Abstract
Sarcopenic obesity combines the words sarcopenia and obesity. This definition of obesity should be better differentiated between visceral and subcutaneous fat phenotypes. For this reason, this review lays the foundation for defining the subcutaneous and the visceral fat into the context of sarcopenia. Thus, the review aims to explore the missing links on pathogenesis of visceral fat and its relationship on age: defining the peri-muscular fat as a new entity and the subcutaneous fat as a first factor that leads to the obesity paradox. Last but not least, this review underlines and motivates the mechanisms of the hormonal responses and anti-inflammatory adipokines responsible for the clinical implications of sarcopenic visceral obesity, describing factor by factor the multiple axis between the visceral fat-sarcopenia and all mortality outcomes linked to cancer, diabetes, cardiovascular diseases, cirrhosis, polycystic ovary, disability and postoperative complications.
Highlights
The definition of sarcopenic obesity combines the definitions of sarcopenia and obesity
The authors of the same study concluded that such risks were associated with an increase in visceral adipose tissue, while elderly patients with sarcopenic subcutaneous obesity seem to benefit from lower mortality rates in what is known as the “obesity paradox.”
In the light of the increasing evidence that elderly individuals with several chronic diseases and elevated body mass index (BMI) present a more favorable prognosis compared to individuals who are normal or underweight, a phenomenon known as “the obesity paradox”, it becomes imperative that we explore the positive and negative aspects of being obese at older ages, especially in relation to sarcopenic obesity
Summary
The definition of sarcopenic obesity combines the definitions of sarcopenia (low muscle mass and strength) and obesity (excess adiposity). Park et al [13] who observed that increased high-sensitivity CRP was associated with the presence of sarcopenic obesity in Korean adults Such findings reinforce the proposed mechanism related to the role of proinflammatory cytokines secreted by metabolically active adipocytes or adipose tissues in the development and progression of sarcopenic obesity [11]. During the aging process, the shift of adipose tissue from subcutaneous to visceral adipose sites along with skeletal muscle atrophy leads to an imbalance between proinflammatory adipokines and anti-inflammatory myokines [14] This unfavorable adipokine/cytokine profile represents a common mechanism for sarcopenia, obesity and immune senescence in elderly populations [15]. Further evidence suggests that subcutaneous fat has a key role in modulating peripheral insulin resistance by regulating visceral fat accumulation [21]
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