Age-related Changes In Body Composition Research Articles

An Analysis of Age-Related Body Composition Changes and Metabolic Patterns in Korean Adults Using FDG-PET/CT Health Screening Data.

F-18-fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) can be used to measure bone mineral density (BMD), cross-sectional muscle area (CSMA), Hounsfield units (HU) of liver and muscle, subcutaneous adipose tissue (SAT), abdominal visceral adipose tissue (VAT), and glucose metabolism. The present study aimed to identify age-related changes in body composition and glucose metabolism in Korean using opportunistic FDG-PET/CT imaging. We analyzed FDG-PET/CT, clinical history, and laboratory data abstracted from the medical records of patients who underwent health screening at a single institute between 2017 and 2022. In total, 278 patients were included in the analysis (male:female=140:138). Age and body mass index were positively correlated in female, but negatively correlated in male. BMD decreased with age more in female, and CSMA decreased with age more in male. Muscle HU decreased with age for both sexes. In female, SAT and VAT increased with age; and in male, SAT decreased slightly while VAT remained stable. Muscle glucose metabolism showed no association with age in male but increased with age in female. CSMA correlated positively with BMD overall; and positively correlated with VAT and SAT in male only. In female only, both SAT and VAT showed negative correlations with glucose metabolism and correlated positively with muscle glucose metabolism. Liver HU values were inversely correlated with VAT, especially in female; and positively correlated with muscle glucose metabolism in female only. FDG-PET/CT demonstrated distinct patterns of age-related changes in body composition and glucose metabolism, with significant differences between sexes.

Prevalence and Predictors of Normal-Weight Obesity among Women.

The present study aimed to (a) assess normal-weight obesity (NWO) and general obesity prevalence among women of different ages residing in urban areas, (b) evaluate subcutaneous fat thickness (SFT) in women with NWO, (c) establish SFT cutoff points for distinguishing NWO, and (d) explore eating habits linked to NWO. This cross-sectional study with 184 women aged 18-65 with NWO, normal weight without obesity (NWNO), overweight and general obesity included evaluation of body composition, SFT assessment using 2.5 MHz A-mode ultrasound (ISAK protocol, 7 sites) and lifestyle inquiries. The curvilinear relationship between body fat and BMI rendered BMI an unreliable indicator of adiposity in women with normal weight (BMI < 25 kg/m2). Almost 30% of women with a high body fat percentage (BFP ≥ 30%) were misclassified when BMI was used to measure adiposity. The overall obesity prevalence defined by BFP was almost four times higher than that defined by BMI (56.0 vs. 18.0%, p = 1 × 10-4). Women with NWO, overweight and general obesity shared a similar SFT profile and eating habits, setting them apart from those with NWNO. The mean SFT was the most reliable NWO predictor, with a threshold set at 12 mm equal to the 66th percentile. Mean SFT accurately classified 85% of women with NWO. While age did not significantly affect subcutaneous fat accumulation, total fat levels increased with age (R2 = 0.07 and R2 = 0.19, padj = 0.1 and padj = 9 × 10-4). Higher NWO prevalence in middle-aged women was linked to age-related increase in fat mass and decrease in fat-free mass. Engaging in regular physical activity and reducing snack consumption effectively countered age-related changes in body composition (padj < 0.05). Women under 45 years who consumed sweet bakery items, fast food, and snacks more frequently showed higher BFP and NWO status (padj < 0.05). Prevention strategies should focus on monitoring body composition and promoting healthy behaviors, particularly among young women transitioning into adulthood and women over 45 years.

Associations Between Fat and Lean Mass Indexes and Physical Performance in Prefrail and Frail Older Women.

Age-related changes in body composition have been associated with reduced physical performance. However, the relationship of fat and lean mass indexes with physical performance in the setting of frailty is yet to be clearly established. We investigated the association between fat and lean mass indexes and physical performance in prefrail and frail older women. Fifty-one community-dwelling women 65 years and older (mean age 76 years) were classified as prefrail or frail according to a modified frailty phenotype. Body composition was estimated by dual-energy X-ray absorptiometry, while physical performance was assessed via the following tests: Berg balance scale, timed-stands, timed up-and-go test, 6-minute walk test, and the short performance physical battery. Correlation coefficients were determined to assess the association between body composition and physical performance parameters. Associations between continuous variables with a p-value <0.05 were included in a linear regression analysis. All fat mass indexes predicted a reduced performance in at least one functional test. Among the lean mass indexes, only leg lean mass adjusted by body fat mass was directly associated with better physical performance. Our findings indicate that fat mass indexes may have a greater impact on physical performance than lean mass in frail and prefrail older women.

REDEFINING OBESITY: A RATIO OF FAT AND MUSCLE MASS COMPARED TO BODY MASS INDEX IN OLDER ADULTS

Abstract Body composition is an important determinant of physical fitness and overall health in older adults. Body mass index (BMI) is currently the standard used to categorize clinical thresholds for body composition (underweight, normal weight, overweight, obese). However, BMI does not account for key aspects of body composition like skeletal muscle mass (SMM) and fat mass (FM). This can lead to misclassification and inaccurate inferences about metabolic health. A FM/SMM ratio may better capture age-related changes in body composition like sarcopenia and obesity, but it is unknown whether FM/SMM correlates more closely with muscularity and adiposity than BMI. This cross-sectional study assessed 103 older adults (16 men, 87 women; mean age 75.7 ± 7.19 years; BMI 26.8 ± 5.22 kg/m2) for SMM, FM, and body fat percentage (BF%) using bioelectrical impedance analysis (InBody S10). BF% was more highly correlated with FM/SMM (r = 0.979, p &amp;lt; 0.001) than BMI (r = 0.702, p &amp;lt; 0.001), and a Fisher’s R-to-Z analysis indicates that the difference is significant (95% CI [0.826, 0.926], z = 12.217, p &amp;lt; 0.001). However, SMM showed weak correlation with both FM/SMM (r = -0.306, p = 0.002) and BMI (r = 0.349, p &amp;lt; 0.001). FM/SMM may better detect changes in adiposity compared to BMI, suggesting utility as an obesity measure. Further research should examine the longitudinal validity of FM/SMM in older adults and its ability to predict metabolic and musculoskeletal health.

An analytical investigation of body parts more susceptible to aging and composition changes using statistical hypothesis testing

In recent years, age-related changes in body composition in the elderly are attracting attention. This is associated with a decline in physical functions and an increased risk of disease development. In general, age-related changes in body composition can be minimized with appropriate exercise. However, there are no studies that investigate body parts susceptibility to aging and changes in body composition of those parts. Therefore, devising exercise programs and advising daily life while taking these into account becomes difficult. This study aims to identify body parts that are more susceptible to aging and their body composition changes. The body composition was obtained with a Direct Segmental Multi-frequency Bioelectrical Impedance Analysis using InBody770 in 8 male elderly patients who had been shortly hospitalized. Statistical hypothesis testing was used to determine whether site-specific body composition changed significantly between hospital discharge and 1 year, 1 year and 2 years, and hospital discharge and 2 years. The results showed that Lean body mass, Total Body Water, Intracellular Water, Extracellular Water in the right arm; Lean body mass and Total Body Water in the left arm and trunk are more sensitive to aging.

Abstract 18874: Beyond the Beat: Predicting Frailty in Cardiovascular Patients Using Heart Rate Variability

Introduction: Frailty is the increased vulnerability to health issues due to age-related changes in body composition, mobility, and autonomic control. Heart rate variability (HRV) measures the oscillations between consecutive heartbeats. The LF/HF (low frequency/high frequency) ratio, a parameter of HRV, reflects the complex balance between sympathetic and parasympathetic control and cardiac autonomic regulation. Previous studies have linked the LF/HF ratio with frailty. Our goal was to determine if this association holds true in patients with cardiovascular disease (CVD) and if the LF/HF ratio can be used as a surrogate marker of frailty in these patients. Methods: A cross-sectional study was conducted at McGill University's Jewish General Hospital, involving adult patients at the ambulatory cardiology clinic. Resting HRV was evaluated for 2 minutes and 30 seconds using the Elite HRV CorSense monitor. Patients with electrical pacing, atrial fibrillation, or other arrhythmias during the visit were excluded. Frailty was assessed using the clinical frailty scale (CFS), with a CFS ≥ 5 indicating frailty. Routine comprehensive history and physical examinations were performed. Results: The cohort included 155 patients (66.9 ± 13 years, 68 females). Frailty prevalence was 15% (78.6 ± 10 years, 12 females), with a median LF/HF ratio of 0.37. The non-frail population (64.8 ± 12 years, 56 females) showed a significantly higher LF/HF ratio of 1.01 (p&lt;0.001). This difference was driven by a decrease in LF power in the frail group (78.3 ms 2 ) compared to the non-frail group (231.9 ms 2 , p=0.01). The LF/HF ratio correlated with frailty, decreasing by 0.437 for each unit increase in CFS (p&lt;0.001). An LF/HF ratio of 0.37 best predicted frailty (54% sensitivity, 82% specificity, 0.77 ROC). Adjustment for age, sex, and comorbidities did not alter the association between LF/HF ratio and frailty. Conclusions: The LF/HF ratio exhibits an inverse correlation with frailty, making it a predictive tool for identifying CVD patients who may benefit from further frailty evaluation. Additionally, HRV parameters show potential for monitoring frailty and guiding interventions. However, additional research is needed to assess their practical implementation fully.

Pattern of Age-Related Changes in Body Composition: A Cohort Study in Older Hispanic Adults

Pattern of Age-Related Changes in Body Composition: A Cohort Study in Older Hispanic Adults

Role of phase angle in older adults with focus on the geriatric syndromes sarcopenia and frailty.

Age-related changes in body composition reflect an increased risk for disease as well as disability. Bioimpedance analysis is a safe and inexpensive bed side method to measure body composition, but the calculation of body compartments with BIA is hampered in older adults. Phase angle, a raw parameter derived from bioimpedance analysis, is free from calculation-inherent errors. It declines with age and disease and is highly predictive of a variety of clinical outcomes as well as mortality. This review summarizes the current evidence linking the phase angle to geriatric syndromes such as malnutrition, sarcopenia and frailty and also investigates whether the phase angle reacts to interventions. Since the majority of studies show an association between the phase angle and these geriatric syndromes, a low phase angle is not suitable to exclusively indicate a specific condition. It does not inform on the underlying cause and as such, a low phase angle mainly indicates increased risk. Phase angle decline over time is reflected by deterioration of e.g. frailty status. It reacts to physical training and detraining, but studies investigating whether these induced changes are also associated with improved outcome are missing.

Multi-atlas segmentation and quantification of muscle, bone and subcutaneous adipose tissue in the lower leg using peripheral quantitative computed tomography.

Accurate and reproducible tissue identification is essential for understanding structural and functional changes that may occur naturally with aging, or because of a chronic disease, or in response to intervention therapies. Peripheral quantitative computed tomography (pQCT) is regularly employed for body composition studies, especially for the structural and material properties of the bone. Furthermore, pQCT acquisition requires low radiation dose and the scanner is compact and portable. However, pQCT scans have limited spatial resolution and moderate SNR. pQCT image quality is frequently degraded by involuntary subject movement during image acquisition. These limitations may often compromise the accuracy of tissue quantification, and emphasize the need for automated and robust quantification methods. We propose a tissue identification and quantification methodology that addresses image quality limitations and artifacts, with increased interest in subject movement. We introduce a multi-atlas image segmentation (MAIS) framework for semantic segmentation of hard and soft tissues in pQCT scans at multiple levels of the lower leg. We describe the stages of statistical atlas generation, deformable registration and multi-tissue classifier fusion. We evaluated the performance of our methodology using multiple deformable registration approaches against reference tissue masks. We also evaluated the performance of conventional model-based segmentation against the same reference data to facilitate comparisons. We studied the effect of subject movement on tissue segmentation quality. We also applied the top performing method to a larger out-of-sample dataset and report the quantification results. The results show that multi-atlas image segmentation with diffeomorphic deformation and probabilistic label fusion produces very good quality over all tissues, even for scans with significant quality degradation. The application of our technique to the larger dataset reveals trends of age-related body composition changes that are consistent with the literature. Because of its robustness to subject motion artifacts, our MAIS methodology enables analysis of larger number of scans than conventional state-of-the-art methods. Automated analysis of both soft and hard tissues in pQCT is another contribution of this work.

Metabolic changes in aging humans: current evidence and therapeutic strategies.

Aging and metabolism are inextricably linked, and many age-related changes in body composition, including increased central adiposity and sarcopenia, have underpinnings in fundamental aging processes. These age-related changes are further exacerbated by a sedentary lifestyle and can be in part prevented by maintenance of activity with aging. Here we explore the age-related changes seen in individual metabolic tissues — adipose, muscle, and liver — as well as globally in older adults. We also discuss the available evidence for therapeutic interventions such as caloric restriction, resistance training, and senolytic and senomorphic drugs to maintain healthy metabolism with aging, focusing on data from human studies.

Вікасоційовані зміни жирової та знежиреної маси у чоловіків

We examined 342 healthy men aged 20 to 89 years to establish age-related changes in body composition in physiological aging. Body composition was assessed by dual-energy X-ray absorptiometry (fat and lean mass of the body, trunk and extremities, fat content, fat mass index, lean mass index, appendicular lean mass and appendicular lean mass index). The study found an age-associated decrease in lean mass and an increase in fat mass. The related index of fat mass significantly increased in aged men, reaching the maximum in the age group 50–59 years – 8.44 [6.19 – 10.33] compared with the group of 20-29 years old men – 5.24 [4.00 – 7.01] kg/m2 (P &lt; 0.001). The appendicular lean mass reached a maximum in men 30-39 years old and decreased with age. The loss of lean mass at the age of 40-49 years was 5.2%, 50-59 years – 8.1%, 60-69 years – 9.3%, 70-79 years – 18.5%, 80-89 years – 22.1%. The incidence of sarcopenia probably increased with age and was in the age groups of 50-59 years – 5.3%, 60-69 years – 5.1%, 70-79 years – 15.1%, 80-89 years – 41.0%. Conclusively, age-related features of the body composition in men consisted of a decrease in lean mass with an increase in the frequency of sarcopenia from 5.3% in the age group 50-59 years to 41.0% in the age group 80-89 years on the background of increasing body fat.

Facing the challenge of polypharmacy when prescribing for older people with cardiovascular disease. A review by the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy.

Population ageing has resulted in an increasing number of older people living with chronic diseases (multimorbidity) requiring five or more medications daily (polypharmacy). Ageing produces important changes in the cardiovascular system and represents the most potent single cardiovascular risk factor. Cardiovascular diseases (CVDs) constitute the greatest burden for older people, their caregivers, and healthcare systems. Cardiovascular pharmacotherapy in older people is complex because age-related changes in body composition, organ function, homeostatic mechanisms, and comorbidities modify the pharmacokinetic and pharmacodynamic properties of many commonly used cardiovascular and non-cardiovascular drugs. Additionally, polypharmacy increases the risk of adverse drug reactions and drug interactions, which in turn can lead to increased morbi-mortality and healthcare costs. Unfortunately, evidence of drug efficacy and safety in older people with multimorbidity and polypharmacy is limited because these individuals are frequently underrepresented/excluded from clinical trials. Moreover, clinical guidelines are largely written with a single-disease focus and only occasionally address the issue of coordination of care, when and how to discontinue treatments, if required, or how to prioritize recommendations for patients with multimorbidity and polypharmacy. This review analyses the main challenges confronting healthcare professionals when prescribing in older people with CVD, multimorbidity, and polypharmacy. Our goal is to provide information that can contribute to improving drug prescribing, efficacy, and safety, as well as drug adherence and clinical outcomes.

Characteristics of Body Composition and Relationship between Muscle Mass and Muscle Strength among Elderly Women in Different Age Groups

Age-related changes in the body composition of older adults differ among age groups. The purpose of the present study was to clarify the characteristics of body compositions in young (age, 65 - 74 years; yE group) and old (age, ≥75 years; oE group) elderly women, and compare the relationship between muscle mass and strength in elderly women with that in young women for preventing motor function loss in older adults. A total of 30 elderly and 45 young women aged ≥ 65 and 19 - 22 years, respectively, participated in this study. The participants underwent body composition measurement via bioelectrical impedance analysis and examinations of handgrip and leg muscle strength. The age-related body composition changes varied among age groups. Compared with young women, fat-free mass (FFM) in the yE group did not decrease significantly; however, fat mass (FM) and waist-hip ratio (WHR) were significantly greater. Compared with the yE group, decreases in FFM, FM, and WHR in the oE group were significant; furthermore, the decrease in FM measurements was attributed to the loss of FM in the trunk and limbs (upper and lower). The measurement results suggested that the greater FM decrease in the oE group was characterized by decreases in both visceral and subcutaneous fat. In the yE group, the muscle mass was comparable to that in young women; however, there was a remarkable reduction in the lower-limb muscle mass (9% - 10%). In the oE group, muscle mass was reduced in all body parts, including upper and lower limbs and trunk. In young women, significant positive correlations between muscle mass and muscle strength in the upper and lower limbs were observed. No such correlations in the lower limbs were found in elderly women, indicating that muscle mass is not proportionally reflected in muscle strength. In conclusion, for improving and maintaining the health of elderly women, especially those above the age of 75 years, it is important to maintain muscle mass, including muscle strength, and prevent the loss of muscle quality.

Depression and Age-Related Changes in Body Composition, Cardiovascular Function, Grip Strength, and Lung Function

Individuals with mental disorders, on average, die prematurely, have higher levels of physical comorbidities and may experience accelerated ageing. In individuals with lifetime depression and healthy controls, we examined associations between age and multiple physiological measures. The UK Biobank study recruited >500,000 participants, aged 37-73, between 2006–2010. Generalised additive models were used to examine associations between age and grip strength, cardiovascular function, body composition, lung function and bone mineral density. Analyses were conducted separately in males and females with depression compared to healthy controls. Analytical samples included up to 342,393 adults (mean age = 55.87 years; 52.61% females). We found statistically significant differences between individuals with depression and healthy controls for most physiological measures, with standardised mean differences between -0.145 and 0.156. There was some evidence that age-related changes in body composition, cardiovascular function, lung function and heel bone mineral density followed different trajectories in individuals with depression. These differences did not uniformly narrow or widen with age. For example, BMI in female cases was 1.1 kg/m2 higher at age 40 and this difference narrowed to 0.4 kg/m2 at age 70. In males, systolic blood pressure was 1 mmHg lower in cases at age 45 and this difference widened to 2.5 mmHg at age 65. Individuals with depression differed from healthy controls across a broad range of physiological measures. Differences in ageing trajectories differed by sex and were not uniform across physiological measures, with evidence of both age-related narrowing and widening of case-control differences.

Lifetime depression and age-related changes in body composition, cardiovascular function, grip strength and lung function: sex-specific analyses in the UK Biobank.

Individuals with depression, on average, die prematurely, have high levels of physical comorbidities and may experience accelerated biological ageing. A greater understanding of age-related changes in physiology could provide novel biological insights that may help inform strategies to mitigate excess mortality in depression. We used generalised additive models to examine age-related changes in 15 cardiovascular, body composition, grip strength and lung function measures, comparing males and females with a lifetime history of depression to healthy controls. The main dataset included 342,393 adults (mean age = 55.87 years, SD = 8.09; 52.61% females). We found statistically significant case-control differences for most physiological measures. There was some evidence that age-related changes in body composition, cardiovascular function, lung function and heel bone mineral density followed different trajectories in depression. These differences did not uniformly narrow or widen with age and differed by sex. For example, BMI in female cases was 1.1 kg/m2 higher at age 40 and this difference narrowed to 0.4 kg/m2 at age 70. In males, systolic blood pressure was 1 mmHg lower in depression cases at age 45 and this difference widened to 2.5 mmHg at age 65. These findings suggest that targeted screening for physiological function in middle-aged and older adults with depression is warranted to potentially mitigate excess mortality.

Lifetime depression and age-related changes in body composition, cardiovascular function, grip strength and lung function: sex-specific analyses in the UK Biobank

AimsIndividuals with mental disorders, on average, die prematurely, have higher levels of physical comorbidities and may experience accelerated ageing. In individuals with lifetime depression and healthy controls, we examined associations between age and multiple physiological measures.MethodThe UK Biobank study recruited &gt;500,000 participants, aged 37–73 years, between 2006–2010. Generalised additive models were used to examine associations between age and grip strength, cardiovascular function, body composition, lung function and bone mineral density. Analyses were conducted separately in males and females with depression compared to healthy controls.ResultAnalytical samples included up to 342,393 adults (mean age = 55.87 years; 52.61% females). We found statistically significant differences between individuals with depression and healthy controls for most physiological measures, with standardised mean differences between -0.145 and 0.156. There was some evidence that age-related changes in body composition, cardiovascular function, lung function and heel bone mineral density followed different trajectories in individuals with depression. These differences did not uniformly narrow or widen with age. For example, BMI in female cases was 1.1 kg/m2 higher at age 40 and this difference narrowed to 0.4 kg/m2 at age 70. In males, systolic blood pressure was 1 mmHg lower in cases at age 45 and this difference widened to 2.5 mmHg at age 65.ConclusionIndividuals with depression differed from healthy controls across a broad range of physiological measures. Differences in ageing trajectories differed by sex and were not uniform across physiological measures, with evidence of both age-related narrowing and widening of case-control differences.

Nutrition for Older Athletes: Focus on Sex-Differences.

Regular physical exercise and a healthy diet are major determinants of a healthy lifespan. Although aging is associated with declining endurance performance and muscle function, these components can favorably be modified by regular physical activity and especially by exercise training at all ages in both sexes. In addition, age-related changes in body composition and metabolism, which affect even highly trained masters athletes, can in part be compensated for by higher exercise metabolic efficiency in active individuals. Accordingly, masters athletes are often considered as a role model for healthy aging and their physical capacities are an impressive example of what is possible in aging individuals. In the present review, we first discuss physiological changes, performance and trainability of older athletes with a focus on sex differences. Second, we describe the most important hormonal alterations occurring during aging pertaining regulation of appetite, glucose homeostasis and energy expenditure and the modulatory role of exercise training. The third part highlights nutritional aspects that may support health and physical performance for older athletes. Key nutrition-related concerns include the need for adequate energy and protein intake for preventing low bone and muscle mass and a higher demand for specific nutrients (e.g., vitamin D and probiotics) that may reduce the infection burden in masters athletes. Fourth, we present important research findings on the association between exercise, nutrition and the microbiota, which represents a rapidly developing field in sports nutrition.

Lifetime depression and age-related changes in body composition, cardiovascular measures, grip strength and lung function

IntroductionIndividuals with mental disorders, on average, die prematurely and may experience accelerated biological ageing.ObjectivesWe examined sex-specific associations between age and physiological measures in individuals with lifetime depression and healthy controls.MethodsUK Biobank recruited &gt;500,000 participants, aged 37-73, between 2006–2010. Generalised additive models (GAMs) were used to examine associations between age and multiple cardiovascular, body composition, grip strength and lung function measures. Analyses were conducted separately in males and females with lifetime depression compared to healthy controls.ResultsAnalytical samples included up to 342,393 adults (mean age = 55.87 years, SD = 8.09; 52.61% females). We found statistically significant differences between individuals with lifetime depression and healthy controls for most physiological measures, with standardised mean differences between -0.145 and 0.156. There was some evidence that age-related changes in body composition, cardiovascular measures, lung function and heel bone mineral density followed different trajectories in individuals with lifetime depression. However, these differences did not uniformly narrow or widen with age. For example, BMI in females with lifetime depression was approximately 1.1 kg/m2 higher at age 40 and this difference narrowed to about 0.4 kg/m2 at age 70. In males, systolic blood pressure was approximately 1 mmHg lower in individuals with lifetime depression at age 45 and this difference widened to about 2.5 mmHg at age 65.ConclusionsEvidence of differences in ageing trajectories between individuals with lifetime depression and healthy controls was not uniform across physiological measures and differed by sex.DisclosureJM receives studentship funding from the Biotechnology and Biological Sciences Research Council (BBSRC) and Eli Lilly and Company Limited. CML is a member of the Scientific Advisory Board of Myriad Neuroscience.

Age-Related Changes in Body Composition and Bone Mineral Density and Their Relationship with the Duration of Diabetes and Glycaemic Control in Type 2 Diabetes.

PurposeTo investigate age-related changes in body composition (BC) and bone mineral density (BMD) in type 2 diabetes (T2D) and analyse whether diabetes duration or glycaemic control affects these factors.Patients and MethodsWe enrolled 1474 hospitalized T2D patients (817 males and 657 females; 45–85 years). BC and BMD were assessed by dual-energy X-ray absorptiometry (DEXA). Patients were stratified into age groups: 45–54, 55–64, 65–74, and ≥75 years. Continuous variables were compared using t-tests or one-way analysis of variance (ANOVA), and categorical variables were compared using chi-square tests. Effects of age, diabetes duration, and haemoglobin A1C (HbA1c) on BC and BMD were assessed with multiple linear regression models.ResultsIn T2D, in females, changes in fat mass index (FMI) were positively correlated with age, while changes in lean mass index (LMI) were unrelated to age. Changes in FMI or LMI in males were unrelated to age. For regional BC distribution, changes in visceral adipose tissue (VAT) were positively correlated with age for both males and females, while changes in appendage lean mass (ALM) were negatively correlated with age. For BMD, changes in total BMD (TBMD) in males were not correlated with age, while changes in lumbar spine BMD (LBMD) were positively correlated with age, and femoral neck BMD (FNBMD) was negatively correlated with age. Changes in BMD in all parts of females were negatively correlated with age. In addition, changes in BC and BMD were unrelated to diabetes duration, and HbA1c was mainly associated with decreases in lean mass but had little effect on other BC and BMD parameters.ConclusionIn T2D, changes in BC and BMD were associated with age but not diabetes duration. A higher HbA1c is associated with lower lean mass.

Weight-adjusted waist index reflects fat and muscle mass in the opposite direction in older adults.

Age-related changes in body composition include decreased muscle mass and preserved or increased fat mass. There is no anthropometric index to assess both muscle and fat mass. Using a cross-sectional sample of 602 participants aged ≥65years from the Ansan Geriatric study, we evaluated the association of weight-adjusted waist index (WWI) with muscle and fat mass and compared these with body mass index (BMI) and waist circumference (WC). WWI was calculated as WC (cm) divided by the square root of body weight (kg). Body composition was measured using bioelectrical impedance analysis, dual-energy X-ray absorptiometry and abdominal computed tomography. WWI positively correlated with total abdominal fat area (TFA) (r = 0.421, P < 0.001), visceral fat area (VFA) (r = 0.264, P < 0.001), and percentage of total tissue fat (r = 0.465, P < 0.001), but negatively correlated with appendicular skeletal muscle mass (ASM) (r = -0.511, P < 0.001) and ASM/height2 (r = -0.324, P < 0.001). Mean ASM was highest in the first quartile of WWI (17.85kg/m2) and showed a decreasing trend, with the lowest value in the fourth WWI quartile (13.21kg/m2, P for trend <0.001). In contrast, mean TFA was lowest in the first quartile and highest in the fourth WWI quartile (P for trend <0.001). The probability of combined low muscle mass and high fat mass was >3× higher in the fourth WWI quartile than in the lowest quartile (odds ratio 3.22, 95% confidence interval 1.32-7.83). WWI is an anthropometric index positively associated with fat mass and negatively associated with muscle mass in older adults.