarcopenia, associations with functional outcomes were not assessed. Men with sarcopenic obesity according to the ESPEN-EASO definition had significantly lower hand grip strength, higher chair-stands time and slower gait speed (all P < 0.05), increased odds for ADL (odds ratio: 5.02, 95% CI: 1.85-13.58) and IADL (2.18, 1.38-3.45) disability, and higher 12-month incident falls rates (incident rate ratio: 1.59, 95% CI: 1.03-2.44) than men with neither sarcopenia nor obesity. CONCLUSION Low muscle strength is common in older men with obesity, but the prevalence of sarcopenia is likely to be underestimated when the EWGSOP2 operational definition is applied in this population. The ESPEN-EASO operational definition of sarcopenic obesity appears to provide a valid approach for identifying older men with obesity who are at risk of poor functional outcomes related to sarcopenia.
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Affiliation(s)
- David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
| | - Fiona Blyth
- School of Public Health, University of Sydney, New South Wales, Sydney, Australia; Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia
| | - Vasi Naganathan
- Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia
| | - David G Le Couteur
- Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; ANZAC Research Institute & Charles Perkins Centre, University of Sydney, New South Wales, Sydney, Australia
| | - David J Handelsman
- Department of Andrology, Concord Hospital & ANZAC Research Institute, University of Sydney, New South Wales, Sydney, Australia
| | - Louise M Waite
- Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia
| | - Vasant Hirani
- School of Public Health, University of Sydney, New South Wales, Sydney, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia
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Reiter L, Bauer S, Traxler M, Schoufour JD, Weijs PJM, Cruz-Jentoft A, Topinková E, Eglseer D. Effects of Nutrition and Exercise Interventions on Persons with Sarcopenic Obesity: An Umbrella Review of Meta-Analyses of Randomised Controlled Trials. Curr Obes Rep 2023; 12:250-263. [PMID: 37249818 PMCID: PMC10482763 DOI: 10.1007/s13679-023-00509-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Sarcopenic obesity (SO) is an increasing phenomenon and has been linked to several negative health consequences. The aim of this umbrella review is the assessment of effectiveness and certainty of evidence of nutrition and exercise interventions in persons with SO. METHOD We searched for meta-analyses of RCTs in PubMed, EMBASE and CENTRAL that had been conducted in the last five years, focusing on studies on the treatment and prevention of SO. The primary endpoints were parameters for SO, such as body fat in %, skeletal muscle mass index (SMMI), gait speed, leg strength and grip strength. The methodological quality was evaluated using AMSTAR and the certainty of evidence was assessed using GRADE. RESULTS Four systematic reviews with between 30 to 225 participants were included in the umbrella review. These examined four exercise interventions, two nutrition interventions and four interventions that combined nutrition and exercise. Resistance training was the most frequently studied intervention and was found to improve gait speed by 0.14 m/s to 0.17 m/s and lower leg strength by 9.97 kg. Resistance, aerobic, mixed exercise and hypocaloric diet combined with protein supplementation is not significantly effective on selected outcomes for persons with SO compared to no intervention. The low number of primary studies included in the reviews resulted in moderate to very low certainty of evidence. CONCLUSION Despite the lack in certainty of evidence, resistance training may be a suitable intervention for persons with SO, in particular for improving muscle function. Nevertheless, further research is necessary to strengthen the evidence.
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Affiliation(s)
- Lea Reiter
- Medical University of Graz, Institute of Nursing Science, Neue Stiftingtalstraße 6 West, P/06, 8010, Graz, Austria
| | - Silvia Bauer
- Medical University of Graz, Institute of Nursing Science, Neue Stiftingtalstraße 6 West, P/06, 8010, Graz, Austria
| | - Mariella Traxler
- Medical University of Graz, Institute of Nursing Science, Neue Stiftingtalstraße 6 West, P/06, 8010, Graz, Austria
| | - Josje D Schoufour
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Dr. Meurerhuis, Dokter Meurerlaan 8, 1067 SM, Amsterdam, Netherlands
| | - Peter J M Weijs
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Dr. Meurerhuis, Dokter Meurerlaan 8, 1067 SM, Amsterdam, Netherlands
- Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Amsterdam Public Health Institute, VU University, Amsterdam, Netherlands
| | - Alfonso Cruz-Jentoft
- Servicio de Geriatría, Hospital Universitario Ramón Y Cajal (IRYCIS), Ctra. Colmenar Viejo, 28034, Madrid, Spain
| | - Eva Topinková
- Charles University Department of Geriatric Medicine, First Faculty of Medicine, Londynska 15, Praha 2, 120 00, Prague, Czech Republic
| | - Doris Eglseer
- Medical University of Graz, Institute of Nursing Science, Neue Stiftingtalstraße 6 West, P/06, 8010, Graz, Austria.
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Saino Y, Kawase F, Nagano A, Ueshima J, Kobayashi H, Murotani K, Inoue T, Nagami S, Suzuki M, Maeda K. Diagnosis and prevalence of sarcopenic obesity in patients with colorectal cancer: A scoping review. Clin Nutr 2023; 42:1595-1601. [PMID: 37480796 DOI: 10.1016/j.clnu.2023.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND & AIMS Sarcopenic obesity (SO) is associated with worse outcomes in patients with colorectal cancer (CRC); however, the diagnostic methods and prevalence of SO vary among studies. Therefore, we conducted this scoping review to investigate the diagnosis of SO in CRC, identify the associated problems, and determine its prevalence. METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guidelines. A literature search was performed by two independent reviewers on studies that diagnosed SO in CRC using the MEDLINE, EMBASE, CINAHL, CENTRAL, Web of Science, and Ichushi-Web (in Japanese) databases. Observational, longitudinal, cross-sectional, and clinical trials written in English or Japanese as of July 2022 were included. Studies that did not define SO were excluded from the analysis. The study protocol was pre-registered in Figshare. RESULTS In total, 670 studies were identified, 22 of which were included. Eighteen studies used sarcopenia in combination with obesity to diagnose SO. Sarcopenia was mainly diagnosed using skeletal muscle mass index (SMI), and only one combined with grip strength or gait speed. Obesity was diagnosed based on the body mass index (BMI; n = 11), followed by visceral fat area (VFA; n = 5). The overall prevalence of SO in patients with CRC was 15% (95%CI, 11-21%). The prevalence of SO in surgical resection and colorectal cancer liver metastases was 18% (95%CI, 12-25%) and 11% (95%CI, 3-36%), respectively. CONCLUSIONS SO in patients with CRC was mainly diagnosed based on a combination of SMI and BMI, and muscle strength and body composition were rarely evaluated. The prevalence of SO was approximately 15%, depending on the diagnostic methods used. Since SO in patients with CRC is associated with poor prognosis, further research on diagnostic methods for the early detection of SO and its clinical outcomes is needed.
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Affiliation(s)
- Yoko Saino
- Department of Clinical Nutrition, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto, Tokyo 135-8550, Japan; Department of Nutrition and Metabolism, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
| | - Fumiya Kawase
- Department of Nutrition, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 20 Nakata, Yagami-cho, Toyota, Aichi 444-2351, Japan.
| | - Ayano Nagano
- Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, 11-1 Imazuyamanaka-cho, Nishinomiya, Hyogo 663-8211, Japan.
| | - Junko Ueshima
- Department of Nutritional Service, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa, Tokyo 141-8625, Japan.
| | - Haruko Kobayashi
- General Incorporated Association Manabi Public Library, 306 Wakabadai, Meito, Nagoya, Aichi 465-0015, Japan.
| | - Kenta Murotani
- Biostatistics Center, Kurume University. 67, Asahimachi, Kurume, Fukuoka 830-0011, Japan.
| | - Tatsuro Inoue
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami, Kita-ku, Niigata 950-3198, Japan.
| | - Shinsuke Nagami
- Department of Speech-Language Pathology and Audiology, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama 701-0193, Japan.
| | - Mizue Suzuki
- Department of Rehabilitation, Faculty of Allied Health Sciences, Yamato University, 2-5-1 Katayama, Suita, Osaka 564-0082, Japan.
| | - Keisuke Maeda
- Nutrition Therapy Support Center, Aichi Medical University Hospital1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan.
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Chen D, Yuan Z, Guo Y, Mo W, Liu W, Liang D, Chen A, Zhang Y, Zhang N, Wei X. Prognostic Impact of Quantifying Sarcopenia and Adipopenia by Chest CT in Severe Aplastic Anemia Patients Treated With Allogeneic Hematopoietic Stem Cell Transplantation. Acad Radiol 2023; 30:1936-1945. [PMID: 36379814 DOI: 10.1016/j.acra.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/24/2022] [Accepted: 10/17/2022] [Indexed: 11/15/2022]
Abstract
RATIONALE AND OBJECTIVES To investigate the prognostic role of chest CT-defined sarcopenia and adipopenia in severe aplastic anemia (SAA) patients treated with hematopoietic stem cell transplantation (HSCT). MATERIALS AND METHODS This was a retrospective study of 123 consecutive SAA patients treated with HSCT. CT imaging was performed to quantify the pectoralis muscle (including major and minor) index (PMI) and the corresponding subcutaneous adipose tissue index (SAI). Sarcopenia and adipopenia were defined as PMI and SAI lower than the respective sex-specific medians. Correlations of the PMI and SAI with anthropometric indexes were calculated. Transplant-related outcomes were compared between the sarcopenia and adipopenia groups. Prognostic factors for overall survival (OS) and fail-free survival (FFS) were identified by Cox regression and were used to create a nomogram. The accuracy of the nomogram was evaluated by ROC curves. RESULTS PMI showed good correlation with BMI and fat-free mass index (p < 0.001). SAI correlated with BMI and fat mass index (p < 0.001). The sarcopenia group (47.2%) had a significantly worse 3-year OS (90.8% vs. 77.6%, p = 0.045) and 3-year FFS (89.2% vs. 74.1%, p = 0.035) than the nonsarcopenia group. Sarcopenia status and diagnostic category were used to construct the nomogram of OS, as these were independent prognostic factors in the multivariate analysis for OS and FFS (p < 0.05). The area under the curve of the nomogram at one year and three years was 0.801 and 0.721, respectively. CONCLUSION Sarcopenia indicates a poor prognosis in SAA patients undergoing HSCT. Intensive supportive care is suggested for SAA patients with sarcopenia before transplantation.
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Affiliation(s)
- Dandan Chen
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Rd, Yuexiu District, Guangzhou, 510180, Guangdong, China; First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, China
| | - Zhaohu Yuan
- Department of Blood Transfusion, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Yuan Guo
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Rd, Yuexiu District, Guangzhou, 510180, Guangdong, China
| | - Wenjian Mo
- Department of Hematology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Weifeng Liu
- Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Dan Liang
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Rd, Yuexiu District, Guangzhou, 510180, Guangdong, China
| | - Amei Chen
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Rd, Yuexiu District, Guangzhou, 510180, Guangdong, China
| | - Yan Zhang
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Rd, Yuexiu District, Guangzhou, 510180, Guangdong, China
| | - Nianru Zhang
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Rd, Yuexiu District, Guangzhou, 510180, Guangdong, China
| | - Xinhua Wei
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Rd, Yuexiu District, Guangzhou, 510180, Guangdong, China; First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, China.
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Chen Z, Laurentius T, Fait Y, Müller A, Mückter E, Hao D, Bollheimer LC, Nourbakhsh M. Sex-Specific Associations between Serum IL-16 Levels and Sarcopenia in Older Adults. Nutrients 2023; 15:3529. [PMID: 37630720 PMCID: PMC10459512 DOI: 10.3390/nu15163529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Epidemiological studies of older adults have suggested a differential sex-specific prevalence of sarcopenia, which is a condition characterized by a progressive loss of skeletal muscle mass and function. Recently, we collected serum samples from 80 fully evaluated older adults and identified CXCL12α as a sex-independent serum marker of sarcopenia. Here, we used this serum collection to find potential sex-specific serum markers via the simultaneous quantification of 34 inflammatory cytokines/chemokines. The appendicular skeletal muscle index (ASMI) was used as a decisive criterion for diagnosing sarcopenia. A Pearson correlation analysis revealed a negative correlation between ASMI and serum IL-16 in females only (p = 0.021). Moreover, women with sarcopenia exhibited significantly higher IL-16 (p = 0.025) serum levels than women in a control group. In contrast, males with sarcopenia had lower IL-16 (p = 0.013) levels than males in a control group. The further use of Fisher's exact test identified obesity (p = 0.027) and high serum levels of IL-16 (p = 0.029) as significant risk factors for sarcopenia in females. In male older adults, however, malnutrition (p = 0.028) and low serum levels of IL-16 (p = 0.031) were the most significant risk factors for sarcopenia. The differential sex-specific associations of IL-16 in older adults may contribute to the development of more precise regression models for future research and elucidate the role of IL-16 in the progression of sarcopenic obesity.
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Affiliation(s)
| | | | | | | | | | | | | | - Mahtab Nourbakhsh
- Department of Geriatric Medicine, RWTH Aachen University Hospital, 52074 Aachen, Germany; (Z.C.); (T.L.); (Y.F.); (A.M.); (E.M.); (D.H.); (L.C.B.)
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Torres-Costoso A, Martínez-Vizcaíno V, Baptista F, Reina-Gutiérrez S, Núñez de Arenas-Arroyo S, Hernández-Castillejo LE, Garrido-Miguel M. Body composition phenotypes and bone health in young adults: A cluster analysis. Clin Nutr 2023; 42:1161-1167. [PMID: 37244756 DOI: 10.1016/j.clnu.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 04/12/2023] [Accepted: 05/08/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND AND AIMS Lean mass is considered the best predictor of bone mass, as it is an excellent marker of bone mechanical stimulation, and changes in lean mass are highly correlated with bone outcomes in young adults. The aim of this study was to use cluster analysis to examine phenotype categories of body composition assessed by lean and fat mass in young adults and to assess how these body composition categories are associated with bone health outcomes. METHODS Cluster cross-sectional analyses of data from 719 young adults (526 women) aged 18-30 years from Cuenca and Toledo, Spain, were conducted. Lean mass index (lean mass (kg)/height (m)2), fat mass index (fat mass (kg)/height (m)2), bone mineral content (BMC) and areal bone mineral density (aBMD) were assessed by dual-energy X-ray absorptiometry. RESULTS A cluster analysis of lean mass and fat mass index z scores resulted in a classification of a five-category cluster solution that could be interpreted according to the body composition phenotypes of individuals as follows: high adiposity-high lean mass (n = 98), average adiposity-high lean mass (n = 113), high adiposity-average lean mass (n = 213), low adiposity-average lean mass (n = 142), and average adiposity-low lean mass (n = 153). ANCOVA models showed that individuals in clusters with a higher lean mass had significantly better bone health (z score: 0.764, se: 0.090) than their peers in other cluster categories (z score: -0.529, se: 0.074) after controlling for sex, age, and cardiorespiratory fitness (p < 0.05). Additionally, subjects belonging to the categories with a similar average lean mass index but with high or low-adiposity levels (z score: 0.289, se: 0.111; z score: 0.086, se: 0.076) showed better bone outcomes when the fat mass index was higher (p < 0.05). CONCLUSIONS This study confirms the validity of a body composition model using a cluster analysis to classify young adults according to their lean mass and fat mass indices. In addition, this model reinforces the main role of lean mass on bone health in this population and that in phenotypes with high-average lean mass, factors associated with fat mass may also have a positive effect on bone status.
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Affiliation(s)
- Ana Torres-Costoso
- Universidad de Castilla-La Mancha, Facultad de Fisioterapia y Enfermería, Toledo, Spain; Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile.
| | - Fátima Baptista
- Department of Sports and Health, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Sara Reina-Gutiérrez
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | | | | | - Miriam Garrido-Miguel
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain; Universidad de Castilla-La Mancha, Facultad de Enfermería de Albacete, Albacete, Spain
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Simó-Servat A, Guevara E, Perea V, Alonso N, Quirós C, Puig-Jové C, Barahona MJ. Role of Muscle Ultrasound for the Study of Frailty in Elderly Patients with Diabetes: A Pilot Study. BIOLOGY 2023; 12:884. [PMID: 37372168 DOI: 10.3390/biology12060884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/29/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Sarcopenia and diabetes contribute to the development of frailty. Therefore, accessible methods, such as muscle ultrasounds (MUSs), to screen for sarcopenia should be implemented in clinical practice. METHODS We conducted a cross-sectional pilot study including 47 patients with diabetes (mean age: 77.72 ± 5.08 years, mean weight: 75.8 kg ± 15.89 kg, and body mass index: 31.19 ± 6.65 kg/m2) categorized as frail by the FRAIL Scale or Clinical Frailty Scale and confirmed by Fried's Frailty Phenotype or Rockwood's 36-item Frailty Index. We used the SARC-F questionnaire to identify sarcopenia. The Short Physical Performance Battery (SPPB) and the Timed Up and Go (TUG) tests were used to assess physical performance and the risk of falls, respectively. In addition, other variables were measured: fat-free mass (FFM) and Sarcopenia Risk Index (SRI) with the bioimpedance analysis (BIA); thigh muscle thickness (TMT) of the quadriceps with MUS; and hand-grip strength with dynamometry. RESULTS We observed correlations between the SARC-F and FFM (R = -0.4; p < 0.002) and hand-grip strength (R = -0.5; p < 0.0002), as well as between the TMT and FFM of the right leg (R = 0.4; p < 0.02) and the SRI (R = 0.6; p < 0.0001). We could predict sarcopenia using a logistic regression model with a ROC curve (AUC = 0.78) including FFM, handgrip strength, and TMT. The optimal cut-off point for maximum efficiency was 1.58 cm for TMT (sensitivity = 71.4% and specificity = 51.5%). However, we did not observe differences in the TMT among groups of greater/less frailty based on the SARC-F, SPPB, and TUG (p > 0.05). CONCLUSIONS MUSs, which correlated with the BIA (R = 0.4; p < 0.02), complemented the diagnosis, identifying regional sarcopenia of the quadriceps in frail patients with diabetes and improving the ROC curve to AUC = 0.78. In addition, a TMT cut-off point for the diagnosis of sarcopenia of 1.58 cm was obtained. Larger studies to validate the MUS technique as a screening strategy are warranted.
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Affiliation(s)
- Andreu Simó-Servat
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
- Department of Medicine, Autonomous University of Barcelona, 08193 Barcelona, Spain
| | - Ernesto Guevara
- Department of Geriatrics, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
| | - Verónica Perea
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
| | - Núria Alonso
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
| | - Carmen Quirós
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
| | - Carlos Puig-Jové
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
| | - María-José Barahona
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
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Abstract
The obesity epidemic in aging populations poses significant public health concerns for greater morbidity and mortality risk. Age-related increased adiposity is multifactorial and often associated with reduced lean body mass. The criteria used to define obesity by body mass index in younger adults may not appropriately reflect age-related body composition changes. No consensus has been reached on the definition of sarcopenic obesity in older adults. Lifestyle interventions are generally recommended as initial therapy; however, these approaches have limitations in older adults. Similar benefits in older compared with younger adults are reported with pharmacotherapy, however, large randomized clinical trials in geriatric populations are lacking.
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Affiliation(s)
- Noemi Malandrino
- Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University School of Medicine, The Johns Hopkins University, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA
| | - Salman Z Bhat
- Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University School of Medicine, The Johns Hopkins University, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA
| | - Maha Alfaraidhy
- The Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA
| | - Rajvarun S Grewal
- California Health Sciences University - College of Osteopathic Medicine (CHSU-COM), 2500 Alluvial Avenue, Clovis, CA 93611, USA
| | - Rita Rastogi Kalyani
- Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University School of Medicine, The Johns Hopkins University, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA; Center on Aging and Health, The Johns Hopkins University, 2024 East Monument Street, Baltimore, MD 21205, USA.
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