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Zhang N, He J, Qu X, Kang L. Research Hotspots and Trends of Interventions for Sarcopenic Obesity: A Bibliometric Analysis. Cureus 2024; 16:e64687. [PMID: 39021741 PMCID: PMC11252088 DOI: 10.7759/cureus.64687] [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: 07/16/2024] [Indexed: 07/20/2024] Open
Abstract
Sarcopenic obesity, characterized by both obesity and sarcopenia, significantly impacts health and independence of affected individuals. There is an urgent need to explore effective strategies for addressing or preventing sarcopenic obesity. An initial critical step is to promptly assess the impact of academic research in this field, considering factors such as geographical regions, authors, journals, and institutions. It is also essential to analyze current trends and identify potential areas that may inspire future researchers to conduct further studies, ultimately improving public health outcomes for individuals with sarcopenic obesity. To achieve this, bibliometric research was conducted using the Web of Science Core Collection database to identify English language articles and reviews focusing on sarcopenic obesity interventions published between January 1, 2004, and June 15, 2024, followed by a literature review. A total of 929 English-language articles were collected, consisting of 645 research articles and 284 reviews. Research output in the field has shown significant growth since 2017, reaching a peak of 139 papers in 2022. The United States leads in publication output with 234 papers and a total of 13,971 citations, highlighting substantial international collaboration. Both the United States and Europe are recognized as key academic hubs for sarcopenic obesity intervention research, characterized by robust academic interactions. Moreover, there has been a notable increase in publication volume from China, South Korea, and Japan. Noteworthy authors in this field include Boirie Y from Université Clermont Auvergne in France, Prado CM from the University of Alberta in Canada, Cruz-Jentoft AJ from Hospital Universitario Ramon y Cajal in Spain, and Prado CM from the University of Alberta, known for their high citation count. The University of Alberta leads in the number of publications, while the University of Verona in Italy leads in citation frequency. Journals with higher publication volumes in sarcopenic obesity intervention include Nutrients, Clinical Nutrition, and Journal of Cachexia Sarcopenia and Muscle. Among the top 20 keywords, the most relevant interventions for sarcopenic obesity are exercise, nutrition, resistance training, physical activity, and muscle strength. The primary evidence currently available suggests that resistance training is the most effective method for enhancing muscle strength in sarcopenic obesity patients. Additionally, combining protein supplementation with resistance exercise has shown encouraging results in reducing fat mass in these individuals. To progress in this field, it is crucial to foster collaboration among countries, regions, and academic institutions, promoting multidisciplinary partnerships.
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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
| | - Jiarong He
- Department of Hemodialysis, Gansu Provincial People's Hospital, Lanzhou, CHN
| | - Xuan Qu
- Department of Geriatrics, 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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Deemer SE, Roberts BM, Smith DL, Plaisance EP, Philp A. Exogenous ketone esters as a potential therapeutic for treatment of sarcopenic obesity. Am J Physiol Cell Physiol 2024; 327:C140-C150. [PMID: 38766768 DOI: 10.1152/ajpcell.00471.2023] [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: 09/21/2023] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 05/22/2024]
Abstract
Identifying effective treatment(s) for sarcopenia and sarcopenic obesity is of paramount importance as the global population advances in age and obesity continues to be a worldwide concern. Evidence has shown that a ketogenic diet can be beneficial for the preservation of muscle quality and function in older adults, but long-term adherence is low due in part to the high-fat (≥80%), very low carbohydrate (<5%) composition of the diet. When provided in adequate amounts, exogenous ketone esters (KEs) can increase circulating ketones to concentrations that exceed those observed during prolonged fasting or starvation without significant alterations in the diet. Ketone esters first emerged in the mid-1990s and their use in preclinical and clinical research has escalated within the past 10-15 years. We present findings from a narrative review of the existing literature for a proposed hypothesis on the effects of exogenous ketones as a therapeutic for preservation of skeletal muscle and function within the context of sarcopenic obesity and future directions for exploration. Much of the reviewed literature herein examines the mechanisms of the ketone diester (R,S-1,3-butanediol diacetoacetate) on skeletal muscle mass, muscle protein synthesis, and epigenetic regulation in murine models. Additional studies are needed to further examine the key regulatory factors producing these effects in skeletal muscle, examine convergent and divergent effects among different ketone ester formulations, and establish optimal frequency and dosing regimens to translate these findings into humans.
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Affiliation(s)
- Sarah E Deemer
- Department of Kinesiology, Health Promotion & Recreation, University of North Texas, Denton, Texas, United States
| | - Brandon M Roberts
- US Army Research Institute of Environmental Medicine (USARIEM), Natick, Massachusetts, United States
| | - Daniel L Smith
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Eric P Plaisance
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Andrew Philp
- Centre for Healthy Ageing, Centenary Institute, Sydney, New South Wales, Australia
- School of Sport, Exercise and Rehabilitation Sciences, University of Technology Sydney, Sydney, New South Wales, Australia
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Lan L, Shao S, Zheng X. Associations between Sarcopenia and trajectories of activities of daily living disability: a nationwide longitudinal study of middle-aged and older adults in China from 2011 to 2018. Arch Public Health 2024; 82:97. [PMID: 38918853 PMCID: PMC11197329 DOI: 10.1186/s13690-024-01329-x] [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: 02/27/2024] [Accepted: 06/18/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Sarcopenia is an age-related clinical syndrome, which is associated with numerous adverse outcomes among older adults. The relationship between sarcopenia and activities of daily living (ADL) disability has been studied in China, but these findings usually focused on a single time point. The patterns of ADL can change over time and vary among individuals. Therefore, it is necessary to explore the association between sarcopenia and trajectories of ADL disability. METHODS According to Asian Working Group for Sarcopenia (AWGS) 2019 criteria, muscle mass, muscle strength, and physical performance measurements were measured to diagnose sarcopenia. A six-item ADL score was used to measure ADL disability, and trajectories of ADL disability were identified by the latent class trajectory modelling (LCTM). Multiple logistic regression models were performed to examine the association between sarcopenia and trajectories of ADL disability. RESULTS Among 9113 middle-aged and older adults, three trajectories of ADL disability were determined according to changes in ADL score during follow-up, including a mild-high trajectory (n = 648, 7.11%), followed by the low-mild trajectory (n = 3120, 34.24%) and low-low trajectory (n = 5345, 58.65%). After adjustment for covariates, severe sarcopenia was significantly associated with higher risks of being in the mild-high trajectory group (OR = 3.31, 95%CI: 2.10-5.22) and the low-mild trajectory group (OR = 1.44, 95%CI: 1.05-1.98), compared with the low-low trajectory group. This association was still observed when stratified by age and gender. In addition, participants with sarcopenic obesity were associated with a higher risk of ADL disability (OR = 3.99; 95% CI: 2.50-6.09). CONCLUSIONS Among the middle-aged and older Chinese adults, sarcopenia and sarcopenic obesity were both associated with persistent higher trajectories of ADL disability. It suggested that early interventions to sarcopenia and sarcopenic obesity among the middle-aged and older adults may reduce the progression of ADL disability.
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Affiliation(s)
- Lei Lan
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, China
| | - ShiMiao Shao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, China
| | - Xiaowei Zheng
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, Wuxi, Jiangsu Province, 214122, China.
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Zeng Y, He X, Peng X, Zhao L, Yin C, Mao S. Combined Nutrition with Exercise: Fueling the Fight Against Sarcopenia Through a Bibliometric Analysis and Review. Int J Gen Med 2024; 17:1861-1876. [PMID: 38715745 PMCID: PMC11075762 DOI: 10.2147/ijgm.s462594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/21/2024] [Indexed: 05/24/2024] Open
Abstract
Objective This bibliometric analysis and review aimed to examine the current research status and trends in the combination of nutrition and exercise training for sarcopenia. Additionally, it sought to provide researchers with future research directions in this field. Methods Relevant publications were obtained from the Web of Science Core Collection (WoSCC) database, covering the period from January 1995 to October 2023. The collected publications were analyzed using CiteSpace, VOSviewer, Bibliometrix, and Review Manager. Results Out of the 2528 retrieved publications, the United States emerged as the leading contributor in terms of publication volume. The University of Texas System was identified as the most productive institution. Luc J C van Loon emerged as the most published author in this field. Analysis of keywords revealed recent hot topics and emerging areas of interest, such as "gut microbiota" and "mechanisms". Upon further evaluation, resistance training (RT) and protein supplementation were identified as the most commonly employed and effective methods. Conclusion RT and protein supplementation are widely recognized as effective strategies. Future research should focus on investigating the molecular aspects of sarcopenia. Moreover, the potential therapeutic role of gut microbiota in sarcopenia requires further comprehensive investigation in human subjects to establish its correlation.
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Affiliation(s)
- Yixian Zeng
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, 100084, People’s Republic of China
| | - Xingfei He
- Wuxi Huishan District Rehabilitation Hospital, Wuxi, 214001, People’s Republic of China
| | - Xinchun Peng
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, 100084, People’s Republic of China
| | - Li Zhao
- School of Sports Science, Beijing Sport University, Beijing, 100084, People’s Republic of China
| | - Chengqian Yin
- Department of Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, People’s Republic of China
| | - Shanshan Mao
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, 100084, People’s Republic of China
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González Arnáiz E, Ariadel Cobo D, Estébanez B, Barajas Galindo D, Pintor de la Maza B, Urioste Fondo A, Dameto Pons C, Cuevas MJ, Ballesteros Pomar MD. Prevalence of sarcopenic obesity according to different diagnostic methods and cut-off points in candidates for bariatric surgery. Clin Nutr 2024; 43:1087-1093. [PMID: 38579371 DOI: 10.1016/j.clnu.2024.03.015] [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: 11/28/2023] [Revised: 02/26/2024] [Accepted: 03/22/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND AND AIMS Sarcopenic obesity (SO) is defined as a combination of low strength and muscle mass along with excess adiposity. Our study aimed to determine the prevalence of sarcopenic obesity in candidates for bariatric surgery, according to ESPEN/EASO criteria using bioimpedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). METHODS Retrospective study of adult patients (18-60 years) candidates for bariatric surgery (BMI ≥40 kg/m2 or ≥35 kg/m2 with associated complications). Adiposity was assessed by the percentage of fat mass by DXA, according to Gallagher's cut-off points. Muscle strength was measured by hand grip according to Sánchez-Torralvo, Dodds, and <-2SD cut-off points of healthy reference population. Muscle mass was determined by DXA (ALM/weight according to Batsis) and by BIA (SMM/weight according to Janssen and according to reference population). In addition, the agreement of the different diagnostic methods of sarcopenic obesity was analyzed. RESULTS A total of 124 subjects were included in the study, with 71.8 % being women. The overall mean age was 42.6 (SD 8.9) years. SO prevalence was found to be 13 %-22 % applying BIA with the SMM/weight equation according to Janssen, 14 %-23 % utilizing BIA with the SMM/weight equation according to the reference population, and 13 %-23 % employing DXA with the ALM/weight equation following Batsis criteria, depending on the specific hand grip strength cut-off points used. In general, we found good or very good concordances with the different diagnostic methods (with kappa values between 0.6 and 0.97). CONCLUSIONS The prevalence of SO according to ESPEN/EASO criteria in candidates for bariatric surgery was 13 %-23 % based on the diagnostic method and cut-off points used.
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Affiliation(s)
- Elena González Arnáiz
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia de Salud de Castilla y León (SACYL), Alto de Nava s/n, 24071 León, Spain; Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - Diana Ariadel Cobo
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia de Salud de Castilla y León (SACYL), Alto de Nava s/n, 24071 León, Spain; Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - Brisamar Estébanez
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - David Barajas Galindo
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia de Salud de Castilla y León (SACYL), Alto de Nava s/n, 24071 León, Spain
| | - Begoña Pintor de la Maza
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia de Salud de Castilla y León (SACYL), Alto de Nava s/n, 24071 León, Spain
| | - Ana Urioste Fondo
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia de Salud de Castilla y León (SACYL), Alto de Nava s/n, 24071 León, Spain
| | - Carmen Dameto Pons
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia de Salud de Castilla y León (SACYL), Alto de Nava s/n, 24071 León, Spain
| | - María J Cuevas
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - María D Ballesteros Pomar
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia de Salud de Castilla y León (SACYL), Alto de Nava s/n, 24071 León, Spain; Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain.
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6
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Zhu Y, Mierau JO, Bakker SJL, Dekker LH, Navis GJ. Sarcopenia augments the risk of excess weight on COVID-19 hospitalization: A prospective study using the Lifelines COVID-19 cohort. Nutrition 2024; 121:112361. [PMID: 38367316 DOI: 10.1016/j.nut.2024.112361] [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: 04/06/2023] [Revised: 11/20/2023] [Accepted: 01/15/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE We investigated the associations of sarcopenia alone, overweight or obesity, and sarcopenic overweight or obesity with COVID-19 hospitalization. METHODS Participants from the Lifelines COVID-19 cohort who were infected with COVID-19 were included in this study. Sarcopenia was defined as a relative deviation of muscle mass of ≤ -1.0 SD from the sex-specific mean 24-h urinary creatinine excretion. Overweight or obesity was defined as a body mass index ≥ 25 kg/m2. Sarcopenic overweight or obesity was defined as the presence of overweight or obesity and low muscle mass. COVID-19 hospitalization was self-reported. Logistic regression models were used to analyze the associations of sarcopenia alone, overweight or obesity, and sarcopenic overweight or obesity with COVID-19 hospitalization. RESULTS Of the 3594 participants infected with COVID-19 and recruited in this study, 173 had been admitted to the hospital. Compared with the reference group, individuals with overweight or obesity and sarcopenic overweight or obesity were 1.78-times and 2.09-times more likely to have been hospitalized for COVID-19, respectively, whereas sarcopenia alone did not increase the risk of COVID-19 hospitalization. CONCLUSIONS In this middle-aged population, sarcopenic overweight or obesity elevated the risk of hospitalization for COVID-19 in those infected with COVID-19 more than overweight or obesity alone. These data support the relevance of sarcopenic overweight or obesity as a risk factor beyond the geriatric setting and should be considered in risk stratification in future public health and vaccination campaigns.
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Affiliation(s)
- Yinjie Zhu
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, The Netherlands.
| | - Jochen O Mierau
- Team Strategy and External Relations, University of Groningen, University Medical Center Groningen, The Netherlands; Lifelines Cohort Study and Biobank, Groningen, The Netherlands; Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, The Netherlands
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Louise H Dekker
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Gerjan J Navis
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
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Chagnac A, Friedman AN. Measuring Albuminuria in Individuals With Obesity: Pitfalls of the Urinary Albumin-Creatinine Ratio. Kidney Med 2024; 6:100804. [PMID: 38576526 PMCID: PMC10993191 DOI: 10.1016/j.xkme.2024.100804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
An increased urinary albumin excretion rate is an important early risk factor for chronic kidney disease and other major outcomes and is usually measured using the urinary albumin-creatinine ratio (ACR). Obesity is highly prevalent in the general and chronic kidney disease populations and is an independent risk factor for moderately increased albuminuria (henceforth, moderate albuminuria). In this review, we describe how the ACR was developed and used to define moderate albuminuria. We then investigate how biases related to urinary creatinine excretion are introduced into the ACR measurement and how the use of the 30-mg/g threshold decreases the performance of the test in populations with higher muscle mass, with a primary focus on why and how this occurs in the obese population. The discussion then raises several strategies that can be used to mitigate such bias. This review provides a comprehensive overview of the medical literature on the uses and limitations of ACR in individuals with obesity and critically assesses related issues. It also raises into question the widely accepted 30-mg/g threshold as universally adequate for the diagnosis of moderate albuminuria. The implications of our review are relevant for clinicians, epidemiologists, and clinical trialists.
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Affiliation(s)
- Avry Chagnac
- Maccabi Healthcare Services, Ramat Hasharon Medical Center, Israel
| | - Allon N. Friedman
- Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN
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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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9
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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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10
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Akbas F, Usta Atmaca H, Yazici D. Dynapenic Abdominal Obesity and Metabolic Health in Non-Geriatric Patients with Obesity. Metab Syndr Relat Disord 2024; 22:77-83. [PMID: 37878298 DOI: 10.1089/met.2023.0153] [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] [Indexed: 10/26/2023] Open
Abstract
Background: Dynapenic abdominal obesity (DAO) is the combination of low muscle strength and high central adiposity, which can lead to functional and cardiometabolic impairments. Objective: The aim of this study was to examine the relationship between DAO and metabolic parameters in non-geriatric patients with obesity. Methods: All patients seen in the obesity outpatient clinic during a random month, along with 30 healthy individuals, were included in the study. Body mass index (BMI), waist circumference (WC), hip circumference (HC), serum fasting blood glucose, triglyceride, high-density lipoprotein, low-density lipoprotein (LDL), insulin, and glycated hemoglobin (HbA1c) levels were measured. Muscle function tests were conducted. Hypertension and diabetes mellitus diagnoses were recorded. DAO was determined using handgrip strength and WC. Metabolic syndrome was defined based on International Diabetes Federation (IDF) criteria. Data were analyzed using SPSS. Results: A total of 106 individuals participated in the study, including 76 individuals with obesity as the case group and 30 healthy individuals as the control group. In the case group, BMI, WC, HC, and chair stand test results were higher compared to the control group. There was no significant difference between the case and control groups in terms of gait speed or handgrip test results. In the case group, 30 people (39.5%) had dynapenic obesity (DO), and in the control group, 8 people (26.7%) had DO. There was no significant difference in DO rates between the case and control groups. In the case group, the HbA1c level was higher in DO (+) group than DO (-) group. In the control group, DO (+) group had higher LDL and HbA1c level than DO (-) group. No significant difference was observed in other search parameters between the DO (+) and DO (-) groups in both the case and control groups. Conclusion: DAO is common among people with obesity and contributes to a poor prognosis, increased morbidity, and mortality. Therefore, including its treatment in the management of obesity is crucial for individuals of all age ranges.
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Affiliation(s)
- Feray Akbas
- Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Hanife Usta Atmaca
- Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Dilek Yazici
- Department of Endocrinology and Metabolism, Koc University Medical School, Istanbul, Turkey
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11
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Janani S, Sedhunivas R. Effectiveness of exercise interventions on muscle mass among older adults with sarcopenic obesity: A scoping review. Aging Med (Milton) 2024; 7:115-120. [PMID: 38571676 PMCID: PMC10985769 DOI: 10.1002/agm2.12288] [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: 11/15/2023] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 04/05/2024] Open
Abstract
A disease known as sarcopenic obesity is characterized by decreased lean body mass in conjunction with excessive amounts of adipose tissue. Skeletal muscle mass, also known as SMM, is responsible for the largest share of fat-free mass in the body and plays an extremely vital role in the maintaining of metabolic health. Physical activity and exercise boosts the physiological health and overall quality of life of senior citizens. The objective of the study is to investigate the effectiveness of varied exercise interventions among the geriatric people with sarcopenic obesity. During the time period (2016-2023), a scoping review was undertaken using PubMed, orthopedic journals, and the Google Scholar database, and six literature evidences relating to the topic were discovered and subsequently analyzed. The study includes six randomized control trial publications that investigated the effectiveness and impact of exercise therapies on sarcopenic obesity. According to the pre and post-test values found in the reviewed articles, we discovered that resistance exercise is more effective than aerobic or combination exercise therapies. In conclusion, according to this scoping analysis, resistance training is more effective than other types of exercise in improving muscle mass in older people with sarcopenic obesity.
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Affiliation(s)
- S. Janani
- Atthi Naturopathy and Yoga Medical CollegeGudiyathamIndia
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12
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Xu Y, Li X, Hu T, Shen Y, Xiao Y, Wang Y, Bao Y, Ma X. Neck circumference as a potential indicator of pre-sarcopenic obesity in a cohort of community-based individuals. Clin Nutr 2024; 43:11-17. [PMID: 37992633 DOI: 10.1016/j.clnu.2023.11.006] [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: 04/03/2023] [Revised: 10/25/2023] [Accepted: 11/10/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND & AIMS ESPEN/EASO advocates screening for sarcopenic obesity based on the concomitant presence of an elevated body mass index (BMI) or waist circumference. Neck circumference (NC) is another simple and reliable anthropometric measurement for estimating obesity; however, its ability to detect sarcopenic obesity has not yet been established. The aim of the present study was to explore the association between NC and sarcopenic obesity in a Shanghai community population. METHODS The study included 1542 participants (622 men and 920 women) with a mean age of 58 years who underwent an examination for the detection of obesity at baseline in 2013-2014 and received a re-examination in 2015-2016. An automatic bioelectric impedance analyzer was used to estimate body composition, and magnetic resonance imaging was used to measure abdominal fat distribution. The definition of pre-sarcopenic obesity combined low skeletal muscle mass adjusted by weight (SMM/W) with obesity which defined according to overall adiposity or fat distribution as BMI ≥25 kg/m2, fat percentage (fat%) ≥ 25% in men and 30% in women, or visceral fat area (VFA) ≥ 80 cm2, respectively. RESULTS In both men and women, subjects with low SMM/W had a higher level of NC than those without (both P < 0.01). In turn, participants with elevated NC had a higher proportion of pre-sarcopenic obesity in both men and women, regardless of adiposity status assessed by BMI, fat%, or VFA (all P < 0.01). During an average follow up of 2.1 years, for each 1 cm increase in NC, multivariable-adjusted hazard ratios of pre-sarcopenic obesity in which adiposity status assessed by high BMI were 1.40 (1.11-1.76) in men and 1.32 (1.13-1.56) in women; in addition, such association remained between NC and pre-sarcopenic obesity assessed by high fat% or high VFA. CONCLUSION NC is closely associated with the incidence of sarcopenic obesity, suggesting that it could be helpful for screening sarcopenic obesity in a community-based population.
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Affiliation(s)
- Yiting Xu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Xiaoya Li
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Tingting Hu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yunfeng Xiao
- Department of Radiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Yufei Wang
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China.
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13
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Zwartkruis VW, Suthahar N, Idema DL, Mahmoud B, van Deutekom C, Rutten FH, van der Schouw YT, Rienstra M, de Boer RA. Relative fat mass and prediction of incident atrial fibrillation, heart failure and coronary artery disease in the general population. Int J Obes (Lond) 2023; 47:1256-1262. [PMID: 37684330 DOI: 10.1038/s41366-023-01380-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/24/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Relative fat mass (RFM) is an emerging marker of obesity that estimates body fat percentage using a sex-specific formula containing height and waist circumference (WC). We studied the association of RFM with incident atrial fibrillation (AF), heart failure (HF), and coronary artery disease (CAD) and explored RFM cutoffs for cardiovascular disease (CVD) prediction. METHODS We studied 95,003 participants (age 45 ± 13 years, 59% women) without prevalent AF, HF or CAD from the population-based Lifelines study. Outcomes were ascertained using electrocardiography and self-reported questionnaire data. We used logistic regression to study the association of RFM with individual outcomes and a composite outcome (incident AF, HF, and/or CAD). Multivariable models were adjusted for components of the SCORE risk model (age, sex, systolic blood pressure, cholesterol, and smoking). Optimal cutoffs were determined using the Youden index. RESULTS During a median follow-up of 3.8 (3.0-4.6) years, 224 (0.2%) participants developed AF, 1003 (1.1%) HF and 657 (0.7%) CAD. After multivariable adjustment, RFM was significantly associated with all outcomes (standardised OR 1.26, 95% CI 1.18-1.34 for the composite outcome). Optimal RFM cutoffs ( ≥26 for men, ≥38 for women) were lower than previously proposed RFM cutoffs ( ≥30 for men, ≥40 for women). In general, overall discriminative ability of RFM and its cutoffs was at least similar (in women) or better (in men) compared to BMI and WC. Since RFM was substantially correlated with age, we additionally determined age-specific cutoffs, which ranged from 23 to 27 in men and 33 to 43 in women. CONCLUSIONS RFM is associated with incident AF, HF, and CAD and may be used as a simple and intuitive marker of obesity and cardiovascular risk in the general population. This study provides potential RFM cutoffs for CVD prediction that may be used by future studies or preventive strategies targeting obesity and cardiovascular risk.
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Affiliation(s)
- Victor W Zwartkruis
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Navin Suthahar
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Department of Cardiology, Thorax Center, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Demy L Idema
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Belend Mahmoud
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Colinda van Deutekom
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Frans H Rutten
- Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Yvonne T van der Schouw
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Michiel Rienstra
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Rudolf A de Boer
- Department of Cardiology, Thorax Center, Erasmus University Medical Center, Rotterdam, the Netherlands.
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Cheah KJ, Cheah LJ. Benefits and side effects of protein supplementation and exercise in sarcopenic obesity: A scoping review. Nutr J 2023; 22:52. [PMID: 37872544 PMCID: PMC10591413 DOI: 10.1186/s12937-023-00880-7] [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: 04/04/2023] [Accepted: 10/02/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Protein supplements have been widely used among those who are struggling with sarcopenic obesity among older adults. However, despite their popularity, there is still a lack of concrete evidence on both the potential benefits and side effects of protein supplementation and exercise on sarcopenic obesity (SO). OBJECTIVE Thus, we aimed to determine the impacts of protein supplementation and exercise in older adults with sarcopenic obesity. METHOD A systematic database search was conducted for randomised controlled trials, quasi experimental study and pre-post study design addressing the effects of protein supplementation in improving sarcopenic obesity among older adults. This scoping review was conducted based on PRISMA-Scr guidelines across PubMed, Embase, Web of Science and Cochrane Library databases. To assess record eligibility, two independent reviewers performed a rigorous systematic screening process. RESULTS Of the 1,811 citations identified, 7 papers met the inclusion criteria. Six studies were randomised controlled trials and one study was a pre-post test study design. The majority of studies discussed the use of both protein supplements and exercise training. The included studies prescribed protein intake ranging from 1.0 to 1.8 g/kg/BW/day for the intervention group, while the duration of exercise performed ranged from 2 to 3 times per week, with each session lasting for 1 hour. Whey protein supplementation has been shown to be effective in improving sarcopenic conditions and weight status in SO individuals. The combination of exercise training especially resistance training and the used of protein supplement provided additional benefits in terms of lean muscle mass as well as biomarkers. The study also revealed a lack of consistency in exercise design among interventions for sarcopenic obesity. CONCLUSION Overall, it appears to be a promising option for SO individuals to improve their sarcopenic condition and weight status through the combination of resistance exercise and whey protein supplementation. However, it also highlights the need for caution when it comes to high amounts of protein intake prescription. Future research is warranted to investigate the optimal exercise design for this population, given the limited research conducted in this specific area.
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Affiliation(s)
- Khang Jin Cheah
- Department of Allied Health Sciences, Faculty of Science, Universiti Tunku Abdul Rahman, Jalan Universiti, Bandar Barat, Kampar, 31900, Malaysia.
- Centre for Biomedical and Nutrition Research, Universiti Tunku Abdul Rahman, Jalan Universiti, Bandar Barat, Kampar, 31900, Malaysia.
| | - Lin Jia Cheah
- Department of Health, North West Regional Hospital, Cooee, Tasmania, 7320, Australia
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15
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Zhou C, Zhan L, He P, Yuan J, Zha Y. Associations of sarcopenic obesity vs either sarcopenia or obesity alone with cognitive impairment risk in patients requiring maintenance hemodialysis. Nutr Clin Pract 2023; 38:1115-1123. [PMID: 37525570 DOI: 10.1002/ncp.11044] [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: 12/24/2022] [Revised: 06/01/2023] [Accepted: 06/27/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND The association between sarcopenic obesity (SO) and cognitive impairment (CI) risk in patients requiring maintenance hemodialysis (MHD) is not known. In this study, we investigated the prevalence of SO in MHD patients. Furthermore, we would explore and compare the associations between SO, sarcopenia, and obesity with CI risk in this population. METHODS A multicenter, cross-sectional study was conducted. Data from 2743 adult MHD patients were recorded. SO was defined as the co-occurrence of sarcopenia and obesity. Cognitive function was assessed with the Mini-Mental State Examination (MMSE). Multiple logistic regression models, stratified analyses, and interactive analyses were conducted. RESULTS 21.58% of the participants met the criteria for SO. The overall prevalence of CI was 23.3% in our study. Participants in the SO group had the highest CI prevalence (34.6%). The association between SO and CI was weakened but remained statistically significant after adjusting for age, sex, and educational status (odds ratio, 1.47; 95% CI, 1.11-1.96). However, associations between sarcopenia, obesity, and CI disappeared after adjusting for these variables. The additional adjustment did not attenuate the significant association between SO and CI. Subgroup analyses and interactive analyses showed that the associations were similar across subgroups (P > 0.05 for interaction for all). CONCLUSIONS SO and CI are highly prevalent in MHD patients. Participants with SO are at significantly higher risk of CI than those with sarcopenia or obesity alone. Furthermore, this association is consistent across different subgroups.
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Affiliation(s)
- Chaomin Zhou
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, China
- Medical College of Guizhou University, Guiyang, China
| | - Lin Zhan
- Central Laboratory of Guizhou Provincial People's Hospital, Guiyang, China
| | - PignHong He
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, China
| | - Jing Yuan
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, China
| | - Yan Zha
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, China
- Medical College of Guizhou University, Guiyang, China
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16
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Juby A, Davis C, Minimaana S, Mager D. Observational cohort study of highly functioning community-dwelling older adults to assess their sarcopenic status, leisure physical activity, and quality of life over 12-months. Heliyon 2023; 9:e20078. [PMID: 37809471 PMCID: PMC10559810 DOI: 10.1016/j.heliyon.2023.e20078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Background The prevalence of sarcopenia varies depending on the cohort evaluated, and the diagnostic criteria used. Older adults with sarcopenia report lower quality of life than their non-sarcopenic peers. Leisure physical activity is reported to have a variable effect on sarcopenic status. Most studies to date, have been done in "vulnerable" populations, with fewer done on independent community-dwelling older adults. None have been done in an Alberta, Canada population. Objectives To prospectively evaluate the sarcopenic status of independent community-dwelling older Albertan adults; whether this changed over 12-months; and any association with self-reported leisure activity or quality of life. Methods Independent community-dwelling older adults were invited to participate in a 12-month observational study. Assessments were done at baseline, 6 and 12-months for physical function (TUG, SPPB, gait speed, Tinetti, grip strength), muscle mass (DXA, arm and calf circumference), body fat (skinfold, DXA), reported daily exercise (aerobic, resistance), quality of life (EQ5D), and laboratory parameters. European Working Group on Sarcopenia in Older People (EWGSOP) definitions of sarcopenic status were used. Results All 50 participants (11 male), were independent of all basic activities of daily living at baseline, and most instrumental activities (some needed assistance with driving or finances). They had an average age of 75.8 (67-90) years, with average MMSE and MoCA cognitive scores of 28.1/30 (20-30) and 24.8/30 (14-30) respectively. Eight participants dropped out prior to their first DXA test. Of the remaining 42, 17 participants (5 male) fulfilled the EWGSOP revised criteria for probable, pre-sarcopenia, or sarcopenia, giving a rate of baseline total sarcopenia of 40.5% in this community-dwelling sample. The majority were pre-sarcopenic (28.6%), and sarcopenia was present only in 7.1%. The total sarcopenia group had a lower BMI (25.6 ± 5.1 versus 29 ± 5, p = 0.01), less body fat by skinfold measurement (36.4 ± 6.5 versus 39.3 ± 8.1, p = 0.01) and lower mid-calf (35.6 ± 3.2 versus 37.6 ± 3.4, p = 0.04) and mid-arm (29.1 ± 2.5 versus 31.9 ± 3.5, p = 0.02) circumferences when compared to their non-sarcopenic peers. After 12-months, 39 participants remained in the study. Of these, the sarcopenic status of 7 improved, 10 declined, with the remaining 56% not changing. There were no statistically significant differences in baseline laboratory parameters between the groups, including 25(OH)D status. But, of the status decliners, 40% had suboptimal 25(OH)D at baseline. Self-reported leisure activity (both total time and frequency) was not associated with sarcopenic status at 12-months. EuroQol -5D was not associated with sarcopenic status. Conclusions The rate of sarcopenia was 7.1%, but the total rate of pre, probable and sarcopenia in this highly functioning, community-dwelling older adult cohort was 40.5%. In the majority (75%), there was either no change, or an improvement, in their sarcopenic status over 12-months. There was no association identified with self-reported leisure activity or quality of life in this cohort.
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Affiliation(s)
- A.G. Juby
- Department of Medicine, Division of Geriatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - C.M.J. Davis
- Faculty of Kinesiology, University of Alberta, Edmonton, Alberta, Canada
| | - S. Minimaana
- Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
| | - D.R. Mager
- Faculty of Agriculture, Food and Nutrition Sciences, University of Alberta, Edmonton, Alberta, Canada
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17
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Dobbie LJ, Coelho C, Crane J, McGowan B. Clinical evaluation of patients living with obesity. Intern Emerg Med 2023; 18:1273-1285. [PMID: 37119384 PMCID: PMC10412477 DOI: 10.1007/s11739-023-03263-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/11/2023] [Indexed: 05/01/2023]
Abstract
Obesity is a significant public health concern which is implicated in cardiometabolic disease, mechanical complications and psychiatric sequelae. BMI is currently used for diagnosis; however, it has limited sensitivity for adiposity in certain circumstances. This has led to the development of risk stratification tools like the Edmonton Staging criteria and the Kings Obesity Staging Criteria: these facilitate and guide comprehensive obesity-related complication assessment. Healthcare professionals working within obesity clinics should adopt evidence-based communication strategies, including shared decision-making, motivational interviewing, and realistic goal setting. It is also vital to avoid weight-stigmatising terminology in all aspects of care, as this can negatively impact patients. Primary care plays an essential part in obesity care and should work to promptly identify cases, initiate treatment and forward on to specialist services where appropriate. Clinical evaluation of the patient living with obesity should take a holistic approach and involve input from bariatric physicians, dietitians, psychologists, and bariatric surgeons, wider members of the multi-disciplinary team should be involved where needed. Clinicians should take a detailed history, examination and order laboratory tests to investigate for complications. Overall, with appropriate evaluation, these assessments can guide patient management and facilitate long-term improvement in health.
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Affiliation(s)
| | | | - James Crane
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
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18
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Wei S, Nguyen TT, Zhang Y, Ryu D, Gariani K. Sarcopenic obesity: epidemiology, pathophysiology, cardiovascular disease, mortality, and management. Front Endocrinol (Lausanne) 2023; 14:1185221. [PMID: 37455897 PMCID: PMC10344359 DOI: 10.3389/fendo.2023.1185221] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/16/2023] [Indexed: 07/18/2023] Open
Abstract
Sarcopenic obesity is defined as the coexistence of sarcopenia and obesity in the same individual, characterized by of the co-presence of body fat accumulation and muscle loss. This condition is currently a major concern as it is associated with frailty and disabilities such as cardiovascular disease, fractures, dementia, cancer, and increased all-cause mortality. Particularly, older individuals remain at risk of sarcopenic obesity. Progress at several levels is needed to improve the global prognostic outlook for this condition, including the elaboration and implementation of a more uniform definition that may favor the identification and specification of prevalence by age group. Furthermore, improvements in the understanding of the pathogenesis of sarcopenic obesity may lead to the development of more specific therapeutic interventions to improve prognosis. We reviewed the knowledge on sarcopenic obesity and its associations with cardiovascular diseases and mortality.
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Affiliation(s)
- Shibo Wei
- Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Thanh T. Nguyen
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, Republic of Korea
| | - Yan Zhang
- Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Dongryeol Ryu
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, Republic of Korea
| | - Karim Gariani
- Division of Endocrinology, Diabetes, Nutrition and Therapeutic Patient Education, Department of Medical Specialties, Geneva University Hospitals, Geneva, Switzerland
- Diabetes Center, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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19
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Mohamed Haris NH, Krishnasamy S, Chin KY, Mariappan V, Arumugam M. Metabolic Syndrome Screening and Nutritional Status of Patients with Psoriasis: A Scoping Review. Nutrients 2023; 15:2707. [PMID: 37375611 DOI: 10.3390/nu15122707] [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: 05/08/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Background: Patients with plaque psoriasis have an increased risk of metabolic syndrome. However, no studies have assessed the nutritional status or screening methods of this population. Aims: This review aimed to identify and summarise metabolic syndrome screening criteria and the tools/methods used in nutrition assessment in patients with plaque psoriasis. Data synthesis: PubMed, Web of Science, Ovid and Scopus were searched from inception to March 2023, following the Arkensey and O'Malley framework, to identify articles that report nutritional assessment methods/tools and metabolic screening criteria. Twenty-one studies were identified. Overall, these studies used four different screening criteria to define metabolic syndrome. Patients with psoriasis had a high prevalence of metabolic syndrome and had a poor nutritional status compared to controls. However, only anthropometric measures such as weight, height and waist circumference were employed to determine the nutritional status. Only two studies assessed the vitamin D status. Conclusions: Patients with psoriasis have a poor nutritional status, and they are at risk of nutrient deficiencies. However, these health aspects are not routinely assessed and may increase the risk of malnutrition among these patients. Therefore, additional assessments, such as body composition and dietary assessment, are needed to determine the nutritional status to provide a suitable intervention.
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Affiliation(s)
- Nur Hanisah Mohamed Haris
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Shanthi Krishnasamy
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
- Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Vanitha Mariappan
- Centre for Toxicology and Health Risk Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Mohan Arumugam
- Internal Medicine & Dermatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
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Jung UJ. Sarcopenic Obesity: Involvement of Oxidative Stress and Beneficial Role of Antioxidant Flavonoids. Antioxidants (Basel) 2023; 12:antiox12051063. [PMID: 37237929 DOI: 10.3390/antiox12051063] [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: 03/27/2023] [Revised: 04/25/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
Sarcopenic obesity, which refers to concurrent sarcopenia and obesity, is characterized by decreased muscle mass, strength, and performance along with abnormally excessive fat mass. Sarcopenic obesity has received considerable attention as a major health threat in older people. However, it has recently become a health problem in the general population. Sarcopenic obesity is a major risk factor for metabolic syndrome and other complications such as osteoarthritis, osteoporosis, liver disease, lung disease, renal disease, mental disease and functional disability. The pathogenesis of sarcopenic obesity is multifactorial and complicated, and it is caused by insulin resistance, inflammation, hormonal changes, decreased physical activity, poor diet and aging. Oxidative stress is a core mechanism underlying sarcopenic obesity. Some evidence indicates a protective role of antioxidant flavonoids in sarcopenic obesity, although the precise mechanisms remain unclear. This review summarizes the general characteristics and pathophysiology of sarcopenic obesity and focuses on the role of oxidative stress in sarcopenic obesity. The potential benefits of flavonoids in sarcopenic obesity have also been discussed.
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Affiliation(s)
- Un Ju Jung
- Department of Food Science and Nutrition, Pukyong National University, 45 Yongso-ro, Nam-gu, Busan 48513, Republic of Korea
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21
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Pham T, McNeil JJ, Barker AL, Orchard SG, Newman AB, Robb C, Ernst ME, Espinoza S, Woods RL, Nelson MR, Beilin L, Hussain SM. Longitudinal association between handgrip strength, gait speed and risk of serious falls in a community-dwelling older population. PLoS One 2023; 18:e0285530. [PMID: 37155689 PMCID: PMC10166501 DOI: 10.1371/journal.pone.0285530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/25/2023] [Indexed: 05/10/2023] Open
Abstract
OBJECTIVE Both grip strength and gait speed can be used as markers of muscle function, however, no previous study has examined them in the same population with respect to risk of falls. METHODS In this prospective cohort study, utilising data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial and ASPREE-Fracture substudy, we analysed the association of grip strength and gait speed and serious falls in healthy older adults. Grip strength was measured using a handheld dynamometer and gait speed from 3-metre timed walks. Serious falls were confined to those involving hospital presentation. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for associations with falls. RESULTS Over an average of 4.0±1.3 years, amongst 16,445 participants, 1,533 had at least one serious fall. After adjustment for age, sex, physical activity, body mass index, Short Form 12 (state of health), chronic kidney disease, polypharmacy and aspirin, each standard deviation (SD) lower grip strength was associated with 27% (HR 1.27, 95% CI 1.17-1.38) higher risk of falls. The results remained the same for males and females. There was a dose-response relationship in the association between grip strength and falls risk. The higher risk of falls was observed in males in all body mass index (BMI) categories, but only in obese females. The association between gait speed and falls risk was weaker than the association between grip strength and falls risk. CONCLUSIONS All males and only obese females with low grip strength appear to be at the greatest risk of serious falls. These findings may assist in early identification of falls.
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Affiliation(s)
- Thao Pham
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anna L. Barker
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Suzanne G. Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anne B. Newman
- Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Catherine Robb
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael E. Ernst
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Family Medicine, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, United States of America
| | - Sara Espinoza
- Division of Geriatrics, Gerontology & Palliative Medicine, Sam and Ann Barshop Institute for Longevity and Aging Studies, UT Health San Antonio, San Antonio, Texas, United States of America
- Geriatrics Research, Education and Clinical Center, South Texas Veterans Health Care System, San Antonio, Texas, United States of America
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mark R. Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Lawrence Beilin
- Medical School, Royal Perth Hospital, University of Western Australia, Perth, Australia
| | - Sultana Monira Hussain
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Medical Education, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
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22
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Pardo E, Lescot T, Preiser JC, Massanet P, Pons A, Jaber S, Fraipont V, Levesque E, Ichai C, Petit L, Tamion F, Taverny G, Boizeau P, Alberti C, Constantin JM, Bonnet MP. Association between early nutrition support and 28-day mortality in critically ill patients: the FRANS prospective nutrition cohort study. Crit Care 2023; 27:7. [PMID: 36611211 PMCID: PMC9826592 DOI: 10.1186/s13054-022-04298-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/28/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Current guidelines suggest the introduction of early nutrition support within the first 48 h of admission to the intensive care unit (ICU) for patients who cannot eat. In that context, we aimed to describe nutrition practices in the ICU and study the association between the introduction of early nutrition support (< 48 h) in the ICU and patient mortality at day 28 (D28) using data from a multicentre prospective cohort. METHODS The 'French-Speaking ICU Nutritional Survey' (FRANS) study was conducted in 26 ICUs in France and Belgium over 3 months in 2015. Adult patients with a predicted ICU length of stay > 3 days were consecutively included and followed for 10 days. Their mortality was assessed at D28. We investigated the association between early nutrition (< 48 h) and mortality at D28 using univariate and multivariate propensity-score-weighted logistic regression analyses. RESULTS During the study period, 1206 patients were included. Early nutrition support was administered to 718 patients (59.5%), with 504 patients receiving enteral nutrition and 214 parenteral nutrition. Early nutrition was more frequently prescribed in the presence of multiple organ failure and less frequently in overweight and obese patients. Early nutrition was significantly associated with D28 mortality in the univariate analysis (crude odds ratio (OR) 1.69, 95% confidence interval (CI) 1.23-2.34) and propensity-weighted multivariate analysis (adjusted OR (aOR) 1.05, 95% CI 1.00-1.10). In subgroup analyses, this association was stronger in patients ≤ 65 years and with SOFA scores ≤ 8. Compared with no early nutrition, a significant association was found of D28 mortality with early enteral (aOR 1.06, 95% CI 1.01-1.11) but not early parenteral nutrition (aOR 1.04, 95% CI 0.98-1.11). CONCLUSIONS In this prospective cohort study, early nutrition support in the ICU was significantly associated with increased mortality at D28, particularly in younger patients with less severe disease. Compared to no early nutrition, only early enteral nutrition appeared to be associated with increased mortality. Such findings are in contrast with current guidelines on the provision of early nutrition support in the ICU and may challenge our current practices, particularly concerning patients at low nutrition risk. Trial registration ClinicalTrials.gov Identifier: NCT02599948. Retrospectively registered on November 5th 2015.
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Affiliation(s)
- Emmanuel Pardo
- Sorbonne Université, GRC 29, AP-HP, DMU DREAM, Département d'Anesthésie-Réanimation, Hôpital Saint-Antoine, Assistance publique-hôpitaux de Paris, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France.
| | - Thomas Lescot
- Sorbonne Université, GRC 29, AP-HP, DMU DREAM, Département d'Anesthésie-Réanimation, Hôpital Saint-Antoine, Assistance publique-hôpitaux de Paris, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France
| | - Jean-Charles Preiser
- Service des Soins intensifs, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Pablo Massanet
- Département Anesthésie-Réanimation, Centre Hospitalier Universitaire Nîmes, 30000, Nîmes, France
| | - Antoine Pons
- Sorbonne Université, GRC 29, AP-HP, DMU DREAM, Département d'Anesthésie-Réanimation, Hôpital Pitié-Salpêtrière, Assistance publique-hôpitaux de Paris, 75013, Paris, France
| | - Samir Jaber
- Department of Anaesthesia and Intensive Care Unit, Regional University Hospital of Montpellier, St-Eloi Hospital, University of Montpellier. PhyMedExp, INSERM U1046, CNRS UMR, 9214, Montpellier Cedex 5, France
| | - Vincent Fraipont
- Service de Soins Intensifs, Centre Hospitalier Régional de Liège, 4000, Liège, Citadelle, Belgium
| | - Eric Levesque
- Service d'anesthésie-réanimation chirurgicale, GHU Henri-Mondor, 94000, Créteil, France
| | - Carole Ichai
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Département Anesthésie-Réanimation, Nice, France
| | - Laurent Petit
- Service de réanimation chirurgicale et traumatologique Pellegrin place Amélie Raba-Léon, 33000, Bordeaux, France
| | - Fabienne Tamion
- Service de Médecine Intensive Réanimation, CHU Rouen, Université de Normandie, UNIROUEN, INSERM U1096, 76000, Rouen, France
| | - Garry Taverny
- AP-HP, Hôpital Robert-Debré, Unité d'Epidémiologie Clinique, 48 bd Serurier, 75019, Paris, France
| | - Priscilla Boizeau
- AP-HP, Hôpital Robert-Debré, Unité d'Epidémiologie Clinique, 48 bd Serurier, 75019, Paris, France
| | - Corinne Alberti
- AP-HP, Hôpital Robert-Debré, Unité d'Epidémiologie Clinique, 48 bd Serurier, 75019, Paris, France
| | - Jean-Michel Constantin
- Sorbonne Université, GRC 29, AP-HP, DMU DREAM, Département d'Anesthésie-Réanimation, Hôpital Pitié-Salpêtrière, Assistance publique-hôpitaux de Paris, 75013, Paris, France
| | - Marie-Pierre Bonnet
- Sorbonne Université, Département Anesthésie-Réanimation, Hôpital Armand Trousseau, DMU DREAM, GRC 29, AP-HP, Paris, France
- Université Paris Cité, INSERM, INRA, Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Maternité Port Royal, 53 avenue de l'Observatoire, 75014, Paris, France
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23
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Lu L, He X, Song Y, Zhuang M, Wu X, Chen N. Prevalence and risk factors of sarcopenia without obesity and sarcopenic obesity among Chinese community older people in suburban area of Shanghai: A cross-sectional study. Front Aging Neurosci 2022; 14:1034542. [PMID: 36605360 PMCID: PMC9807613 DOI: 10.3389/fnagi.2022.1034542] [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: 09/01/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives The aim of the present study was to explore the prevalence and risk factors of sarcopenia without obesity (S) and sarcopenic obesity (SO) among community-dwelling older people in the Chongming District of Shanghai, China, according to the Asian Working Group for Sarcopenia (AWGS) 2019 Consensus as the diagnostic criteria of sarcopenia. Methods In this cross-sectional study, a total of 1,407 subjects aged ≥65 years were included, where the mean age of the subjects was 71.91 ± 5.59 years and their mean body mass index (BMI) was 24.65 ± 3.32 kg/m2. According to the Asian Working Group for Sarcopenia (AWGS) 2019 Consensus, sarcopenia was defined as a low appendicular skeletal muscle mass index (≤7.0 kg/m2 in males and ≤5.7 kg/m2 in females), decreased handgrip strength (<28.0 kg in males and <18.0 kg in females), and/or low gait speed (<1.0 m/s) or poor 5-time chair stand test (5CST) (≥12s). The SO met both the diagnostic criteria for sarcopenia and obesity, meanwhile obesity was defined as an increased percentage of body fat (PBF) (≥25% in males and ≥35% in females). Univariate and multiple logistic regression analyses were performed to explore the risk factors of both S and SO. Results The prevalence of S and SO was 9.74% (M: 9.29%, F: 10.05%) and 9.95% (M: 13.94%, F: 7.14%). Lower BMI (OR = 0.136, 95% CI: 0.054-0.340, p < 0.001), lower hip circumference (OR = 0.858, 95% CI: 0.816-0.903, p < 0.001), farming (OR = 1.632, 95% CI: 1.053-2.530, p = 0.028), higher high-density lipoprotein cholesterol (HDL-C) level (OR = 2.235, 95% CI: 1.484-3.367, p < 0.001), and a sleep duration <7 h (OR = 0.561, 95% CI: 0.346-0.909, p = 0.019) were risk factors for S. While aging (70-74 y, OR = 1.923, 95% CI: 1.122-3.295, p = 0.017; 75-79 y, OR = 3.185, 95% CI: 1.816-5.585, p < 0.001; ≥80 y, OR = 7.192, 95% CI: 4.133-12.513, p < 0.001), male (OR = 1.981, 95% CI: 1.351-2.904, p < 0.001), higher BMI (OR = 4.865, 95% CI: 1.089-21.736, p = 0.038), higher monocyte level (OR = 4.203, 95% CI: 1.340-13.181, p = 0.014), and a sleep duration >9 h (OR = 1.881, 95% CI: 1.117-3.166, p = 0.017) were risk factors for SO. Conclusion Our study showed the high prevalence of S and SO among community-dwelling older people in the Chongming District. The SO was more prevalent in males. Behavioral factors and lifestyle (such as farming and sleep duration) were associated more with the development of S, while age and male gender were associated more with the development of SO.
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Affiliation(s)
- Linqian Lu
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China,Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China,School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xiangfeng He
- Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Yanping Song
- Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Min Zhuang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xie Wu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China,*Correspondence: Xie Wu ✉
| | - Nan Chen
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China,Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China,School of Kinesiology, Shanghai University of Sport, Shanghai, China,Nan Chen ✉
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Kumari M, Khanna A. Prevalence of Sarcopenic Obesity in Various Comorbidities, Diagnostic Markers, and Therapeutic Approaches: A Review. Ann Geriatr Med Res 2022; 26:296-308. [PMID: 36397294 PMCID: PMC9830070 DOI: 10.4235/agmr.22.0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 10/31/2022] [Indexed: 11/20/2022] Open
Abstract
The coexistence of sarcopenia and obesity characterizes sarcopenic obesity. In this condition, there is an imbalance between lean and fat mass amounts. It is a prevalent issue that is gaining prevalence among the elderly population. To evaluate the condition, allied health professionals may employ non-invasive diagnostic techniques, such as gait speed, skeletal muscle mass, and muscle strength. Nevertheless, early diagnosis and treatment of pathology are essential for preventing debilitating effects and providing the highest quality of care. This article reviews the prevalence of sarcopenic obesity in numerous medical conditions, such as cancer, arthritis, postoperative cases, diabetes mellitus, obesity, and metabolic syndrome. In addition, this paper aims to examine the available evidence regarding the prevalence of sarcopenic obesity in other conditions along with their diagnostic markers and therapeutic approaches.
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Affiliation(s)
- Mangalam Kumari
- Department of Physiotherapy, School of Allied Health Sciences, Sharda University, Greater Noida, Uttar Pradesh 201306, India
| | - Archana Khanna
- Department of Physiotherapy, School of Allied Health Sciences, Sharda University, Greater Noida, Uttar Pradesh 201306, India,Corresponding Author: Archana Khanna, PhD Department of Physiotherapy, School of Allied Health Sciences, Sharda University, Greater Noida, Uttar Pradesh 201306, India E-mail:
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Chuan F, Chen S, Ye X, Kang S, Mei M, Tian W, Liao K, Li Y, Gong L, Li R, Zhou B. Sarcopenic obesity predicts negative health outcomes among older patients with type 2 diabetes: The Ageing and Body Composition of Diabetes (ABCD) cohort study. Clin Nutr 2022; 41:2740-2748. [PMID: 36370663 DOI: 10.1016/j.clnu.2022.10.023] [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: 06/09/2022] [Revised: 10/20/2022] [Accepted: 10/31/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND AIMS The definition of and diagnostic criteria for sarcopenic obesity (SO) remain unclear, hindering the assessment of its prevalence as well as its clinical relevance to negative health outcomes, especially in diabetic patients, who are more prone to body composition changes. The aim of this study was to investigate the prevalence of SO and its impact on negative health outcomes among elderly patients with type 2 diabetes (T2DM) from the Ageing and Body Composition of Diabetes (ABCD) cohort. METHODS This retrospective cohort study included 386 elderly patients with T2DM (177 males and 209 females, mean age of 67.91 ± 6.10 years). SO was defined as the coexistence of sarcopenia defined by the 2019 Asian Working Group for Sarcopenia up-to-date consensus and obesity identified by five alternative measurements as follows: body mass index (BMI)≥28 kg/m2 (BMI28), BMI≥25 kg/m2 (BMI25), body fat percentage (BF%)≥25% for men or 35% for women, visceral fat area (VFA)≥100 cm2, or android fat mass (AF) higher than the sex-specific median. The primary endpoint was all-cause death or fragility fracture, and the secondary endpoint was a composite of cardiovascular diseases (CVDs). Cox proportional hazards regression analysis was used to estimate the association between SO and negative health outcomes. RESULTS The prevalence of SO was 0.2% (BMI28), 2.5% (BMI25), 9.8% (AF), and 18.7% (BF% or VFA) among elderly patients with T2DM, according to the different obesity surrogate markers. During a mean follow-up period of 3.46 ± 1.15 years, 50 patients reached the primary endpoint, and 33 patients had incident CVD. SO classified using BF% was significantly associated with the primary endpoint [hazard ratio (HR) = 2.94, 95% CI = 1.25-6.92] and incident CVD (HR = 6.02, 95% CI = 1.56-23.15), even after comprehensive adjustment for bone-, comorbidity-, and diabetes-specific confounding variables. When SO was classified using BMI25, VFA and AF, similar results were found for adverse outcomes. However, SO classified using BMI25 resulted in misclassification of SO for 61 participants, 19 of whom experienced adverse events during follow-up, and SO classified using VFA or AF was not significantly associated with incident CVD. CONCLUSIONS SO is not uncommon in geriatric patients with T2DM, and its prevalence varies widely depending on the diverse surrogate indices of body fat excess. Furthermore, SO may be a better independent risk factor for negative health outcomes when classified using BF%.
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Affiliation(s)
- Fengning Chuan
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Endocrinology, Chongqing University Fuling Hospital, Chongqing, China
| | - Siyu Chen
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Ye
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shuang Kang
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mei Mei
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenqing Tian
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kun Liao
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Li
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lilin Gong
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rong Li
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bo Zhou
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Ceylan S, Balcı C. Letter to Editor: Association of body mass index with COVID-19 related in-hospital death. Clin Nutr 2022; 41:3138. [PMID: 35393140 PMCID: PMC8902860 DOI: 10.1016/j.clnu.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 03/04/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Serdar Ceylan
- Corresponding author. Sıhhiye, 06230, Ankara, Turkey
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Association of Micronutrients and Handgrip Strength in Korean Older Population: A Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10101980. [PMID: 36292428 PMCID: PMC9602344 DOI: 10.3390/healthcare10101980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/28/2022] [Accepted: 10/06/2022] [Indexed: 11/04/2022] Open
Abstract
Sarcopenia is characterized by the loss of skeletal muscle mass, strength, and physical performance. Dynapenia and kratopenia are described as the loss of muscle strength and power. Nutritional intake status is one of the factors affecting the prevention of an age-related muscle decline such as sarcopenia, dynapenia, or kratopenia in older populations. This study aimed to investigate the association between the intake of micronutrients and handgrip strength in 1254 individuals (546 men and 708 women) of the Korean older population from the most recent dataset. They were analyzed and divided into two groups: a LHS group with low handgrip strength (<28 kg for men and <18 kg for women) and a normal group with normal handgrip strength. Logistic regression analysis was performed to estimate the odds ratios (ORs) and 95% confidence intervals (Cis) of the associations between micronutrient intakes and low handgrip strength in Korean older population by gender. Among micronutrients, insufficient potassium intake showed a significant association with low handgrip strength for men (OR: 3.159, 95% CI: 1.164−8.578) and women (OR: 2.793, 95% CI: 1.380−5.654) aged ≥65 years, respectively (p = 0.005 for men, p = 0.024 for women), as a result of adjusting for all confounding factors that could affect low handgrip strength. In conclusion, potassium intake among micronutrients in Korean older populations with low handgrip strength might need continuous monitoring for the intervention or prevention of dynapenia or sarcopenia.
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Kompaniyets L, Goodman AB, Wiltz JL, Shrestha SS, Grosse SD, Boehmer TK, Blanck HM. Inpatient care cost, duration, and acute complications associated with BMI in children and adults hospitalized for COVID-19. Obesity (Silver Spring) 2022; 30:2055-2063. [PMID: 35730688 PMCID: PMC9350354 DOI: 10.1002/oby.23522] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study aimed to assess the association of BMI with inpatient care cost, duration, and acute complications among patients hospitalized for COVID-19 at 273 US hospitals. METHODS Children (aged 2-17 years) and adults (aged ≥18 years) hospitalized for COVID-19 during March 2020-July 2021 and with measured BMI in a large electronic administrative health care database were included. Generalized linear models were used to assess the association of BMI categories with the cost and duration of inpatient care. RESULTS Among 108,986 adults and 409 children hospitalized for COVID-19, obesity prevalence was 53.4% and 45.0%, respectively. Among adults, overweight and obesity were associated with higher cost of care, and obesity was associated with longer hospital stays. Children with severe obesity had higher cost of care but not significantly longer hospital stays, compared with those with healthy weight. Children with severe obesity were 3.7 times (95% CI: 1.4-9.5) as likely to have invasive mechanical ventilation and 62% more likely to have an acute complication (95% CI: 39%-90%), compared with children with healthy weight. CONCLUSIONS These findings show that patients with a high BMI experience significant health care burden during inpatient COVID-19 care.
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Affiliation(s)
- Lyudmyla Kompaniyets
- COVID‐19 ResponseCenters for Disease Control and PreventionAtlantaGeorgiaUSA
- Division of Nutrition, Physical Activity, and ObesityCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Alyson B. Goodman
- Division of Nutrition, Physical Activity, and ObesityCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Jennifer L. Wiltz
- COVID‐19 ResponseCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Sundar S. Shrestha
- COVID‐19 ResponseCenters for Disease Control and PreventionAtlantaGeorgiaUSA
- Office on Smoking and HealthCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Scott D. Grosse
- National Center on Birth Defects and Developmental DisabilitiesCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Tegan K. Boehmer
- COVID‐19 ResponseCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Heidi M. Blanck
- Division of Nutrition, Physical Activity, and ObesityCenters for Disease Control and PreventionAtlantaGeorgiaUSA
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Prevalence and Determinants of Sarcopenic Obesity in Older Adults: Secondary Data Analysis of the Longitudinal Ageing Study in India (LASI) Wave 1 Survey (2017-18). Adv Ther 2022; 39:4094-4113. [PMID: 35788961 DOI: 10.1007/s12325-022-02216-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/06/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Sarcopenic obesity (SO) represents the confluence of two epidemics-an aging population and an increasing rate of obesity. The two diseases may act synergistically, and SO may significantly affect morbidity and mortality. However, the burden is not defined to drive the policy changes. Hence the present study was done to estimate the prevalence and predictors of SO in India. METHODS We did a secondary data analysis of the 72,250 older adults who participated in the first wave of the Longitudinal Aging Study in India (2017-18). Possible sarcopenia was defined as per the guidelines by the Asian Working Group for Sarcopenia (AWGS) criteria. The modified criterion of overweight and obesity for Asian adults was used to categorize obesity. Presence of both sarcopenia and obesity depicted SO. Weighted analysis was done to estimate the prevalence of SO, and multinomial bivariate logistics regression was used to identify the predictors of SO. RESULTS The overall prevalence of obesity, sarcopenia, and SO was 27.1%, 41.9%, and 8.7%, respectively. The mean age, weight, body mass index (BMI), and blood pressure of adults with SO were significantly higher compared to others. Higher age, urban residence, west and south regions of India, consumption of tobacco or alcohol, no physical activity, and presence of diabetes contribute to SO. CONCLUSION The burden of SO seems to be less but amounts to a massive number in an aging country. We stress increased screening of the geriatric age group and advocate increased physical activity and dietary modifications to realize the concept of healthy aging.
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Yoo TK, Rhim HC, Lee YT, Yoon KJ, Park CH. Relationship between hyperhomocysteinemia and coexisting obesity with low skeletal muscle mass in asymptomatic adult population. Sci Rep 2022; 12:12439. [PMID: 35858996 PMCID: PMC9300668 DOI: 10.1038/s41598-022-16401-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 07/08/2022] [Indexed: 11/09/2022] Open
Abstract
The relationship between hyperhomocysteinemia (HHcy) and obesity with low skeletal muscle mass (LMM) has not been established. We aim to assess the association between HHcy and the coexistence of obesity and LMM in asymptomatic adult population. We conducted a population-based cross-sectional study among asymptomatic individuals who underwent measurements of plasma homocysteine and body composition analysis. HHcy was defined as > 15 umol/L, obesity as body mass index ≥ 25 (kg/m2), and LMM as skeletal muscle index less than 2 SD below the sex-specific mean of young adults. The participants were classified into ‘control’, ‘obesity alone’, ‘LMM alone’, and ‘obesity with LMM’. Among 113,805 participants, the prevalence of HHcy was 8.3% in control, 8.7% in obesity alone, 10.0% in LMM alone, and 13.0% in obesity with LMM (p for trend < 0.001). In a multivariable logistic regression analysis, the associations showed a positive trend for HHcy along the groups from obesity alone, to LMM alone, and to obesity with LMM. HHcy was independently associated with the presence of LMM alone (adjusted odds ratio 1.186 [95% confidence interval 1.117–1.259]) and obesity with LMM (1.424 [1.134–1.788]), respectively. This study demonstrated that HHcys was more strongly associated with coexistence of obesity and LMM than either condition alone in the adult population.
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Affiliation(s)
- Tae Kyung Yoo
- Department of Medicine, MetroWest Medical Center/Tufts University School of Medicine, Framingham, MA, USA
| | - Hye Chang Rhim
- Department of Medicine, MetroWest Medical Center/Tufts University School of Medicine, Framingham, MA, USA
| | - Yong-Taek Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunanro, Jongno-gu, Seoul, 03181, Republic of Korea
| | - Kyung Jae Yoon
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunanro, Jongno-gu, Seoul, 03181, Republic of Korea.,Medical Research Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chul-Hyun Park
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunanro, Jongno-gu, Seoul, 03181, Republic of Korea. .,Medical Research Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Kim J, Baek Y, Jeong K, Lee S. Association of Dietary Factors With Grip Strength, Body Fat, and Prevalence of Sarcopenic Obesity in Rural Korean Elderly With Cardiometabolic Multimorbidity. Front Nutr 2022; 9:910481. [PMID: 35911108 PMCID: PMC9329691 DOI: 10.3389/fnut.2022.910481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/06/2022] [Indexed: 12/24/2022] Open
Abstract
Background and Aims Aging accompanied by cardiometabolic multimorbidity (CM) promotes chronic low-grade inflammation, increased oxidative stress, and insulin resistance (IR), which result in loss of muscle mass and functional impairment. Better quality diets have been directly associated with muscle health and decreased risk of all-cause mortality. However, no study has investigated the relationship of dietary factors with grip strength, body composition, and prevalence of sarcopenic obesity (SO) in Korean rural residents according to their CM pattern. Therefore, we aimed to examine this association among this population. Materials and Methods This cross-sectional study utilized data from 932 rural residents aged ≥ 65 years. An exploratory tetrachoric factor analysis revealed four multimorbidity patterns: CM, inflammatory disease, respiratory disease, and cancer and other diseases. All participants were categorized into the CM and non-CM groups. Skeletal muscle mass and the prevalence of sarcopenia were estimated using bioelectrical impedance analysis (BIA). Dietary assessment was analyzed using a validated 106-item food frequency questionnaire. Adjusted multiple linear regression and multivariate logistic regression were employed to examine the association of dietary factors with muscle strength, quality, and SO prevalence ratio in elderly participants. Results The mean age of the participants was 71.8 ± 0.1 years (65.8% women). Dietary fat and protein intake were positively correlated with handgrip strength in women with CM, after adjusting for covariates (p = 0.001). Similarly, protein intake (g/kg) was positively associated with appendicular skeletal muscle mass (ASM; kg/m2) and ASM (%) in both sexes in the CM and non-CM groups. Regarding the tertiles of wheat intake (g/d), 2.1-fold increase in SO prevalence ratios [prevalence ratio (PR): 2.149, confidence intervals (CIs): 1.134–4.071] was observed in the highest tertile (T3: 269.1 g/d), compared to the lowest tertile (Q1: 8.6 g/d) in the CM group. Higher tertile of meat intake (T2: 34.8 g/d, T3: 99.5 g/d) had a 2-fold increase in SO (PR: 1.932, CIs: 1.066–3.500) compared to the lowest tertile (T1: 9.2 g/d) in the CM group. Conclusion Overconsumption of wheat and meat negatively impacted the development of SO, while protein intake was positively associated with grip strength and skeletal muscle mass in elderly Koreans with CM.
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Krenzlin H, Schmidt L, Jankovic D, Schulze C, Brockmann MA, Ringel F, Keric N. Impact of Sarcopenia and Bone Mineral Density on Implant Failure after Dorsal Instrumentation in Patients with Osteoporotic Vertebral Fractures. Medicina (B Aires) 2022; 58:medicina58060748. [PMID: 35744011 PMCID: PMC9228941 DOI: 10.3390/medicina58060748] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Objectives: Age-related loss of bone and muscle mass are signs of frailty and are associated with an increased risk of falls and consecutive vertebral fractures. Management often necessitates fusion surgery. We determined the impacts of sarcopenia and bone density on implant failures (IFs) and complications in patients with spondylodesis due to osteoporotic vertebral fractures (OVFs). Materials and Methods: Patients diagnosed with an OVF according to the osteoporotic fracture classification (OF) undergoing spinal instrumentation surgery between 2011 and 2020 were included in our study. The skeletal muscle area (SMA) was measured at the third lumbar vertebra (L3) level using axial CT images. SMA z-scores were calculated for the optimal height and body mass index (BMI) adjustment (zSMAHT). The loss of muscle function was assessed via measurement of myosteatosis (skeletal muscle radiodensity, SMD) using axial CT scans. The bone mineral density (BMD) was determined at L3 in Hounsfield units (HU). Results: A total of 68 patients with OVFs underwent instrumentation in 244 segments (mean age 73.7 ± 7.9 years, 60.3% female). The median time of follow-up was 14.1 ± 15.5 months. Sarcopenia was detected in 28 patients (47.1%), myosteatosis in 45 patients (66.2%), and osteoporosis in 49 patients (72%). The presence of sarcopenia was independent of chronological age (p = 0.77) but correlated with BMI (p = 0.005). The zSMAHT was significantly lower in patients suffering from an IF (p = 0.0092). Sarcopenia (OR 4.511, 95% CI 1.459–13.04, p = 0.0092) and osteoporosis (OR 9.50, 95% CI 1.497 to 104.7, p = 0.014) increased the likelihood of an IF. Using multivariate analysis revealed that the zSMAHT (p = 0.0057) and BMD (p = 0.0041) were significantly related to IF occurrence. Conclusion: Herein, we established sarcopenic obesity as the main determinant for the occurrence of an IF after instrumentation for OVF. To a lesser degree, osteoporosis was associated with impaired implant longevity. Therefore, measuring the SMA and BMD using an axial CT of the lumbar spine might help to prevent an IF in spinal fusion surgery via early detection and treatment of sarcopenia and osteoporosis.
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Affiliation(s)
- Harald Krenzlin
- Department of Neurosurgery, University Medical Center, 55131 Mainz, Germany; (L.S.); (D.J.); (C.S.); (F.R.); (N.K.)
- Correspondence:
| | - Leon Schmidt
- Department of Neurosurgery, University Medical Center, 55131 Mainz, Germany; (L.S.); (D.J.); (C.S.); (F.R.); (N.K.)
| | - Dragan Jankovic
- Department of Neurosurgery, University Medical Center, 55131 Mainz, Germany; (L.S.); (D.J.); (C.S.); (F.R.); (N.K.)
| | - Carina Schulze
- Department of Neurosurgery, University Medical Center, 55131 Mainz, Germany; (L.S.); (D.J.); (C.S.); (F.R.); (N.K.)
| | - Marc A. Brockmann
- Department of Neuroradiology, University Medical Center, 55131 Mainz, Germany;
| | - Florian Ringel
- Department of Neurosurgery, University Medical Center, 55131 Mainz, Germany; (L.S.); (D.J.); (C.S.); (F.R.); (N.K.)
| | - Naureen Keric
- Department of Neurosurgery, University Medical Center, 55131 Mainz, Germany; (L.S.); (D.J.); (C.S.); (F.R.); (N.K.)
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Dumain C, Broner J, Arnaud E, Dewavrin E, Holubar J, Fantone M, de Wazières B, Parreau S, Fesler P, Guilpain P, Roubille C, Goulabchand R. Patients' Baseline Characteristics, but Not Tocilizumab Exposure, Affect Severe Outcomes Onset in Giant Cell Arteritis: A Real-World Study. J Clin Med 2022; 11:jcm11113115. [PMID: 35683507 PMCID: PMC9181652 DOI: 10.3390/jcm11113115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/17/2022] [Accepted: 05/27/2022] [Indexed: 12/05/2022] Open
Abstract
Objectives: Giant cell arteritis (GCA) is associated with severe outcomes such as infections and cardiovascular diseases. We describe here the impact of GCA patients’ characteristics and treatment exposure on the occurrence of severe outcomes. Methods: Data were collected retrospectively from real-world GCA patients with a minimum of six-months follow-up. We recorded severe outcomes and treatment exposure. In the survival analysis, we studied the predictive factors of severe outcomes occurrence, including treatment exposure (major glucocorticoids (GCs) exposure (>10 g of the cumulative dose) and tocilizumab (TCZ) exposure), as time-dependent covariates. Results: Among the 77 included patients, 26% were overweight (BMI ≥ 25 kg/m2). The mean cumulative dose of GCs was 7977 ± 4585 mg, 18 patients (23%) had a major GCs exposure, and 40 (52%) received TCZ. Over the 48-month mean follow-up period, 114 severe outcomes occurred in 77% of the patients: infections—29%, cardiovascular diseases—18%, hypertension—15%, fractural osteoporosis—8%, and deaths—6%. Baseline diabetes and overweight were predictive factors of severe outcomes onset (HR, 2.41 [1.05−5.55], p = 0.039; HR, 2.08 [1.14−3.81], p = 0.018, respectively) independently of age, sex, hypertension, and treatment exposure. Conclusion: Diabetic and overweight GCA patients constitute an at-risk group requiring tailored treatment, including vaccination. The effect of TCZ exposure on the reduction of severe outcomes was not proved here.
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Affiliation(s)
- Cyril Dumain
- Internal Medicine Department, CHU Nîmes, University of Montpellier, 30029 Nîmes, France; (C.D.); (J.B.); (E.A.); (J.H.); (M.F.)
| | - Jonathan Broner
- Internal Medicine Department, CHU Nîmes, University of Montpellier, 30029 Nîmes, France; (C.D.); (J.B.); (E.A.); (J.H.); (M.F.)
| | - Erik Arnaud
- Internal Medicine Department, CHU Nîmes, University of Montpellier, 30029 Nîmes, France; (C.D.); (J.B.); (E.A.); (J.H.); (M.F.)
| | - Emmanuel Dewavrin
- Intensive Care Medicine Department, Lapeyronie Hospital, CHU Montpellier, 34090 Montpellier, France;
| | - Jan Holubar
- Internal Medicine Department, CHU Nîmes, University of Montpellier, 30029 Nîmes, France; (C.D.); (J.B.); (E.A.); (J.H.); (M.F.)
| | - Myriam Fantone
- Internal Medicine Department, CHU Nîmes, University of Montpellier, 30029 Nîmes, France; (C.D.); (J.B.); (E.A.); (J.H.); (M.F.)
| | - Benoit de Wazières
- Department of Internal Medicine and Geriatrics, CHU Nîmes, University of Montpellier, 30029 Nîmes, France;
| | - Simon Parreau
- Department of Internal Medicine, Limoges University Hospital Center, 87042 Limoges, France;
| | - Pierre Fesler
- Department of Internal Medicine, Lapeyronie Hospital, CHU Montpellier, 34090 Montpellier, France; (P.F.); (C.R.)
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295 Montpellier, France
| | - Philippe Guilpain
- Department of Internal Medicine and Multi-Organic Diseases, St. Eloi Hospital, CHU Montpellier, 34295 Montpellier, France;
- Institute for Regenerative Medicine & Biotherapy, St. Eloi Hospital, University of Montpellier, INSERM, 34295 Montpellier, France
| | - Camille Roubille
- Department of Internal Medicine, Lapeyronie Hospital, CHU Montpellier, 34090 Montpellier, France; (P.F.); (C.R.)
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295 Montpellier, France
| | - Radjiv Goulabchand
- Internal Medicine Department, CHU Nîmes, University of Montpellier, 30029 Nîmes, France; (C.D.); (J.B.); (E.A.); (J.H.); (M.F.)
- Institute for Regenerative Medicine & Biotherapy, St. Eloi Hospital, University of Montpellier, INSERM, 34295 Montpellier, France
- Correspondence: ; Tel.: +33-(0)4-66683241
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Zambon Azevedo V, Silaghi CA, Maurel T, Silaghi H, Ratziu V, Pais R. Impact of Sarcopenia on the Severity of the Liver Damage in Patients With Non-alcoholic Fatty Liver Disease. Front Nutr 2022; 8:774030. [PMID: 35111794 PMCID: PMC8802760 DOI: 10.3389/fnut.2021.774030] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/21/2021] [Indexed: 12/12/2022] Open
Abstract
An extensive body of the literature shows a strong interrelationship between the pathogenic pathways of non-alcoholic fatty liver disease (NAFLD) and sarcopenia through the muscle-liver-adipose tissue axis. NAFLD is one of the leading causes of chronic liver diseases (CLD) affecting more than one-quarter of the general population worldwide. The disease severity spectrum ranges from simple steatosis to non-alcoholic steatohepatitis (NASH), cirrhosis, and its complications: end-stage chronic liver disease and hepatocellular carcinoma. Sarcopenia, defined as a progressive loss of the skeletal muscle mass, reduces physical performances, is associated with metabolic dysfunction and, possibly, has a causative role in NAFLD pathogenesis. Muscle mass is a key determinant of the whole-body insulin-mediated glucose metabolism and impacts fatty liver oxidation and energy homeostasis. These mechanisms drive the accumulation of ectopic fat both in the liver (steatosis, fatty liver) and in the muscle (myosteatosis). Myosteatosis rather than the muscle mass per se, seems to be closely associated with the severity of the liver injury. Sarcopenic obesity is a recently described entity which associates both sarcopenia and obesity and may trigger worse clinical outcomes including hepatic fibrosis progression and musculoskeletal disabilities. Furthermore, the muscle-liver-adipose tissue axis has a pivotal role in changes of the body composition, resulting in a distinct clinical phenotype that enables the identification of the "sarcopenic NAFLD phenotype." This review aims to bring some light into the complex relationship between sarcopenia and NAFLD and critically discuss the key mechanisms linking NAFLD to sarcopenia, as well as some of the clinical consequences associated with the coexistence of these two entities: the impact of body composition phenotypes on muscle morphology, the concept of sarcopenic obesity, the relationship between sarcopenia and the severity of the liver damage and finally, the future directions and the existing gaps in the knowledge.
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Affiliation(s)
- Vittoria Zambon Azevedo
- Doctoral School Physiology, Physiopathology and Therapeutics 394, Sorbonne Université, Paris, France
- Centre de Recherche de Cordeliers, INSERM UMRS 1138, Paris, France
| | - Cristina Alina Silaghi
- Department of Endocrinology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Thomas Maurel
- Institute of Cardiometabolism and Nutrition, Paris, France
- Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Horatiu Silaghi
- Department of Surgery V, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Vlad Ratziu
- Centre de Recherche de Cordeliers, INSERM UMRS 1138, Paris, France
- Institute of Cardiometabolism and Nutrition, Paris, France
- Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
- Sorbonne Université, Paris, France
| | - Raluca Pais
- Institute of Cardiometabolism and Nutrition, Paris, France
- Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
- Sorbonne Université, Paris, France
- Centre de Recherche Saint Antoine, INSERM UMRS 938, Paris, France
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Haigis D, Matting L, Wagner S, Sudeck G, Frahsa A, Thiel A, Eschweiler G, Nieß AM. Identification of Sarcopenic Obesity in German Nursing Home Residents-The Role of Body Composition and Malnutrition in the BaSAlt Cohort-Study. Nutrients 2021; 13:nu13113791. [PMID: 34836048 PMCID: PMC8625583 DOI: 10.3390/nu13113791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Sarcopenic obesity (SO) is a phenotype, which is defined by reduced muscle strength, muscle mass, and obesity. Limited mobility leads to increased sedentary behavior and decreased physical activity. Both sarcopenia and obesity are aggravated by these factors. In combination, SO is an additional challenge for the setting nursing home (NH). Previous studies have shown a low prevalence of residents with SO in comparable settings, such as community-dwelling. We hypothesize that the BaSAlt cohort also has a small proportion of residents with SO. Methods: For the analysis, 66 residents (women: 74.2%) aged ≥ 65 years from NH, were screened for SO based on EWGSOP2 specifications and cut-off values to classify obesity. Results: Severe sarcopenia was quantified in eleven residents (16.7%). The majority of sarcopenic residents were women (n = 10) compared to men (n = 1). However, no SO could be identified by assessment of body mass index, fat mass in percentage, and fat mass index. Conclusion: As expected, the setting-specific cohort showed a low number of SO. Furthermore, no case of SO was identified in our study. Sarcopenia was associated with an increased fat-free mass in NH residents. Nevertheless, sarcopenia and obesity play important roles in the preservation of residents’ health.
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Affiliation(s)
- Daniel Haigis
- Department of Sports Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany; (S.W.); (A.M.N.)
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Correspondence:
| | - Leon Matting
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Institute of Sport Science, Faculty of Economics and Social Sciences, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Silas Wagner
- Department of Sports Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany; (S.W.); (A.M.N.)
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
| | - Gorden Sudeck
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Institute of Sport Science, Faculty of Economics and Social Sciences, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Annika Frahsa
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Institute of Sport Science, Faculty of Economics and Social Sciences, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
- Institute of Social and Preventive Medicine, Faculty of Medicine, University of Bern, 3012 Bern, Switzerland
| | - Ansgar Thiel
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Institute of Sport Science, Faculty of Economics and Social Sciences, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Gerhard Eschweiler
- Centre for Geriatric Medicine, Faculty of Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany;
| | - Andreas Michael Nieß
- Department of Sports Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany; (S.W.); (A.M.N.)
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
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Evans K, Abdelhafiz D, Abdelhafiz AH. Sarcopenic obesity as a determinant of cardiovascular disease risk in older people: a systematic review. Postgrad Med 2021; 133:831-842. [PMID: 34126036 DOI: 10.1080/00325481.2021.1942934] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Aging is associated with body composition changes that include a reduction of muscle mass or sarcopenia and an increase in visceral obesity. Thus, aging involves a muscle-fat imbalance with a shift toward more fat and less muscle. Therefore, sarcopenic obesity, defined as a combination of sarcopenia and obesity, is a global health phenomenon due to the increased aging of the population combined with the increased epidemic of obesity. Previous studies have shown inconsistent association between sarcopenic obesity and the risk of cardiovascular disease (CVD). AIMS To systematically review the recent literature on the CVD risks associated with sarcopenic obesity and summarizes ways of diagnosis and prevention. METHODS A systematic review of studies that reported the association between sarcopenic obesity and CVD risk in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. RESULTS Risk factors of sarcopenic obesity included genetic factors, aging, malnutrition, sedentary lifestyle, hormonal deficiencies and other molecular changes. The muscle-fat imbalance with increasing age results in an increase in the pro-inflammatory adipokines secreted by adipocytes and a decline in the anti-inflammatory myokines secreted by myocytes. This imbalance promotes and perpetuates a chronic low-grade inflammatory state that is characteristic of sarcopenic obesity. After application of exclusion criteria, only 12 recent studies were included in this review. The recent studies have shown a consistent association between sarcopenic obesity and cardiovascular disease risk although most of the studies are of cross-sectional design that does not confirm a causal relationship. In addition, most of the population studied were of Asian origin which may limit the generalizability of the results. Non-pharmacological interventions by exercise training and adequate nutrition appear to be useful in maintenance of muscle strength and muscle mass in combination with a reduction of adiposity to promote healthy aging. CONCLUSIONS Sarcopenic obesity appears to increase the risk of CVD in older people; however, future prospective studies of diverse population are still required. Although non-pharmacologic interventions are useful in reducing the risk of sarcopenic obesity, novel specific pharmacologic agents are lacking.
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Affiliation(s)
- Katherine Evans
- Department of Geriatric Medicine, Rotherham General Hospital, Rotherham UK
| | | | - Ahmed H Abdelhafiz
- Department of Geriatric Medicine, Rotherham General Hospital, Rotherham UK
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Kompaniyets L, Goodman AB, Belay B, Freedman DS, Sucosky MS, Lange SJ, Gundlapalli AV, Boehmer TK, Blanck HM. Body Mass Index and Risk for COVID-19-Related Hospitalization, Intensive Care Unit Admission, Invasive Mechanical Ventilation, and Death - United States, March-December 2020. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 70:355-361. [PMID: 33705371 PMCID: PMC7951819 DOI: 10.15585/mmwr.mm7010e4] [Citation(s) in RCA: 262] [Impact Index Per Article: 87.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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