Abstract
of skeletal muscle (SM) to adipose tissue (AT) or the composition of FFM (i.e. SM proportion of lean mass) may also depend on adiposity and contribute to sarcopenia. Methods: In a large database (n = 1,737) of healthy males and females (age 11 84 years and BMI 13.5 52.5 kg/m2) we investigated changes in the relationship between FFM and FM (normalized by height as fat free mass index and fat mass index: FFMI and FMI, kg/m2 assessed by densitometry) with increasing adiposity and age. In a subgroup (n = 263) we also analyzed the relationship between regional SM and (i) AT (by whole body MRI) or (ii) total soft tissue (by DXA) with increasing adiposity. Results: The relationship between lean and fat mass was influenced by adiposity, age and gender. With increasing adiposity, SM/AT declined faster at the trunk in men and at the extremities in women. The contribution of appendicular SM to lean soft tissue of arms and legs decreased with higher adiposity in both genders (FMI > 6.97 kg/m2 in women; FMI > 7.77 kg/m2 in men). Conclusion: Besides adiposity, age and gender should be taken into account when evaluating the normal relationship between lean and fat mass. In addition, simple parameters like the ratio of FFM/FM or SM/AT at the legs become increasingly inaccurate for the diagnosis of sarcopenic obesity at a higher adiposity.
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