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Chen LK. Unique compositional signature, pathophysiology and clinical implications of sarcopenic obesity. Arch Gerontol Geriatr 2024; 124:105501. [PMID: 38821729 DOI: 10.1016/j.archger.2024.105501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Affiliation(s)
- Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan.
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Song WQ, Zhong WF, Gao J, Li ZH, Ren JJ, Shen D, Wang XM, Shen QQ, You FF, Fu Q, Li C, Chen H, Lv YB, Shi XM, Mao C. Metabolic obesity phenotypes and all-cause mortality among the Chinese oldest-old population: a prospective cohort study. Int J Obes (Lond) 2024:10.1038/s41366-024-01571-x. [PMID: 38926462 DOI: 10.1038/s41366-024-01571-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 06/07/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND The obesity paradox has been reported among older adults. However, whether the favorable effect of obesity is dependent on metabolic status remains largely unknown. We aimed to explore the association of metabolic obesity phenotypes and their changes with all-cause mortality among the Chinese oldest-old population. METHODS This prospective cohort study included 1207 Chinese oldest old (mean age: 91.8 years). Metabolic obesity phenotypes were determined by central obesity and metabolic status, and participants were classified into metabolically healthy obesity (MHO), metabolically unhealthy obesity (MUO), metabolically healthy non-obesity (MHN), and metabolically unhealthy non-obesity (MUN). The hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated by Cox regression models. RESULTS During 5.3 years of follow-up, 640 deaths were documented. Compared with non-obesity, obesity was associated with a decreased mortality risk among participants with metabolically healthy (HR, 0.75; 95% CI, 0.63-0.91) while this association was insignificant among metabolically unhealthy. Compared to MHO, MHN (HR, 1.27; 95% CI, 1.06-1.53) and MUN (HR, 1.49; 95% CI, 1.10-2.02) were significantly associated with an increased mortality risk. Compared to those with stable MHO, those transited from MHO to MUO demonstrated a higher mortality risk (HR, 1.81; 95% CI, 1.06-3.11). CONCLUSIONS MHO predicts better survival among the Chinese oldest-old population. These findings suggest that ensuring optimal management of metabolic health is beneficial and taking caution in weight loss based on the individual body weight for the metabolically healthy oldest-old adults.
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Affiliation(s)
- Wei-Qi Song
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Wen-Fang Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jian Gao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhi-Hao Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiao-Jiao Ren
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Dong Shen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao-Meng Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiao-Qiao Shen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Fang-Fei You
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Qi Fu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Chuan Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Huan Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.
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Veronese N, Ragusa FS, Pegreffi F, Dominguez LJ, Barbagallo M, Zanetti M, Cereda E. Sarcopenic obesity and health outcomes: An umbrella review of systematic reviews with meta-analysis. J Cachexia Sarcopenia Muscle 2024. [PMID: 38897937 DOI: 10.1002/jcsm.13502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/03/2024] [Accepted: 04/16/2024] [Indexed: 06/21/2024] Open
Abstract
Many studies support the idea that sarcopenic obesity (SO) could be considered a potential risk factor for negative health outcomes. These results have been inconsistent, and no umbrella reviews exist regarding this topic. Several databases until November 2023 were searched for systematic reviews with meta-analysis of observational studies (cross-sectional, case-control and prospective). For each association, random-effects summary effect sizes with correspondent 95% confidence intervals (CIs) were evaluated using the GRADE tool. Among the 213 papers initially screened, nine systematic reviews with meta-analysis were included, for a total of 384 710 participants. In cross-sectional and case-control studies, 30 different outcomes were analysed, and 18 were statistically significant. In any population addressed in cross-sectional and case-control studies, compared with non-SO, SO increased the prevalence of cognitive impairment (k = 3; odds ratio [OR] = 3.46; 95% CI: 2.24-5.32; high certainty of evidence), coronary artery disease (k = 2; OR = 2.48; 95% CI: 1.85-3.31) and dyslipidaemia (k = 3; OR = 2.50; 95% CI: 1.51-4.15). When compared with sarcopenia or obesity, the results were conflicting. In prospective studies, the association between SO-compared with non-SO-and other negative outcomes was supported by low/very low certainty of evidence and limited to a few conditions. Besides, no comparison with sarcopenia or obesity was provided. Finally, only a few studies have considered muscle function/physical performance in the diagnostic workup. SO could be considered a risk factor only for a few conditions, with the literature mainly based on cross-sectional and case-control studies. Future studies with clear definitions of SO are needed for quantifying the importance of SO-particularly when compared with the presence of only sarcopenia or obesity-and the weight of muscle function/physical performance in its definition.
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Affiliation(s)
- Nicola Veronese
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Francesco Saverio Ragusa
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Francesco Pegreffi
- Dipartimento di Scienze per la Qualità della Vita-QUVI, Università di Bologna, Rimini, Italy
| | - Ligia J Dominguez
- Faculty of Medicine and Surgery, "Kore" University of Enna, Enna, Italy
| | - Mario Barbagallo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Michela Zanetti
- Geriatric Clinic, Maggiore Hospital of Trieste, Azienda Sanitaria Universitaria Integrata Giuliano Isontina, Trieste, Italy
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Emanuele Cereda
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Wu Y, Li D, Vermund SH. Advantages and Limitations of the Body Mass Index (BMI) to Assess Adult Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:757. [PMID: 38929003 PMCID: PMC11204233 DOI: 10.3390/ijerph21060757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/27/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Abstract
Obesity reflects excessive fat deposits. At-risk individuals are guided by healthcare professionals to eat fewer calories and exercise more, often using body mass index (BMI; weight/height2) thresholds for screening and to guide progress and prognosis. By conducting a mini-narrative review of original articles, websites, editorials, commentaries, and guidelines, we sought to place BMI in the context of its appropriate use in population health, clinical screening, and monitoring in clinical care. The review covers studies and publications through 2023, encompassing consensus reviews and relevant literature. Recent consensus reviews suggest that BMI is a valuable tool for population surveys and primary healthcare screening but has limitations in predicting the risk of chronic diseases and assessing excess fat. BMI can guide nutritional and exercise counseling, even if it is inadequate for reliable individual risk prediction. BMI cut-offs must be reconsidered in populations of varying body build, age, and/or ethnicity. Since BMI-diagnosed overweight persons are sometimes physically and physiologically fit by other indicators, persons who are overweight on BMI should be more fully evaluated, diagnosed, and monitored with combined anthropometric and performance metrics to better clarify risks. The use of combined anthropometric and performance metrics involves integrating measurements of body composition with assessments of physical function and fitness to provide a more comprehensive evaluation of an individual's health and fitness status. Eligibility for bariatric surgery or semaglutide satiety/appetite-reduction medications should not be determined by BMI alone. Awareness of the advantages and limitations of using BMI as a tool to assess adult obesity can maximize its appropriate use in the context of population health and in rapid clinical screening and evaluation.
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Affiliation(s)
- Yilun Wu
- Department of Biostatistics, Yale School of Public Health, New Haven, CT 06510, USA;
| | - Dan Li
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510, USA;
| | - Sten H. Vermund
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510, USA;
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5
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Hu F, Zhang G, Xu Z, Zuo Z, Huang N, Ge M, Liu X, Dong B. The diagnostic agreement of sarcopenic obesity with different definitions in Chinese community-dwelling middle-aged and older adults. Front Public Health 2024; 12:1356878. [PMID: 38903580 PMCID: PMC11188776 DOI: 10.3389/fpubh.2024.1356878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/17/2024] [Indexed: 06/22/2024] Open
Abstract
Background In 2022, the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched a consensus on the diagnostic methods for sarcopenic obesity (SO). The study aimed to identify the prevalence and diagnostic agreement of SO using different diagnostic methods in a cohort of subjects from West China aged at least 50 years old. Methods A large multi-ethnic sample of 4,155 participants from the West China Health and Aging Trend (WCHAT) study was analyzed. SO was defined according to the newly published consensus of the ESPEN/EASO. Furthermore, SO was diagnosed as a combination of sarcopenia and obesity. The criteria established by the Asian Working Group for Sarcopenia 2019 (AWGS2019) were used to define sarcopenia. Obesity was defined by four widely used indicators: percent of body fat (PBF), visceral fat area (VFA), waist circumference (WC), and body mass index (BMI). Cohen's kappa was used to analyze the diagnostic agreement of the above five diagnostic methods. Results A total of 4,155 participants were part of the study, including 1,499 men (63.76 ± 8.23 years) and 2,656 women (61.61 ± 8.20 years). The prevalence of SO was 0.63-7.22% with different diagnostic methods. The diagnosis agreement of five diagnostic methods was poor-to-good (κ: 0.06-0.67). The consensus by the ESPEN/EASO had the poorest agreement with other methods (κ: 0.06-0.32). AWGS+VFA had the best agreement with AWGS+WC (κ = 0.67), and consensus by the ESPEN/EASO had the best agreement with AWGS+ PBF (κ = 0.32). Conclusion The prevalence and diagnostic agreement of SO varies considerably between different diagnostic methods. AWGS+WC has the highest diagnostic rate in the diagnosis of SO, whereas AWGS+BMI has the lowest. AWGS+VFA has a relatively good diagnostic agreement with other diagnostic methods, while the consensus of the ESPEN/EASO has a poor diagnostic agreement. AWGS+PBF may be suitable for the alternative diagnosis of the 2022 ESPEN/EASO.
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Affiliation(s)
- Fengjuan Hu
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Gongchang Zhang
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhigang Xu
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Zhiliang Zuo
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ning Huang
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Meiling Ge
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaolei Liu
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Birong Dong
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Mendoza-Núñez VM, Aguilar-Curiel JV, Castillo-Martínez L, Rodríguez-García WD, Vaquero-Barbosa N, Rosado-Pérez J, Arista-Ugalde TL. Relationship between aging and excess body fat with markers of inflammation, skeletal muscle mass and strength in Mexican community-dwelling people. Ir J Med Sci 2024:10.1007/s11845-024-03727-0. [PMID: 38834899 DOI: 10.1007/s11845-024-03727-0] [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: 12/20/2023] [Accepted: 05/26/2024] [Indexed: 06/06/2024]
Abstract
INTRODUCTION Aging is accompanied by changes in body composition, such as an increase in fat mass (FM), a decrease in skeletal muscle mass index (SMMI) and muscle strength, combined with a chronic inflammatory process (CI). OBJECTIVE Determine the relationship between age and excess body fat with markers of chronic inflammation, skeletal muscle mass and strength. METHODS A cross-sectional alitical study was carried out in a convenience sample of adults 45 to 59 years old (n = 100) and older adults 60 to 74 years old (n = 133). All participants had their body composition measured with an impedance meter. They were subsequently divided into two groups: (i) with excess fat (WEF), (ii) without excess fat (NEF), in order to relate excess fat and age with inflammation, muscle mass and strength. RESULTS NEF adults and older adults had similar values of SMMI (9.1 ± 1.5 vs. 8.8 ± 1.3, p > 0.05) and strength (28 ± 8 vs. 27 ± 8.6, p > 0.05). Likewise, WEF adults showed significantly lower values than NEF adults in the SMMI (7.9 ± 0.8 vs. 9.1 ± 1.5, p < 0.05) and strength (28 ± 8 vs. 22 ± 5, p < 0.001). Also, WEF older adults presented significantly lower values in the SMMI (15.9 ± 1.8 vs. 22.8 ± 5.1, p < 0.05) and strength (17.9 ± 4.8 vs. 27 ± 8.6, p < 0.001). CONCLUSIONS Our findings suggest that excess fat mass is a risk factor that has a significantly greater influence than aging per se on the index of skeletal muscle mass and strength.
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Affiliation(s)
- Víctor Manuel Mendoza-Núñez
- Research Unit On Gerontology, FES Zaragoza, National Autonomous University of Mexico, Guelatao # 66, Alcaldía Iztapalapa, 09230, Mexico City, Mexico.
| | - Jimena Valeria Aguilar-Curiel
- Research Unit On Gerontology, FES Zaragoza, National Autonomous University of Mexico, Guelatao # 66, Alcaldía Iztapalapa, 09230, Mexico City, Mexico
| | - Lilia Castillo-Martínez
- Clinical Nutrition Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Nayeli Vaquero-Barbosa
- Research Unit On Gerontology, FES Zaragoza, National Autonomous University of Mexico, Guelatao # 66, Alcaldía Iztapalapa, 09230, Mexico City, Mexico
| | - Juana Rosado-Pérez
- Research Unit On Gerontology, FES Zaragoza, National Autonomous University of Mexico, Guelatao # 66, Alcaldía Iztapalapa, 09230, Mexico City, Mexico
| | - Taide Laurita Arista-Ugalde
- Research Unit On Gerontology, FES Zaragoza, National Autonomous University of Mexico, Guelatao # 66, Alcaldía Iztapalapa, 09230, Mexico City, Mexico
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Coelho MPP, de Vries TP, Pires AM, Parreira MP, de Alvarenga ÉR, Cambraia RD, Dos Santos RR, Bezerra JMT, Colosimo EA, Rocha GA, Silva LD. Skeletal muscle mass increases after viral eradication with direct-acting antivirals in patients with chronic hepatitis C: A longitudinal study. Aliment Pharmacol Ther 2024; 59:1387-1401. [PMID: 38501893 DOI: 10.1111/apt.17950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/16/2023] [Accepted: 03/04/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Results of studies evaluating the effect of viral eradication following direct-acting antiviral (DDA) therapy on skeletal muscle mass of patients with chronic hepatitis C (CHC) are scarce. AIM To assess the components of sarcopenia (low muscle mass, low muscle strength and low physical performance) in a cohort of CHC individuals before and after DAA therapy. METHODS We performed a longitudinal study of patients with CHC who underwent body composition assessment before (T0), and at 12 (T1) and 48 (T2) weeks after DDA therapy. Bioelectrical Impedance Analysis was used to assess skeletal mass muscle (SM) and phase angle (PhA). SM index (SMI) was calculated by dividing the SM by squared height. Muscle function was evaluated by hand grip strength (HGS) and timed up-and-go (TUG) test. Mixed-effects linear regression models were fitted to SMI, HGS and physical performance and were used to test the effect of HCV eradication by DAA. RESULTS 62 outpatients (mean age, 58.6 ± 10.8 years; 58% with compensated cirrhosis) were included. Significant decreases in liver fibrosis markers and an increase of 0.20 and 0.22 kg/m2 in the SMI were observed at T1 and T2. Following DAA therapy, an increase of one unit of PhA was associated with a reduction of 0.38 min in TUG. CONCLUSION HCV eradication with DAA therapy was associated with a dynamic reduction of non-invasive markers of liver fibrosis and increased muscle mass in 62 patients with CHC who had an undetectable HCV load at 12 weeks after completion of antiviral treatment.
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Affiliation(s)
- Marta Paula Pereira Coelho
- Sciences Applied to Adult Health Care Post-Graduate Programme, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
- Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Thais Pontello de Vries
- Sciences Applied to Adult Health Care Post-Graduate Programme, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
- Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Aline Marcos Pires
- Sciences Applied to Adult Health Care Post-Graduate Programme, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
- Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Milena Pereira Parreira
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Érika Ramos de Alvarenga
- Department of Statistics, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Rodrigo Dias Cambraia
- Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rodrigo Ribeiro Dos Santos
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Juliana Maria Trindade Bezerra
- Biological Sciences Degree Course, Universidade Estadual do Maranhão (UEMA), Lago da Pedra, Brazil
- Animal Science Post-Graduate Programme, Universidade Estadual do Maranhão (UEMA), São Luís, Brazil
- Parasitology Post-Graduate Programme, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Enrico Antonio Colosimo
- Department of Statistics, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Gifone Aguiar Rocha
- Laboratory of Research in Bacteriology, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Luciana Diniz Silva
- Sciences Applied to Adult Health Care Post-Graduate Programme, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
- Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Zhang N, Qu X, Zhou H, Kang L. Mapping Knowledge Landscapes and Emerging Trends of Sarcopenic Obesity in Older Adults: A Bibliometric Analysis From 2004 to 2023. Cureus 2024; 16:e62300. [PMID: 38873392 PMCID: PMC11170931 DOI: 10.7759/cureus.62300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2024] [Indexed: 06/15/2024] Open
Abstract
Background The prevalence of obesity in combination with sarcopenia, the age-related loss of muscle mass and strength or physical function, is on the rise among adults aged 65 years and older. A significant portion of this demographic now falls under the classification of sarcopenic obesity, a high-risk geriatric syndrome predominantly seen in an aging population vulnerable to compounded complications from both sarcopenia and obesity. It is essential to promptly evaluate the impact of academic research in this field, taking into account factors such as geographical regions, authors, journals, and institutions. Furthermore, exploring current topics and identifying potential areas that could inspire future researchers to conduct additional studies is crucial for advancing overall health in this population. Methodology A search was conducted in the Web of Science Core Collection database to identify English language articles and reviews focusing on sarcopenic obesity in older adults, published between January 1, 2004, and December 31, 2023. Bibliometric analysis was performed using VOSviewer (v.1.6.18) and CiteSpace (v.6.1.R2). Results A total of 985 original English-language articles were collected, consisting of 783 articles and 202 reviews. The volume of research publications in this field has shown significant growth since 2012. The United States leads in contributions, with 239 articles (24.3% of the total) and the highest number of citations at 18,403, along with the highest total link strength. The University of Melbourne in Australia stands out with 25 published articles (2.5% of the total). University of Verona in Italy has the most citations at 9,405, and Monash University in Australia has the highest total link strength at 53. Among prolific authors, John A. Batsis from Duke University is the most productive with 24 articles (2.4% of the total). The journal "Nutrients" has the most articles on sarcopenic obesity in older adults, publishing 54 articles (5.5% of the total). Key topics in this area include sarcopenia, obesity, sarcopenic obesity, and elderly. Recent interventions focus on "nutrition" and "exercise" for sarcopenic obesity in older adults. Conclusions Research on sarcopenic obesity in older adults has seen significant growth on a global scale from 2004 to 2023, indicating a promising area for further study with potential benefits from current advancements. Although academic inquiries have shed light on various aspects of sarcopenic obesity in older adults, there remains a noticeable dearth of clinical research and evidence-based medicine on the effective management of this condition in elderly individuals. Future studies could focus on developing tailored interventions for older adults with sarcopenic obesity.
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Affiliation(s)
- Ning Zhang
- Department of Geriatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, CHN
| | - Xuan Qu
- Department of Geriatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, CHN
| | - Haokang Zhou
- Department of Internal Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, CHN
| | - Lin Kang
- Department of Geriatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, CHN
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Yen CH, Lee YW, Chang WJ, Lin PT. The Mini Nutritional Assessment combined with body fat for detecting the risk of sarcopenia and sarcopenic obesity in metabolic syndrome. Br J Nutr 2024; 131:1659-1667. [PMID: 38312003 DOI: 10.1017/s0007114524000369] [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: 02/06/2024]
Abstract
Malnutrition is a key factor in metabolic syndrome (MS) and sarcopenia, assessing the nutritional status of these patients is a pressing issue. The purpose of this study was to clarify sarcopenia and sarcopenic obesity in patients with MS based on nutritional status. This was a case-control study between MS/non-MS. Body composition was measured by dual-energy X-ray absorptiometry. Muscle function was assessed by handgrip strength, five times sit-to-stand test, gait speed test and short physical performance battery (SPPB). The Mini Nutritional Assessment (MNA) was performed to assess the nutritional status in the participants in this study. Overall, a total of 56 % and 13 % of participants suffered from possible sarcopenia and sarcopenia, respectively. There was a higher rate of possible sarcopenic obesity in the MS group than in the non-MS group (48·9 % v. 24·7 %, P < 0·01), and all the sarcopenia participants in the MS group had sarcopenic obesity. MNA score was significantly associated with sarcopenia status (P < 0·01). The MNA combined with body fat score showed better acceptable discrimination for detecting sarcopenic obesity and sarcopenia in MS (AUC = 0·70, 95 % CI 0·53, 0·86). In summary, there was a higher prevalence of possible sarcopenic obesity in MS, and all the MS patients with sarcopenia had sarcopenic obesity in the present study. We suggest that the MNA should be combined with body fat percentage to assess the nutritional status of MS participants, and it also serves as a good indicator for sarcopenia and sarcopenic obesity in MS.
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Affiliation(s)
- Chi-Hua Yen
- School of medicine, Chung Shan Medical University, Taichung402367, Taiwan
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung402367, Taiwan
| | - Yi-Wen Lee
- Department of Nutrition, Chung Shan Medical University, Taichung402367, Taiwan
| | - Wei-Jung Chang
- Department of Nutrition, Chung Shan Medical University, Taichung402367, Taiwan
| | - Ping-Ting Lin
- Department of Nutrition, Chung Shan Medical University, Taichung402367, Taiwan
- Department of Nutrition, Chung Shan Medical University Hospital, Taichung402367, Taiwan
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10
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Qiu W, Cai A, Li L, Feng Y. Trend in prevalence, associated risk factors, and longitudinal outcomes of sarcopenia in China: A national cohort study. J Intern Med 2024. [PMID: 38801732 DOI: 10.1111/joim.13808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
AIMS To estimate the contemporary trend in the prevalence of sarcopenia and evaluate its risk factors and the longitudinal associations with multiple chronic conditions and mortality among Chinese middle-aged and older adults. METHODS This was a nationwide, prospective cohort study using data from the China Health and Retirement Longitudinal Study. The definition of sarcopenia was based on the Asian Working Group for Sarcopenia 2019 algorithm. In the cross-sectional analysis, we estimated the trend in the weighted prevalence of sarcopenia from 2011 to 2015 and examined the associated risk factors for sarcopenia severity in 2011. In the longitudinal analysis, we assessed the longitudinal associations between sarcopenia and 14 chronic conditions and mortality during a 9-year follow-up. RESULTS The weighted prevalence of sarcopenia remained consistently high in the overall population from 2011 (15.9%, 95% confidence intervals [CI]: 15.1, 16.6) to 2015 (15.0%, 95% CI: 14.3, 15.6; p for trend = 0.075). A range of risk factors were independently associated with the severity of sarcopenia, including older age, female sex, lower socioeconomic status, smoking status, malnutrition, and several chronic conditions. Possible sarcopenic and sarcopenic individuals had higher odds of several chronic conditions (i.e., heart disease, chronic lung disease, and memory-related disease) and increased risks of mortality (possible sarcopenia: odds ratios (OR): 1.66, 95% CI: 1.37, 2.00; sarcopenia: OR: 1.69, 95% CI: 1.36, 2.11) in 9 years of follow-up. CONCLUSIONS The prevalence of sarcopenia remained consistently high in the investigated population. Various risk factors were significantly associated with a higher prevalence of sarcopenia. Sarcopenic individuals had higher odds of several chronic conditions and increased risks of mortality, highlighting that the urgent need for dedicated efforts to improve the management of sarcopenic patients.
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Affiliation(s)
- Weida Qiu
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Anping Cai
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Liwen Li
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Yingqing Feng
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
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11
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Prado CM, Batsis JA, Donini LM, Gonzalez MC, Siervo M. Sarcopenic obesity in older adults: a clinical overview. Nat Rev Endocrinol 2024; 20:261-277. [PMID: 38321142 DOI: 10.1038/s41574-023-00943-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 02/08/2024]
Abstract
Sarcopenic obesity is characterized by a concurrent decline in muscle mass and function, along with increased adipose tissue. Sarcopenic obesity is a growing concern in older adults owing to significant health consequences, including implications for mortality, comorbidities and risk of developing geriatric syndromes. A 2022 consensus statement established a new definition and diagnostic criteria for sarcopenic obesity. The pathophysiology of this condition involves a complex interplay between muscle, adipose tissue, hormonal changes, inflammation, oxidative stress and lifestyle factors, among others. Sarcopenic obesity is treated with a range of management approaches, such as lifestyle interventions, exercise, nutrition and medical therapies. Emerging therapies that were developed for treating other conditions may be relevant to sarcopenic obesity, including novel pharmacological agents and personalized approaches such as precision medicine. In this Review, we synthesize the current knowledge of the clinical importance of sarcopenic obesity, its assessment and diagnosis, along with current and emerging management strategies.
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Affiliation(s)
- Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.
| | - John A Batsis
- Division of Geriatric Medicine, School of Medicine, and Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lorenzo M Donini
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - M Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Pelotas, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Mario Siervo
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Curtin Dementia Centre of Excellence, enAble Institute, Curtin University, Perth, Western Australia, Australia
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12
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Li ML, Zhang F, Luo HY, Quan ZW, Wang YF, Huang LT, Wang JH. Improving sarcopenia in older adults: a systematic review and meta-analysis of randomized controlled trials of whey protein supplementation with or without resistance training. J Nutr Health Aging 2024; 28:100184. [PMID: 38350303 DOI: 10.1016/j.jnha.2024.100184] [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: 11/09/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVES The aim of the study was to comprehensively analyze the effects of whey protein (WP)-enriched supplement intake with or without resistance training (RT) in older patients, either from the community or hospital, who were diagnosed with sarcopenia according to the EWGSOP or AWGS criteria. METHODS This meta-analysis study was registered in PROSPERO (CRD42023407885). We searched the PubMed, Embase, Web of Science, and Cochrane Library databases for RCTs up to June 1, 2023. Standardized mean differences (SMD) with 95% confidence intervals (CI) were used to estimate the pooled results. RESULTS Ten RCT studies, including 1154 participants, were included and analyzed. The primary outcomes were the changes in muscle mass, strength, and physical performance. In WP group versus (vs.) Isocaloric placebo (PLA)/Routine consultation (RC) group, WP significantly increased the appendicular skeletal muscle mass index (SMD: 0.47, 95%CI: 0.23, 0.71), appendicular skeletal muscle mass (SMD: 0.28, 95%CI: 0.11, 0.45) and gait speed (SMD: 1.13, 95%CI: 0.82, 1.44) in older patients with sarcopenia. In WP with RT group vs. PLA/ RC group, there was significant increase in handgrip strength (SMD: 0.67, 95%CI: 0.29, 1.04). In addition, in the secondary outcomes, WP significantly reduced interleukin-6, significantly increased insulin-like growth factor-1 and albumin, promoted participants' intake of total energy and protein, enhanced activities of daily living scores in patients, and had no significant effect on BMI, weight, or fat mass. CONCLUSION This review confirms that WP can improve various aspects of older adult with sarcopenia, thereby enhancing their overall physical condition. More studies should be conducted to validate this result and further explore the effects of WP and RT in patients with sarcopenia.
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Affiliation(s)
- Ming-Lin Li
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Fei Zhang
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Han-Yong Luo
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Zi-Wei Quan
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yi-Fei Wang
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Le-Tian Huang
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China.
| | - Jia-He Wang
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China.
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13
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Zhong W, Zhao A, Wei X, Mao S, Li P, Shen Q, Zhang H, Jiang H, Wang P, Zhang Y. The Effect of Sn-2 Palmitate on Blood Glucose, Lipids and Body Composition in Middle-Aged and Elderly Adults: A Randomized, Double-Blinded Controlled Trial. Nutrients 2024; 16:973. [PMID: 38613008 PMCID: PMC11013204 DOI: 10.3390/nu16070973] [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: 02/11/2024] [Revised: 03/18/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Sn-2 palmitate is widely used in infant formula. However, little is known about its effects on metabolism and body composition in middle-aged and elderly adults. In a double-blinded, randomized controlled trial, we enrolled Chinese adults aged 45-75 years with self-reported constipation. Individuals were randomly assigned in a 1:1 ratio to a 1,3-dioleoyl-2-palmitoyl-glycerol (OPO)-enriched oil (66% palmitic acid in the sn-2 position) or a control vegetable oil (24% palmitic acid in the sn-2 position) daily for 24 weeks. Skim milk powder was used as the carrier for both fats. Interviews and body composition were performed at baseline, week 4, week 12 and week 24. A fasting blood draw was taken except at week 4. This study was a secondary analysis and considered exploratory. A total of 111 adults (83 women and 28 men, mean age 64.2 ± 7.0 years) were enrolled, of whom 53 were assigned to the OPO group and 57 to the control group. During the intervention, blood glucose, triglyceride, the triglyceride-glucose index, total cholesterol, low-density lipoprotein cholesterol and remnant cholesterol remained stable, while high-density lipoprotein cholesterol decreased in both groups (p = 0.003). No differences in change were observed between the groups (all p > 0.05). From baseline to week 24, the level of visceral fat increased slightly (p = 0.017), while body weight, total body water, protein, soft lean mass, fat-free mass, skeletal muscle and skeletal muscle mass index (SMI) decreased in two groups (p < 0.01). At weeks 4, 12 and 24, the SMI decreased less in the OPO group than in the control group, with a trend towards significance (p = 0.090). A 24-week daily intake of sn-2-palmitate-enriched oil had no adverse impact on fasting blood glucose, lipids and body composition compared with the control vegetable oil in Chinese adults (funded by Chinese Nutrition Society National Nutrition Science Research Grant, National Key Research and Development Program of China and Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd.; ChiCTR1900026480).
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Affiliation(s)
- Wuxian Zhong
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (W.Z.); (S.M.); (P.L.); (Q.S.)
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Xuetao Wei
- Department of Toxicology, School of Public Health, Peking University, Beijing 100191, China;
| | - Shuai Mao
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (W.Z.); (S.M.); (P.L.); (Q.S.)
| | - Pin Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (W.Z.); (S.M.); (P.L.); (Q.S.)
| | - Qianqian Shen
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (W.Z.); (S.M.); (P.L.); (Q.S.)
| | - Hong Zhang
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai 200137, China;
| | - Hua Jiang
- School of Nursing, Peking University, Beijing 100191, China
| | - Peiyu Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (W.Z.); (S.M.); (P.L.); (Q.S.)
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14
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Huang J, Han J, Rozi R, Fu B, Lu Z, Liu J, Ding Y. Association between lipid accumulation products and osteoarthritis among adults in the United States: A cross-sectional study, NHANES 2017-2020. Prev Med 2024; 180:107861. [PMID: 38244933 DOI: 10.1016/j.ypmed.2024.107861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVE Using cross-sectional data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES) for American, the aim of this research is to investigate the potential association between Lipid Accumulation Products (LAP) and the risk of osteoarthritis (OA). METHODS Data from the NHANES (2017-2020) were downloaded and further analyzed. The participants between 20 and 80 years reported having OA, and other relevant variables and information on LAP were included. The linear and non-linear associations between LAP and OA were evaluated using multivariable logistic regression analysis and smoothed curve fitting methods. A two-part linear regression model was also used to estimate threshold effects. RESULTS The increased risk of OA was shown to have a nonlinear relationship with higher LAP, showing a solid threshold impact with a saturation value of 120.00 cm × mmol/L, according to our data. The two variables showed a positive relationship to the left of the saturation point but no significant association to the right, pointing to a complicated nonlinear relationship between OA prevalence and LAP. CONCLUSIONS Our findings revealed that LAP was an independent risk factor for OA when it was <120.00 cm × mmol/L. The LAP index may serve as a valuable method for predicting and diagnosed OA. To validate our results, further large-scale prospective research are required.
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Affiliation(s)
- Jie Huang
- Orthopaedics of TCM Senior Department, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China; Department of Orthopaedics, School of Medicine, South China University of Technology, Guangzhou 510006, China
| | - Jiaheng Han
- Orthopaedics of TCM Senior Department, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China; Department of Orthopaedics, School of Medicine, South China University of Technology, Guangzhou 510006, China
| | - Rigbat Rozi
- Orthopaedics of TCM Senior Department, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China
| | - Bensheng Fu
- Orthopaedics of TCM Senior Department, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China
| | - Zhengcao Lu
- Orthopaedics of TCM Senior Department, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China; Department of Orthopaedics, School of Medicine, Jinzhou Medical University, Jinzhou 121001, China
| | - Jiang Liu
- Orthopaedics of TCM Senior Department, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China
| | - Yu Ding
- Orthopaedics of TCM Senior Department, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China; Department of Orthopaedics, School of Medicine, South China University of Technology, Guangzhou 510006, China; Department of Orthopaedics, School of Medicine, Jinzhou Medical University, Jinzhou 121001, China.
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15
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Marini E, Sulis S, Vorobel'ová L, Stagi S. Specific bioelectrical vectors pattern in individuals with sarcopenic obesity. Clin Nutr 2024; 43:620-628. [PMID: 38306890 DOI: 10.1016/j.clnu.2024.01.024] [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: 10/03/2023] [Revised: 12/31/2023] [Accepted: 01/22/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Sarcopenic obesity is a common condition in the elderly associated with excessive adiposity and low muscle mass and strength. AIMS This study aims to establish a method for detecting bioelectrical characteristics in individuals with sarcopenic obesity through specific Bioelectrical Impedance Vector Analysis (specific BIVA), while considering the characteristics of individuals with healthy, sarcopenic, and obese conditions. METHODS The sample was composed by 915 Italian adults over 50 years of age (men: 74.6 ± 8.8 y; women:76.3 ± 8.8 y) living in Sardinia (Italy). A dataset of 1590 US adults aged 21 - 49 years retrieved from the 2003 - 2004 National Health and Nutrition Examination Survey was also considered in a final step of the study. Anthropometric (stature, weight, waist, arm, and calf circumferences) and whole-body bioelectrical variables were taken. In the Italian sample, bioelectrical impedance was applied to estimate the relative content of fat mass and skeletal muscle mass. Groups with healthy body composition (NS-NO), or consistent with sarcopenia (S), sarcopenic obesity (S-O), and obesity (O) were defined based on the cut-offs suggested by European expert guidelines (EWGSOP2 and ESPEN-EASO). Specific BIVA was applied to compare groups and to identify the area for sarcopenic obesity within young-adults tolerance ellipses. The position of the specific vector of US individuals with S-O, selected on the basis of DXA measurements, was also considered. RESULTS In both sexes of the Italian sample, the bioelectrical characteristics of the four groups were different (p < 0.001). The differences were mainly related to vector length, indicative of higher fat mass, which was longer in the O and S-O groups, and phase angle, a proxy of intracellular/extracellular water and muscle mass, lower in the sarcopenic groups. Bioelectrical vectors of the S-O group fell in the right quadrant, outside of the 95 % tolerance ellipses of young adults. The mean vector of the US sample with S-O fell in the same area. Within the S-O area, women had similar bioelectrical values, while men showed phase angle variability, which was related to the severity of the condition. CONCLUSIONS Specific BIVA detects body composition peculiarities of individuals with sarcopenic obesity, thus allowing their diagnosis when associated with low handgrip strength values.
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Affiliation(s)
- Elisabetta Marini
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042 Cagliari, Italy.
| | - Simona Sulis
- Department of Anthropology, Comenius University, 84104, Bratislava, Slovakia
| | - Lenka Vorobel'ová
- Department of Anthropology, Comenius University, 84104, Bratislava, Slovakia
| | - Silvia Stagi
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042 Cagliari, Italy
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16
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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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17
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Watanabe D, Yoshida T, Watanabe Y, Yamada Y, Miyachi M, Kimura M. Frailty modifies the association of body mass index with mortality among older adults: Kyoto-Kameoka study. Clin Nutr 2024; 43:494-502. [PMID: 38184941 DOI: 10.1016/j.clnu.2024.01.002] [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: 10/02/2023] [Revised: 11/27/2023] [Accepted: 01/02/2024] [Indexed: 01/09/2024]
Abstract
BACKGROUND & AIMS The differences in the association of body mass index (BMI) with mortality between older adults with and without frailty remain unclear. This study investigated this association in community-dwelling older adults with and without frailty. METHODS This prospective study included 10,912 adults aged ≥65 years who provided valid responses to a baseline mail survey questionnaire in the Kyoto-Kameoka Study in Japan. The BMI was calculated based on self-reported height and body weight and classified into four categories: <18.5, 18.5-21.4, 21.5-24.9, and ≥25.0 kg/m2. Frailty was evaluated using the validated Kihon Checklist and defined as a score of 7 or higher out of a possible 25 points. Mortality data were collected from 30 July 2011 to 30 November 2016. Hazard ratios (HR) for all-cause mortality were calculated using a multivariable Cox proportional hazards model. RESULTS During the 5.3 year median follow-up period (54,084 person-years), 1352 deaths were recorded. After adjusting for confounders, including lifestyle and medical history, compared with participants with a BMI of 21.5-24.9 kg/m2, those in the lower BMI category had a higher mortality HR, while those with a higher BMI displayed an inverse association with mortality (<18.5 kg/m2: HR: 1.85, 95% confidence interval [CI]: 1.58-2.17; 18.5-21.4 kg/m2: HR: 1.38, 95% CI: 1.21-1.58; and ≥25.0 kg/m2: HR: 0.80, 95% CI: 0.67-0.96). In a model stratified by frailty status, the BMI range with the lowest HR for mortality was 23.0-24.0 kg/m2 in non-frail older adults; however, in frail older adults, a higher BMI was inversely associated with mortality. CONCLUSIONS The relationship between BMI and mortality varies between individuals with and without frailty, with those experiencing frailty potentially benefiting from a higher BMI compared to those without frailty. This study suggests that frailty should be assessed when considering the optimal BMI for the lowest mortality risk among older adults.
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Affiliation(s)
- Daiki Watanabe
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama 359-1192, Japan; National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17, Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan.
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17, Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; Senior Citizen's Welfare Section, Kameoka City Government, 8 Nonogami, Yasu-machi, Kameoka-city, Kyoto 621-8501, Japan; National Institute of Biomedical Innovation, National Institutes of Biomedical Innovation, Health and Nutrition, 7-6-8 Saito-Asagi, Ibaraki-city, Osaka 567-0085, Japan.
| | - Yuya Watanabe
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17, Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; Faculty of Sport Study, Biwako Seikei Sport College, 1204 Kitahira, Otsu-city, Shiga 520-0503, Japan.
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17, Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; National Institute of Biomedical Innovation, National Institutes of Biomedical Innovation, Health and Nutrition, 7-6-8 Saito-Asagi, Ibaraki-city, Osaka 567-0085, Japan.
| | - Motohiko Miyachi
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama 359-1192, Japan; National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17, Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan.
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto-city, Kyoto 602-8566, Japan.
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Eitmann S, Matrai P, Hegyi P, Balasko M, Eross B, Dorogi K, Petervari E. Obesity paradox in older sarcopenic adults - a delay in aging: A systematic review and meta-analysis. Ageing Res Rev 2024; 93:102164. [PMID: 38103840 DOI: 10.1016/j.arr.2023.102164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
The prognostic significance of obesity in sarcopenic adults is controversial. This systematic review and meta-analysis aimed to investigate the effect of additional obesity on health outcomes in sarcopenia. MEDLINE, EMBASE, Scopus and CENTRAL were systematically searched for studies to compare health outcomes of adults with sarcopenic obesity (SO) to those of sarcopenic non-obese (SNO) adults. We also considered the methods of assessing obesity. Of 15060 records screened, 65 papers were included (100612 participants). Older community-dwelling SO adults had 15% lower mortality risk than the SNO group (hazard ratio, HR: 0.85, 95% confidence interval 0.76, 0.94) even when obesity was assessed by measurement of body composition. Additionally, meta-regression analysis revealed a significant negative linear correlation between the age and the HR of all-cause mortality in SO vs. SNO community-dwelling adults, but not in severely ill patients. Compared with SNO, SO patients presented lower physical performance, higher risk for metabolic syndrome, but similar cognitive function, risk of falls and cardiovascular diseases. Age-related obesity, SO and later fat loss leading to SNO represent consecutive phases of biological aging. Additional obesity could worsen the health state in sarcopenia, but above 65 years SO represents a biologically earlier phase with longer life expectancy than SNO.
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Affiliation(s)
- Szimonetta Eitmann
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary
| | - Peter Matrai
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary
| | - Peter Hegyi
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary; Centre for Translational Medicine, Semmelweis University, 26 Ulloi street, H-1085 Budapest, Hungary; Division of Pancreatic Diseases, Semmelweis University, 23-26 Baross street, H-1085 Budapest, Hungary
| | - Marta Balasko
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary
| | - Balint Eross
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary; Centre for Translational Medicine, Semmelweis University, 26 Ulloi street, H-1085 Budapest, Hungary; Division of Pancreatic Diseases, Semmelweis University, 23-26 Baross street, H-1085 Budapest, Hungary
| | - Kira Dorogi
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary
| | - Erika Petervari
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary.
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19
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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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Ruperto M, Barril G. Clinical Significance of Nutritional Status, Inflammation, and Body Composition in Elderly Hemodialysis Patients-A Case-Control Study. Nutrients 2023; 15:5036. [PMID: 38140295 PMCID: PMC10745431 DOI: 10.3390/nu15245036] [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: 10/28/2023] [Revised: 12/02/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Nutritional and inflammatory disorders are factors that increase the risk of adverse clinical outcomes and mortality in elderly hemodialysis (HD) patients. This study aimed to examine nutritional and inflammation status as well as body composition in older adults on HD compared to matched controls. A case-control study was conducted on 168 older participants (84 HD patients (cases) and 84 controls) age- and sex-matched. Demographic, clinical, anthropometric, and laboratory parameters were collected from medical records. The primary outcome was nutritional status assessment using a combination of nutritional and inflammatory markers along with the geriatric nutritional risk index (GNRI). Sarcopenic obesity (SO) was studied by the combined application of anthropometric measures. Body composition and hydration status were assessed by bioelectrical impedance analysis (BIA). Univariate and multivariate regression analyses were performed to identify nutritional and inflammatory independent risk indicators in elderly HD patients and controls. A significantly high prevalence of nutritional risk measured by the GNRI was found in HD patients (32.1%) compared to controls (6.0%) (p < 0.001). Elderly HD patients were overweight and had lower percent arm muscle circumference, phase angle (PA), serum albumin (s-albumin), as well as higher percent extracellular body water (ECW%) and serum C-reactive protein (s-CRP) than controls (all at least, p < 0.01). SO was higher in HD patients (15.50%) than in controls (14.30%). By multi-regression analyses, age < 75 years (OR: 0.119; 95%CI: 0.036 to 0.388), ECW% (OR: 1.162; 95%CI: 1.061 to 1.273), PA (OR: 0.099; 95%CI: 0.036 to 0.271), as well as BMI, s-albumin ≥ 3.8 g/dL, and lower s-CRP were independently related between cases and controls (all at least, p < 0.05). Elderly HD patients had increased nutritional risk, SO, inflammation, overhydration, and metabolic derangements compared to controls. This study highlights the importance of identifying nutritional risk along with inflammation profile and associated body composition disorders in the nutritional care of elderly HD patients. Further studies are needed to prevent nutritional disorders in elderly HD patients.
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Affiliation(s)
- Mar Ruperto
- Department of Pharmaceutical & Health Sciences, School of Pharmacy, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Alcorcón, Madrid, Spain
| | - Guillermina Barril
- Nephrology Department, Hospital Universitario La Princesa, C/Diego de León 62, 28006 Madrid, Spain
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Owesny P, Grune T. The link between obesity and aging - insights into cardiac energy metabolism. Mech Ageing Dev 2023; 216:111870. [PMID: 37689316 DOI: 10.1016/j.mad.2023.111870] [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: 07/11/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
Obesity and aging are well-established risk factors for a range of diseases, including cardiovascular diseases and type 2 diabetes. Given the escalating prevalence of obesity, the aging population, and the subsequent increase in cardiovascular diseases, it is crucial to investigate the underlying mechanisms involved. Both aging and obesity have profound effects on the energy metabolism through various mechanisms, including metabolic inflexibility, altered substrate utilization for energy production, deregulated nutrient sensing, and mitochondrial dysfunction. In this review, we aim to present and discuss the hypothesis that obesity, due to its similarity in changes observed in the aging heart, may accelerate the process of cardiac aging and exacerbate the clinical outcomes of elderly individuals with obesity.
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Affiliation(s)
- Patricia Owesny
- Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Tilman Grune
- Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
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22
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Cheng X, Jiang S, Pan B, Xie W, Meng J. Ectopic and visceral fat deposition in aging, obesity, and idiopathic pulmonary fibrosis: an interconnected role. Lipids Health Dis 2023; 22:201. [PMID: 38001499 PMCID: PMC10668383 DOI: 10.1186/s12944-023-01964-3] [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: 09/25/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is considered an age-related disease. Age-related changes, along with other factors such as obesity, hormonal imbalances, and various metabolic disorders, lead to ectopic fat deposition (EFD). This accumulation of fat outside of its normal storage sites is associated with detrimental effects such as lipotoxicity, oxidative stress, inflammation, and insulin resistance. This narrative review provides an overview of the connection between ectopic and visceral fat deposition in aging, obesity, and IPF. It also elucidates the mechanism by which ectopic fat deposition in the airways and lungs, pericardium, skeletal muscles, and pancreas contributes to lung injury and fibrosis in patients with IPF, directly or indirectly. Moreover, the review discusses the impact of EFD on the severity of the disease, quality of life, presence of comorbidities, and overall prognosis in IPF patients. The review provides detailed information on recent research regarding representative lipid-lowering drugs, hypoglycemic drugs, and lipid-targeting drugs in animal experiments and clinical studies. This may offer new therapeutic directions for patients with IPF.
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Affiliation(s)
- Xiaoyun Cheng
- Department of Pulmonary and Critical Care Medicine, The Third Xiangya Hospital of Central South University, Tongzipo Road 138, Yuelu District, Changsha, 410000, China
- Hunan Key Laboratory of Organ Fibrosis, Tongzipo Road 138, Yuelu District, Changsha, 410000, China
| | - Shuhan Jiang
- Department of Pulmonary and Critical Care Medicine, The Third Xiangya Hospital of Central South University, Tongzipo Road 138, Yuelu District, Changsha, 410000, China
- Hunan Key Laboratory of Organ Fibrosis, Tongzipo Road 138, Yuelu District, Changsha, 410000, China
| | - Boyu Pan
- Departments of Orthopedics, The Third Hospital of Changsha, Laodong West Road 176, Tianxin District, Changsha, 410000, China
| | - Wei Xie
- Department of Cardiology, Xiangya Hospital of Central South University, Furong Middle Road 36, Kaifu District, Changsha, 410000, China
| | - Jie Meng
- Department of Pulmonary and Critical Care Medicine, The Third Xiangya Hospital of Central South University, Tongzipo Road 138, Yuelu District, Changsha, 410000, China.
- Hunan Key Laboratory of Organ Fibrosis, Tongzipo Road 138, Yuelu District, Changsha, 410000, China.
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Wannamethee SG, Atkins JL. Sarcopenic Obesity and Cardiometabolic Health and Mortality in Older Adults: a Growing Health Concern in an Ageing Population. Curr Diab Rep 2023; 23:307-314. [PMID: 37566368 PMCID: PMC10640508 DOI: 10.1007/s11892-023-01522-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE OF REVIEW Sarcopenic obesity (SO) is a growing public health problem in older adults. Whether SO confers higher risk of cardiometabolic disease and mortality than obesity or sarcopenia alone is still a matter of debate. We focus on recent findings on SO and cardiometabolic health and mortality in older adults. RECENT FINDINGS SO is associated with increased mortality compared to non-sarcopenic obesity, but similar mortality risk compared to sarcopenia without obesity. SO is associated with a higher risk of cardiovascular disease (CVD), diabetes, and physical disability than obesity or sarcopenia alone. SO, in the presence of diabetes, is associated with the highest risk of CVD and chronic kidney disease. A definition and diagnostic criteria for SO has recently been proposed (ESPEN and EASO). SO is associated with more adverse outcomes overall than sarcopenia or obesity alone. Future research is required to assess the impact of the new SO definition on health outcomes.
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Affiliation(s)
- Sasiwarang Goya Wannamethee
- Department Primary Care and Population Health, University College London, Royal Free Campus, London, NW32PF, UK.
| | - Janice L Atkins
- Epidemiology and Public Health Group, Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, St Luke's Campus, Exeter, EX1 2LU, Devon, UK
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Qu Q, Guo Q, Sun J, Lu X, Cheang I, Zhu X, Yao W, Li X, Zhang H, Zhou Y, Liao S, Gao R. Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate. BMC Geriatr 2023; 23:619. [PMID: 37789259 PMCID: PMC10546679 DOI: 10.1186/s12877-023-04326-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND The influence of sarcopenic obesity (SO) on overall survival in older adults with hypertension has not been addressed. The aim of this study was to investigate the prevalence and mortality predictive value of various body composition phenotypes, focusing mainly on SO, in older adults with hypertension. METHODS We included 1105 hypertensive patients aged ≥ 60 years from the National Health and Nutrition Examination Survey 1999-2004. Sarcopenia was broadly defined based on low lean mass (LLM; as measured by dual-energy X-ray absorptiometry), and was defined using appendicular lean mass (ALM) divided by height squared (ALM/height2), weight (ALM/weight), and body mass index (BMI; ALM/BMI), respectively. Obesity was defined as BMI ≥ 30 kg/m2, body fat percentage ≥ 30/42%, or waist circumference ≥ 102/88 cm. The prevalence of LLM with obesity was estimated according to each ALM index (ALMI). Multivariable Cox regression analysis and sensitivity analysis were used to examine the association between various body composition phenotypes and all-cause mortality. RESULTS In older adults with hypertension, the prevalence of LLM with obesity by the ALM/height2 index (9.8%) was lower relative to the ALM/weight (11.7%) and ALM/BMI indexes (19.6%). After a median follow-up of 15.4 years, 642 deaths occurred. In the fully adjusted models, LLM with obesity was significantly associated with a higher risk of all-cause mortality (hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.14-2.49, P = 0.008; HR 1.48, 95% CI 1.04-2.10, P = 0.028; HR 1.30, 95% CI 1.02-1.66, P = 0.037; respectively) compared with the normal body phenotype, with no statistical differences found in individuals with LLM or obesity alone. Sensitivity analysis confirmed the robustness of the results. CONCLUSIONS The prevalence of LLM with obesity markedly differed in older adults with hypertension according to the 3 different ALMIs, varying from 9.8%, 11.7%, to 19.6%. Patients with both LLM and obesity had a higher risk of all-cause mortality. Further large, prospective, cohort studies are warranted to validate these findings and uncover underlying mechanisms.
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Affiliation(s)
- Qiang Qu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qixin Guo
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Jinyu Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xinyi Lu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Iokfai Cheang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xu Zhu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Wenming Yao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xinli Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Haifeng Zhang
- Department of Cardiology, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, 26 Daoqian Street, Suzhou, 215002, China
- Department of Cardiology, Jiangsu Province Hospital, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yanli Zhou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Shengen Liao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
| | - Rongrong Gao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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Scott D, Blyth F, Naganathan V, Le Couteur DG, Handelsman DJ, Waite LM, Hirani V. Sarcopenia prevalence and functional outcomes in older men with obesity: Comparing the use of the EWGSOP2 sarcopenia versus ESPEN-EASO sarcopenic obesity consensus definitions. Clin Nutr 2023; 42:1610-1618. [PMID: 37481869 DOI: 10.1016/j.clnu.2023.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND & AIMS The potential for older adults with obesity to also have sarcopenia, and the health consequences of 'sarcopenic obesity', may be underappreciated by health professionals. The primary aim of this secondary analysis of a prospective cohort study of older men was to explore the prevalence and functional outcomes of sarcopenic obesity based on different consensus definitions. METHODS 1416 community-dwelling men aged ≥70 years were classified into sarcopenia categories according to the European Working Group on Sarcopenia in Older People (EWGSOP2) definition, and sarcopenic obesity categories according to the European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity (ESPEN-EASO) definition. Descriptive analyses determined prevalence of sarcopenia in obese and non-obese older men. Multivariable analyses compared associations with functional outcomes including activity of daily living (ADL) and instrumental activity of daily living (IADL) disability and 12-month incident falls. RESULTS According to the EWGSOP2 definition, 12.6% of men had confirmed sarcopenia but only 0.3% of men had sarcopenia and obesity (BMI ≥30 kg/m2). Conversely, 9.6% of men had sarcopenic obesity according to the ESPEN-EASO definition. Notably, no men with a BMI ≥32 kg/m2 were classified as having EWGSOP2-confirmed sarcopenia, despite the fact that 60.8% of all men with BMI ≥32 kg/m2 had low muscle strength. Due to low numbers (N = 4) of obese older men with EWGSOP2-confirmed sarcopenia, associations with functional outcomes were not assessed. Men with sarcopenic obesity according to the ESPEN-EASO definition had significantly lower hand grip strength, higher chair-stands time and slower gait speed (all P < 0.05), increased odds for ADL (odds ratio: 5.02, 95% CI: 1.85-13.58) and IADL (2.18, 1.38-3.45) disability, and higher 12-month incident falls rates (incident rate ratio: 1.59, 95% CI: 1.03-2.44) than men with neither sarcopenia nor obesity. CONCLUSION Low muscle strength is common in older men with obesity, but the prevalence of sarcopenia is likely to be underestimated when the EWGSOP2 operational definition is applied in this population. The ESPEN-EASO operational definition of sarcopenic obesity appears to provide a valid approach for identifying older men with obesity who are at risk of poor functional outcomes related to sarcopenia.
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Affiliation(s)
- David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
| | - Fiona Blyth
- School of Public Health, University of Sydney, New South Wales, Sydney, Australia; Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia
| | - Vasi Naganathan
- Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia
| | - David G Le Couteur
- Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; ANZAC Research Institute & Charles Perkins Centre, University of Sydney, New South Wales, Sydney, Australia
| | - David J Handelsman
- Department of Andrology, Concord Hospital & ANZAC Research Institute, University of Sydney, New South Wales, Sydney, Australia
| | - Louise M Waite
- Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia
| | - Vasant Hirani
- School of Public Health, University of Sydney, New South Wales, Sydney, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia
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de Luis D, Primo D, Izaola O, Gómez Hoyos E, López Gómez JJ. Relationship of circulating resistin levels with muscle mass determined by bioelectrical impedance in females with obesity. ENDOCRINOL DIAB NUTR 2023; 70:468-475. [PMID: 37516610 DOI: 10.1016/j.endien.2023.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/23/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION Serum resistin levels have been associated with obesity, visceral fat, and insulin resistance. Its relationship with muscle mass has been less evaluated. OBJECTIVES to evaluate the relationship between muscle mass determined by electrical bioimpedance and circulating resistin levels in obese women over 60 years of age. METHODS We conducted a cross-sectional study in 313 obese women. Anthropometric data (weight, height, body mass index (BMI) and waist circumference), BIA parameters (total fat mass (TFM), fat-free mass (FFM), fat-free mass index (FFMI)), skeletal muscle mass (SMM) and skeletal muscle mass index (SMI)), blood pressure and laboratory tests were recorded. RESULTS Patients were divided into two different groups according to the mean value of SMI (11.93 kg/m2): low SMI versus high SMI. In the low SMI group, the resistin levels were higher than the resistin levels in the high SMI group (delta value: 2.8 + 0.3 ng/dl:p = 0.01). Serum resistin levels are inversely correlated with FFM, FFMI, SMM, and SMI. This adipokine shows a positive correlation with insulin, HOMA-IR and PCR levels. In the model with SMI as the dependent variable, resistin levels explained 12% of the variability in muscle mass (Beta -0.38, 95% CI -0.91 to -0.11). CONCLUSIONS Serum resistin levels are associated with low skeletal muscle mass in obese women over 60 years of age.
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Affiliation(s)
- Daniel de Luis
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación de Endocrinología y Nutrición (CIEN), Universidad de Valladolid, Valladolid, Spain.
| | - David Primo
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación de Endocrinología y Nutrición (CIEN), Universidad de Valladolid, Valladolid, Spain
| | - Olatz Izaola
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación de Endocrinología y Nutrición (CIEN), Universidad de Valladolid, Valladolid, Spain
| | - Emilia Gómez Hoyos
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación de Endocrinología y Nutrición (CIEN), Universidad de Valladolid, Valladolid, Spain
| | - Juan José López Gómez
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación de Endocrinología y Nutrición (CIEN), Universidad de Valladolid, Valladolid, Spain
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Wang X, Xie L, Yang S. Association between weight-adjusted-waist index and the prevalence of rheumatoid arthritis and osteoarthritis: a population-based study. BMC Musculoskelet Disord 2023; 24:595. [PMID: 37474953 PMCID: PMC10357613 DOI: 10.1186/s12891-023-06717-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/13/2023] [Indexed: 07/22/2023] Open
Abstract
INTRODUCTION The weight-adjusted-waist Index (WWI), an innovative metric for assessing obesity, exhibits superior efficacy in appraising lean muscle and adipose tissue mass relative to both the Body Mass Index (BMI) and Waist Circumference (WC). The objective of this research paper is to investigate the correlation between WWI and the incidence of Rheumatoid Arthritis (RA) and Osteoarthritis (OA). METHODS In this population-based study, we collected data from adult participants aged 20-80 years using the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2020 to analyze the association between WWI and the occurrence of RA and OA. NHANES, a nationally representative cross-sectional survey, is designed to evaluate the health and nutritional status of the U.S. POPULATION The current research incorporates an extensive, nationally representative sample of U.S. adults, utilizing weighted multivariate linear regression and smoothed curve fitting techniques to examine linear and non-linear relationships. Threshold effects were determined through a two-part linear regression model. Additionally, subgroup analyses and interaction tests were conducted to explore the connection between WWI and the incidence of RA and OA. RESULTS Our findings reveal a linear positive correlation between WWI and OA prevalence, indicating that an increase in WWI is linked to a heightened risk of OA. Conversely, a non-linear relationship was observed between WWI and RA prevalence, exhibiting a significant threshold effect with a saturation value of 11.21 cm/√kg. A positive association was detected to the left of the saturation point, while no significant association was present between the two variables to the right of the saturation point, suggesting a complex non-linear relationship between RA prevalence and WWI. CONCLUSIONS This investigation demonstrates a positive linear association between WWI and OA prevalence, as well as a complex non-linear relationship with RA prevalence in U.S. adults aged 20-80 years.
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Affiliation(s)
- Xiaohua Wang
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Jiangsu, China
| | - Lin Xie
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Jiangsu, China
| | - Shuo Yang
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
- Jiangsu Province Academy of Traditional Chinese Medicine, Jiangsu, China.
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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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Matos LL, Sanabria A, Robbins KT, Halmos GB, Strojan P, Ng WT, Takes RP, Angelos P, Piazza C, de Bree R, Ronen O, Guntinas-Lichius O, Eisbruch A, Zafereo M, Mäkitie AA, Shaha AR, Coca-Pelaz A, Rinaldo A, Saba NF, Cohen O, Lopez F, Rodrigo JP, Silver CE, Strandberg TE, Kowalski LP, Ferlito A. Management of Older Patients with Head and Neck Cancer: A Comprehensive Review. Adv Ther 2023; 40:1957-1974. [PMID: 36920746 DOI: 10.1007/s12325-023-02460-x] [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: 12/19/2022] [Accepted: 02/10/2023] [Indexed: 03/16/2023]
Abstract
The projected increase in life expectancy over the next few decades is expected to result in a rise in age-related diseases, including cancer. Head and neck cancer (HNC) is a worldwide health problem with high rates of morbidity and mortality. In this report, we have critically reviewed the literature reporting the management of older patients with HNC. Older adults are more prone to complications and toxicities secondary to HNC treatment, especially those patients who are frail or have comorbidities. Thus, this population should be screened prior to treatment for such predispositions to maximize medical management of comorbidities. Chronologic age itself is not a reason for choosing less intensive treatment for older HNC patients. Whenever possible, also older patients should be treated according to the best standard of care, as nonstandard approaches may result in increased treatment failure rates and mortality. The treatment plan is best established by a multidisciplinary tumor board with shared decision-making with patients and family. Treatment modifications should be considered for those patients who have severe comorbidities, evidence of frailty (low performance status), or low performance status or those who refuse the recommendations of the tumor board.
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Affiliation(s)
- Leandro L Matos
- Department of Head and Neck Surgery, Instituto do Cancer do Estado de São Paulo (ICESP), University of São Paulo Medical School, and Faculdade Israelita de Ciências da Saúde Albert Einstein Medical School, São Paulo, Brazil
| | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Universidad de Antioquia, Centro de Excelencia en Cirugia de Cabeza y Cuello-CEXCA, Medellin, Colombia
| | - K Thomas Robbins
- Division of Otolaryngology, Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Gyorgy B Halmos
- Department of Otolaryngology, Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Wai Tong Ng
- Department of Clinical Oncology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Robert P Takes
- Department of Otolaryngology, Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter Angelos
- Department of Surgery and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL, USA
| | - Cesare Piazza
- Unit of Otorhinolaryngology, Head and Neck Surgery, ASST Spedali Civili of Brescia, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, School of Medicine, University of Brescia, Brescia, Italy
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ohad Ronen
- Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Institute of Phoniatry/Pedaudiology, Jena University Hospital, Jena, Germany
| | - Avraham Eisbruch
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Mark Zafereo
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX, USA
| | - Antti A Mäkitie
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Research Program in Systems Oncology, University of Helsinki, Helsinki, Finland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden
| | - Ashok R Shaha
- Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Andres Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Spain
| | | | - Nabil F Saba
- Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Oded Cohen
- Department of Otolaryngology, Head and Neck Surgery, Soroka Medical Center, Israel, Affiliated with Ben-Gurion University of the Negev, Sheva, Israel
| | - Fernando Lopez
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Spain
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Spain
| | - Carl E Silver
- Department of Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
- Department of Otolaryngology, Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Timo E Strandberg
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Center for Life-Course Health Research, University of Oulu, Oulu, Finland
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery, University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 255, 8th Floor, Room 8174, São Paulo, SP, CEP: 05403-000, Brazil.
- Department of Head and Neck Surgery and Otorhinolaryngology, A C Camargo Cancer Center, São Paulo, Brazil.
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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Liu C, Cheng KYK, Tong X, Cheung WH, Chow SKH, Law SW, Wong RMY. The role of obesity in sarcopenia and the optimal body composition to prevent against sarcopenia and obesity. Front Endocrinol (Lausanne) 2023; 14:1077255. [PMID: 36936175 PMCID: PMC10016224 DOI: 10.3389/fendo.2023.1077255] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 02/14/2023] [Indexed: 03/08/2023] Open
Abstract
Background Elderly people with low lean and high fat mass, are diagnosed with sarcopenic obesity (SO), and often have poor clinical outcomes. This study aimed to explore the relationship between obesity and sarcopenia, and the optimal proportion of fat and muscle for old individuals. Methods Participants aged 60 years or above were instructed to perform bioelectrical impedance analysis to obtain the muscle and fat indicators, and handgrip strength was also performed. Sarcopenia was diagnosed according to predicted appendicular skeletal muscle mass and function. Body mass index (BMI) and body fat percentage (BF%) were used to define obesity. The association of muscle and fat indicators were analyzed by Pearson's correlation coefficient. Pearson Chi-Square test was utilized to estimate odds ratios (OR) and 95% confidence intervals (CI) on the risk of sarcopenia according to obesity status. Results 1637 old subjects (74.8 ± 7.8 years) participated in this study. Not only fat mass, but also muscle indicators were positively correlated to BMI and body weight (p < 0.05). Absolute muscle and fat mass in different positions had positive associations (p < 0.05). Muscle mass and strength were negatively related to appendicular fat mass percentage (p < 0.05). When defined by BMI (OR = 0.69, 95% CI [0.56, 0.86]; p = 0.001), obesity was a protective factor for sarcopenia, whilst it was a risk factor when using BF% (OR = 1.38, 95% CI [1.13, 1.69]; p = 0.002) as the definition. The risk of sarcopenia reduced with the increase of BMI in both genders. It was increased with raised BF% in males but displayed a U-shaped curve for females. BF% 26.0-34.6% in old females and lower than 23.9% in old males are recommended for sarcopenia and obesity prevention. Conclusion Skeletal muscle mass had strong positive relationship with absolute fat mass but negative associations with the percentage of appendicular fat mass. Obesity was a risk factor of sarcopenia when defined by BF% instead of BMI. The management of BF% can accurately help elderly people prevent against both sarcopenia and obesity.
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Affiliation(s)
- Chaoran Liu
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Keith Yu-Kin Cheng
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Xin Tong
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wing-Hoi Cheung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Simon Kwoon-Ho Chow
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sheung Wai Law
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ronald Man Yeung Wong
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Iwaki M, Kobayashi T, Nogami A, Saito S, Nakajima A, Yoneda M. Impact of Sarcopenia on Non-Alcoholic Fatty Liver Disease. Nutrients 2023; 15:nu15040891. [PMID: 36839249 PMCID: PMC9965462 DOI: 10.3390/nu15040891] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
With the increasing incidence of non-alcoholic fatty liver disease (NAFLD) and the aging of the population, sarcopenia is attracting attention as one of the pathological conditions involved in the development and progression of NAFLD. In NAFLD, sarcopenia is closely associated with insulin resistance and results from the atrophy of skeletal muscle, an insulin target organ. In addition, inflammatory cytokines that promote skeletal muscle protein breakdown, low adiponectin levels leading to decreased insulin sensitivity, and hyperleptinemia are also involved in NAFLD pathogenesis. The presence of sarcopenia is a prognostic factor and increases the risk of mortality in patients with cirrhosis and post-treatment liver cancer. Sarcopenia, the presence of which mainly occurs due to decreased muscle mass, combined with increased visceral fat, can lead to sarcopenia-associated obesity, which increases the risk of NASH, liver fibrosis, and cardiovascular disease. In order to treat sarcopenia, it is necessary to properly evaluate sarcopenia status. Patients with high BMI, as in sarcopenic obesity, may improve with caloric restriction. However, inadequate oral intake may lead to further loss of muscle mass. Aerobic and resistance exercise should also be used appropriately.
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de Sá-Caputo D, Seixas A, Taiar R, Van der Zee EA, Bernardo-Filho M. Editorial: Non-pharmacological interventions in healthy and pathological aging: Facts and perspectives. Front Aging Neurosci 2023; 15:1191281. [PMID: 37143692 PMCID: PMC10151739 DOI: 10.3389/fnagi.2023.1191281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 05/06/2023] Open
Affiliation(s)
- Danúbia de Sá-Caputo
- Laboratório de Vibrações Mecânicas e Práticas Integrativas (LAVIMPI), Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes and Policlínica Universitária Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- Programa de Pós-Graduação em Fisiopatologia Clínica e Experimental, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- *Correspondence: Danúbia de Sá-Caputo
| | - Adérito Seixas
- Escola Superior de Saúde Fernando Pessoa, Fundação Fernando Pessoa, Porto, Portugal
| | - Redha Taiar
- MATériaux et Ingénierie Mécanique (MATIM), Université de Reims Champagne- Ardenne, Reims, France
| | - Eddy A. Van der Zee
- Department of Molecular Neurobiology, Groningen Institute for Evolutionary Life Sciences (GELIFES), University of Groningen, Groningen, Netherlands
| | - Mario Bernardo-Filho
- Laboratório de Vibrações Mecânicas e Práticas Integrativas (LAVIMPI), Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes and Policlínica Universitária Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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