Abstract
Background and objectiveSarcopenic obesity is associated with a higher risk of cardiometabolic disease and mortality than either sarcopenia or obesity alone. However, no study has investigated body shape indices for the assessment of sarcopenia in obese populations. Thus, this study aimed to evaluate the accuracy of body shape indices to assess sarcopenia in nationally representative populations with abdominal obesity.MethodsData from the U.S. National Health and Nutrition Examination Survey (U.S. NHANES) 1999–2006 and Korea NHANES (KNHANES) 2008–2011 were assessed. The association between Body Shape Index and sarcopenia was analyzed using a receiver operating characteristic curve. The Z-score of the log-transformed A Body Shape Index (LBSIZ) cut-off value was defined as that with the highest score of the Youden’s index. Changes in odds ratios (OR) for sarcopenia were investigated using restricted cubic spline (RCS) plots.ResultsThis study included 8,013 American and 4,859 Korean adults with abdominal obesity. The overall area under the curve (AUC) of LBSIZ for sarcopenia was 0.816 (95% CI: 0.794–0.838) in U.S. NHANES and 0.822 (95% CI: 0.799–0.844) in KNHANES, which was higher than that of the body roundness index, conicity index, and waist to height ratio (p with DeLong’s test <0.001). The cut-off values for the LBSIZ were 1.05 (sensitivity, 88.0%; specificity, 81.5%) for American men, 0.45 (sensitivity, 77.1%; specificity, 70.6%) for American women, 1.15 (sensitivity, 77.5%; specificity, 77.1%) for Korean men and 0.95 (sensitivity, 74.3%; specificity, 69.3%) for Korean women in the development groups. Comparable results were verified in validation groups. The RCS plot indicated that ORs for sarcopenia rapidly increased with an increase in the LBSIZ cut-off value.ConclusionThe increased LBSIZ could function as a reliable and cost-effective screening tool for assessing low muscle mass in populations with abdominal obesity.
Highlights
The World Health Organization reported that 13% of the world’s population had obesity in 2016, and that the prevalence of obesity has dramatically increased over the last 30 years [1]
The overall area under the curve (AUC) of LBSIZ for sarcopenia was 0.816 in U.S NHANES and 0.822 in Korea NHANES (KNHANES), which was higher than that of the body roundness index, conicity index, and waist to height ratio (p with DeLong’s test
The restricted cubic spline (RCS) plot indicated that odds ratios (OR) for sarcopenia rapidly increased with an increase in the LBSIZ cut-off value
Summary
The World Health Organization reported that 13% of the world’s population had obesity in 2016, and that the prevalence of obesity has dramatically increased over the last 30 years [1]. Obesity increases the risk of chronic diseases such as cardiovascular disease (CVD), diabetes, stroke, and cancer and is associated with approximately 4.8% of deaths worldwide [2]. Obesity is defined as an excess of body fat, in clinical practice it is commonly assessed based on body mass index (BMI) [3]. BMI has a limitation for the estimation of the amount and distribution of body fat [4]. Sarcopenic obesity is associated with a higher risk of cardiometabolic disease and mortality than either sarcopenia or obesity alone. No study has investigated body shape indices for the assessment of sarcopenia in obese populations. This study aimed to evaluate the accuracy of body shape indices to assess sarcopenia in nationally representative populations with abdominal obesity
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