Presence Of Sarcopenic Obesity Research Articles

Prevalence of sarcopenic obesity in women and its association with level of independent physical activity combined with sedentary behavior.

This study aimed to determine the prevalence of sarcopenic obesity and its association with the level of physical activity, alone and combined with sedentary behavior. A cross-sectional study was performed. The sample was composed of 317 women aged between 24 and 59 years. Sarcopenic obesity was determined by the coexistence of sarcopenia (reduced muscle mass and strength) and obesity (% fat). Dual-energy x-ray absorption was used to evaluate muscle mass and % fat, with cutoff points of <15 kg and <31.71%, respectively. Strength was assessed by the handgrip test, with a cutoff point of <21.68 kg. Levels of physical activity and sedentary behavior were assessed using the long version of the International Physical Activity Questionnaire. Individuals who did not achieve 150 minutes per week of physical activity were considered insufficiently active. The cutoff point for sedentary behavior was determined based on the 75th percentile (480 min/wk), considering excessive sedentary behavior (≥75th percentile) and low/moderate sedentary behavior (<75th percentile). The prevalence of sarcopenic obesity was 7.9% (95% CI, 4.9-10.8). Sarcopenic obesity was associated with the general physical activity level (odds ratio, 3.96; 95% CI, 1.32-11.8) and being insufficiently active together with low/moderate sedentary behavior (odds ratio, 4.88; 95% CI, 1.49-16.0). There was the presence of sarcopenic obesity in adult women which was associated with the level of general physical activity, alone and combined with sedentary behavior.

Pathophysiological-Based Nutritional Interventions in Cirrhotic Patients with Sarcopenic Obesity: A State-of-the-Art Narrative Review.

In recent decades, following the spread of obesity, metabolic dysfunction has come to represent the leading cause of liver disease. The classical clinical presentation of the cirrhotic patient has, therefore, greatly changed, with a dramatic increase in subjects who appear overweight or obese. Due to an obesogenic lifestyle (lack of physical activity and overall malnutrition, with an excess of caloric intake together with a deficit of proteins and micronutrients), these patients frequently develop a complex clinical condition defined as sarcopenic obesity (SO). The interplay between cirrhosis and SO lies in the sharing of multiple pathogenetic mechanisms, including malnutrition/malabsorption, chronic inflammation, hyperammonemia and insulin resistance. The presence of SO worsens the outcome of cirrhotic patients, affecting overall morbidity and mortality. International nutrition and liver diseases societies strongly agree on recommending the use of food as an integral part of the healing process in the comprehensive management of these patients, including a reduction in caloric intake, protein and micronutrient supplementation and sodium restriction. Based on the pathophysiological paths shared by cirrhosis and SO, this narrative review aims to highlight the nutritional interventions currently advocated by international guidelines, as well as to provide hints on the possible role of micronutrients and nutraceuticals in the treatment of this multifaceted clinical condition.

Association between Sarcopenia and Reduced Bone Mass: Is Osteosarcopenic Obesity a New Phenotype to Consider in Weight Management Settings?

Sarcopenic obesity (SO) is a frequent phenotype in people with obesity; however, it is unclear whether this links with an impaired bone status. In this study, we aimed to investigate the association between SO and low bone mass, and to assess the prevalence of a new entity that combines excessive fat deposition, reduced muscle mass and strength, and low bone mass defined as osteosarcopenic obesity (OSO). Body composition was completed by a DXA scan in 2604 participants with obesity that were categorized as with or without SO, and with low or normal bone mineral content (BMC). Participants with both SO and low BMC were defined as OSO. Among the entire sample, 901 (34.6%) participants met the criteria for SO. This group showed a reduced mean BMC (2.56 ± 0.46 vs. 2.85 ± 0.57, p < 0.01) and displayed a higher prevalence of individuals with low BMC with respect to those without SO (47.3% vs. 25.9%, p < 0.01). Logistic regression analysis showed that the presence of SO increases the odds of having low BMC by 92% [OR = 1.92; 95% CI: (1.60-2.31), p < 0.05] after adjusting for age, body weight, and body fat percentage. Finally, 426 (16.4%) out of the total sample were affected by OSO. Our findings revealed a strong association between SO and reduced bone mass in adults with obesity, and this introduces a new phenotype that combines body fat, muscle, and bone (i.e., OSO) and appears to affect 16% of this population.

Особенности композиционного состава тела и метаболического профиля у детей с саркопеническим ожирением

Sarcopenic obesity (SO) is characterized by a decrease of lean mass and increase of adipose tissue and is associated with various metabolic disorders in adults. The influence of the body composition on the metabolic profile in obese children remains unclear as yet. The purpose of the research was to assess body composition and metabolic profile in children with sarcopenic obesity Methods used: cross-sectional, single-center study was conducted in Feb. 2020-Jul. 2022 which included 116 children (55 boys, 61 girls) with simple obesity (SDS BMI 2.5 [2.2;2.7]) aged 7 to 17 y/o (average age 14.2 [12.3;15.5] y/o) divided into two groups depending on the presence of sarcopenic obesity. The group with sarcopenic obesity ("SO+") included 56 children (19 boys, 37 girls) with simple obesity (SDS BMI 2.5 [2.2; 2.6]). The control group ("SO-") consisted of 60 children (36 boys, 24 girls) with constitutionally exogenous obesity (SDS BMI 2.5 [2.2; 2.7]) without sarcopenia. Results: children with sarcopenic obesity were characterized by an increase in adipose tissue (39.1% [36.4; 41.9] vs 30.6% [27.6; 32.4]; p&lt;0.0001), decrease in lean mass (55.6 [44.8; 63.7] vs 45.6 [39.5; 49.7] kg; p&lt;0.0001) and skeletal muscle mass decrease (25.0 [19.2; 28.2] vs 19.4 [16.3; 22.4] kg; p&lt;0.0001) - all compared to the "SO-" group. There were no statistically significant differences in the frequency of detection of impaired glucose tolerance (p=0.672), insulin resistance (p=0.871) and non-alcoholic fatty liver disease (p=0.657) in both groups. Conclusion: sarcopenic obesity in children is characterized by a reduction of lean mass and skeletal muscle mass and is not accompanied by changes in the metabolic profile. It makes difficult to stratify metabolic risks in this group of pediatric patients.

Skeletal muscle mass, muscle strength, and physical performance in children and adolescents with obesity.

Sarcopenic obesity (SO) is defined as obesity with low skeletal muscle function and mass. This study aimed to evaluate the presence of sarcopenic obesity according to different diagnostic criteria and assess the elements of sarcopenia in children and adolescents with obesity. A total of 95 children and adolescents with obesity (diagnosed with the use of International Obesity Task Force (IOTF) criteria) with a mean age of 12.7( ± 3) years participated in the study. Body composition was assessed with the use of bioelectrical impedance-BIA (Tanita BC480MA) and dual-energy X-ray absorptiometry-DXA (Hologic). Fat mass (FM) and appendicular skeletal muscle mass (SMMa) were expressed as kilograms (kg) and percentage (%). Muscle-to-fat ratio (MFR) was defined as SMMa divided by FM. A dynamometer was used in order to measure grip strength. Six-minute walk test (6MWT) and a timed up-and-go test (TUG) were used to assess physical performance. The presence of SO ranged from 6.32% to 97.89%, depending on the criteria used to define sarcopenia. Children with sarcopenia, defined as a co- occurrence of low skeletal muscle mass % (SMM%) measured by DXA (≤9th centile) according to McCarthy et al. and weak handgrip strength (≤10th centile) according to Dodds et al., had significantly lower SMMa measured by both DXA and BIA, lower maximal handgrip strength, and lower physical performance. Maximal handgrip was positively correlated with SMMa (kg) and SMMa% derived from both DXA and BIA and BIA-MFR. Maximal handgrip was negatively correlated with waist-to-height ratio (WHtR). The distance of 6MWT correlated positively with BIA-measured SMMa% and BIA-MFR. 6MWT distance correlated negatively with BIA-FM% and body mass index (BMI) z-score. TUG was positively correlated with BIA-FM%, BMI z-score, WHtR, and IOTF categories and negatively correlated with BIA-SMMa% and BIA-MFR. The presence of sarcopenia in our study varied depending on the diagnostic criteria used. This is one of the first studies evaluating muscle mass, muscle strength, and physical performance in children and adolescents with obesity. The study highlighted the need for the implementation of a consensus statement regarding SO diagnostic criteria in children and adolescents.

Sarcopenic Obesity Phenotypes in Patients With HIV: Implications for Cardiovascular Prevention and Rehabilitation

BackgroundWe aimed to describe prevalence, incidence, and risk factors for sarcopenic obesity (SO) phenotypes in people living with HIV (PWH) and their association with subclinical cardiovascular disease (CVD). MethodsObservational, longitudinal study of PWH. A minimum of 1 criterion was necessary to diagnose sarcopenia: weak hand grip (HG), low appendicular skeletal muscle index (ASMI), short physical performance battery (SPPB < 11). Obesity was defined as body mass index (BMI) ≥ 30 kg/m2 or visceral adipose tissue (VAT) ≥ 160 cm2. These variables combined generated 5 SO phenotypes: severe SO: low HG + low ASMI + low SPPB + high BMI; SO1: weak HG + high VAT; SO2: weak HG + high BMI; SO3: low ASMI + high VAT; SO4: low ASMI + high BMI. Subclinical CVD was defined as carotid intima-media thickness (IMT) ≥ 1 mm, presence of carotid plaque, or coronary artery calcification (CAC) score > 10. ResultsAmong 2379 male PWH 72%, median age was 52 years, median HIV vintage 21 years, and median BMI 24 kg/m2. Two PWH had severe SO. The prevalence of SO1-SO4 was 19.7%, 3.6%, 20.8% and 0.8%, respectively. Incidence of SO1-SO4 was 6.90, 1.2, 5.6, and 0.29 × 100 person-years, respectively. SO1 was associated with risk of IMT ≥ 1, and SO3 with risk of CAC score > 10. ConclusionsThere was a large variability in incidence and prevalence of SO phenotypes. The presence of SO may have important implications for cardiovascular prevention and cardiac rehabilitation of PWH who suffered events.

Body Composition and Bone Mineral Density in Postmenopausal Women with Advanced Knee Osteoarthritis Undergoing Surgical Treatment.

This study aimed to demonstrate the bone mineral density (BMD) and body composition in postmenopausal women with knee osteoarthritis (OA) who underwent surgical treatment, such as total knee arthroplasty, osteotomy, or meniscectomy. A total of 254 women with OA aged 50 years who underwent surgical treatment were enrolled in this study. We evaluated obesity-related factors, muscle components, and BMD using dual-energy X-ray absorptiometry. No significant differences were noted in the BMD of the hip joint between the symptomatic side of the leg with knee OA and the contralateral side. However, when comparing the BMD of each component, the results indicated a significantly higher BMD in the obesity group based on body mass index (BMI). When defining sarcopenic obesity (SO) using various indicators of obesity (BMI, the estimated visceral adipose tissue area, android/gynoid ratio, and total body fat percentage), the prevalence of SO in the OA group who underwent surgical treatment ranged from 22.0% to 49.6%. This study investigated obesity-related factors in patients with advanced knee OA who underwent surgery, revealing a high prevalence of overweight/obese individuals, the presence of SO, and a complex relationship between obesity, body composition, and bone density, highlighting the potential protective effects of weight-bearing on bone health while exploring the impact of sarcopenia on bone density differences in the context of OA. Depending on various definitions of obesity, diverse proportions of SO in patients with OA have been observed, and further detailed research is required to understand its impact on the condition.

Detecting Sarcopenic Obesity in Survivors of Pediatric Acute Lymphoblastic Leukemia: An Exploration of Body Mass Index and Triponderal Mass Index as Potential Surrogate Markers.

Survivors of pediatric acute lymphoblastic leukemia (ALL) often have altered body composition secondary to treatment effects, including sarcopenic obesity (SO), which increases the risk of both metabolic complications and frailty. SO is difficult to detect without using advanced imaging techniques to which access is often limited. To explore whether common clinical indices can reliably identify the presence of SO in a cohort of long-term survivors of ALL, the discriminatory capacity of body mass index (BMI) or triponderal mass index (TMI, kg/m 3 ) for detecting SO was assessed. Thresholds of BMI and TMI associated with overweight or obesity status had poor sensitivity (<50%) and specificity for detecting SO. Total misclassification rates at these thresholds exceeded 50% and positive likelihood ratios were nonsignificant. Notably, TMI is more strongly correlated with elevated adiposity than is BMI in this survivor population ( R2 =0.73 vs. 0.57), suggesting further exploration is warranted. Our study is limited by the sample size, precluding detailed regression analysis. This study highlights the challenges of identifying SO in survivors of pediatric ALL using common clinical indices. Prospective evaluation of additional potential surrogate markers in survivors, in conjunction with the component features of SO, should be a key focus of future research.

Incremental Shuttle Walk Test and Body Composition Measures: Useful Predictive Factors For Complications After Oesophago-Gastric Cancer Surgery?

Background: Oesophagogastric cancer resection carries a morbidity, as high as 60%. Better patient selection, not only with regards to clinical stage but also fitness, reduces morbidity, and improves outcome. Assessment of body composition measures in particular sarcopenia and the incremental shuttle walk test (ISWT) are 2 such tools to evaluate patients’ fitness. We investigate the usefulness of these 2 tools in predicting post-operative outcomes following oesophagogastric resection. Methods: All patients who underwent oesophagogastric cancer resection between 2017 and 2019 and consented to participate in ISWT were included in the study. Patient demographics, comorbidity profile and distance walked in ISWT were collected from an electronic database kept locally. Body composition measures were calculated using pre-operative staging CT scans. Outcomes assessed included overall complications, major complications (Clavien-Dindo III-V) and overall survival. Results: Sixty-seven patients met the inclusion criteria. Seventy-nine percent of the cohort were males and the median age was 67. The majority had neoadjuvant chemotherapy (85%) and the overall complication rate was 69% with a major complication rate of 34%. There was no difference in complication rates between groups of patients who managed an ISWT distance of &gt;350 m and ≤350 m. Multi-variate analyses showed that total fat index ( P = .041), myosteatosis (OR: 3.89; 95% CI: 1.04-16.76; P = .039) and sarcopenic obesity ( P = .028) were independent predictors of overall complications. The presence of sarcopenic obesity was associated with poorer overall survival ( P = .047). There was no correlation between skeletal muscle index and ISWT. Conclusion: ISWT does not predict post-operative morbidity following oesophagogastric cancer resection. However, sarcopenic obesity was associated with both higher overall complication rates and decreased overall survival. The assessment of body composition using CT scans is a useful pre-operative assessment tool for prediction of outcomes in patients undergoing oesophagogastric cancer resection

Sarcopenic Obesity in Heart Failure With Preserved Ejection Fraction.

Heart failure with preserved ejection fraction (HFpEF) is a public health epidemic that is projected to double over the next two decades. Despite the high prevalence of HFpEF, there are currently no FDA approved therapies for health-related outcomes in this clinical syndrome making it one the greatest unmet needs in cardiovascular medicine. Aging and obesity are hallmarks of HFpEF and therefore there is a high incidence of sarcopenic obesity (SO) associated with this syndrome. The presence of SO in HFpEF patients is noteworthy as it is associated with co-morbidities, worsened cardiovascular health, hospitalizations, quality of life, and mortality. Furthermore, SO plays a central role in exercise intolerance, the most commonly reported clinical symptom of this condition. The aim of this review is to provide insights into the current knowledge pertaining to the contributing pathophysiological mechanisms and clinical outcomes associated with HFpEF-related SO. Current and prospective therapies to address SO in HFpEF, including lifestyle and pharmaceutical approaches, are discussed. The urgent need for future research aimed at better understanding the multifaceted physiological contributions to SO in HFpEF and implementing interventional strategies to specifically target SO is highlighted.

Inflammatory parameters in elderly women with and without sarcopenic obesity

The combination of increased fat mass with a decrease in muscle mass and strength in the elderly has been termed sarcopenic obesity (SO). In addition, augmented levels of inflammatory markers have been reported in subjects with SO. Two hundred-sixteen obese elderly women were included in this cross-sectional study. They underwent body composition analysis by DEXA to define the presence of SO. Volunteers were divided into two groups: SO (n= 83; 66.7 ± 5.6 years) and non-SO (n= 133; 67.6 ± 4.9 years) for the comparison of inflammatory cytokines. There were no significant differences between SO and non-SO groups in the blood concentrations of the inflammatory markers analyzed, e.g. interleukin-6 (0.82 ± 0.20 vs 0.83 ± 0.19 pg/ml; p=0.64), C-reactive protein (2.70 ± 1.55 vs 2.82 ± 1.66 pg/ml; p=0.71), tumor necrosis factor alpha (0.71 ± 0.08 vs 0.70 ± 0.08 pg/ml; p=0.42) and interferon-gamma (0.75 ± 0.14 vs 0.74 ± 0.08 pg/ml; p=0.47), respectively. Thus, in the studied population, inflammatory markers are not exacerbated by SO when compared to obesity without sarcopenia.

Sarcopenic Obesity and Activities of Daily Living in Stroke Rehabilitation Patients: A Cross-Sectional Study.

Reports investigating the relationship between sarcopenic obesity and activities of daily living in older patients with stroke were limited. This study aimed to examine the prevalence of sarcopenic obesity and its association with activities of daily living in older post-stroke patients in convalescent rehabilitation wards. This study was performed in older post-stroke patients admitted to convalescent rehabilitation wards between January 2017 and March 2019. Sarcopenia was diagnosed based on the skeletal muscle mass index and hand grip strength according to the criteria of the 2019 Asian Working Group for Sarcopenia. Obesity was diagnosed according to the body fat percentage; ≥27% in men, ≥38% in women. The primary outcome was the Functional Independence Measure (FIM) score upon admission, which was analyzed using multiple linear regression. In total, 376 participants (women 44%; mean age 77.5 years) were analyzed and classified as normal (22%), simple obesity (17%), sarcopenia without obesity (32%), and sarcopenic obesity (28%). The presence of sarcopenic obesity was independently associated with the FIM score (95% CI, −16.157 to −5.353), whereas simple obesity and sarcopenia without obesity were not. In conclusion, sarcopenic obesity was independently associated with lower activities of daily living capability in older patients with stroke.

The Impact of Sarcopenic Obesity on Health-Related Quality of Life of Treatment-Seeking Patients with Obesity.

There is a paucity of studies on health-related quality of life (HRQoL) and sarcopenic obesity (SO). This study aimed to assess the potential association between SO and impaired HRQoL. The ORWELL 97 questionnaire was used to assess HRQoL and body composition was measured using a bioimpedance analyser (Tanita BC-418) in 130 patients with obesity, referred to the Nutritional and Weight Management outpatient clinic of Beirut Arab University in Lebanon. Participants were then categorized on the basis of the absence or presence of SO. Sixty-four of the 130 participants met the criteria for SO (49.2%) and displayed significantly higher total ORWELL 97 scores than those in the group without SO (64.00 vs. 41.00, p=0.001), indicative of poorer HRQoL. Linear regression analysis showed that SO was associated with an increase in ORWELL 97 scores by nearly 24 units (β=24.35, 95% CI=11.45-37.26; p<0.0001). Moreover, the logistic regression analysis showed that SO increased the odds of clinically significant impairment of HRQoL (ORWELL 97 score ≥74.25) by nearly seven-fold (OR=7.37, 95% CI=1.92-28.39; p=0.004). Our findings show that the presence of SO was associated with increased impairment of HRQoL that reaches clinical significance when compared to obesity only. Future studies are needed to clarify whether this may influence clinical outcomes. If this is shown to be the case, weight management programs should incorporate additional strategies to improve HRQoL in individuals with SO.

Association Between Sarcopenic Obesity and Metabolic Syndrome in Adults: A Systematic Review and Meta-Analysis.

Background In the last two decades, a new phenotype termed Sarcopenic Obesity (SO), in which sarcopenia and obesity coexist, has emerged.Objective The aim of this systematic review and meta-analysis was first to assess the prevalence of Metabolic syndrome (Mets) among individuals with and without SO, and second, to determine if SO may increase the relative risk of Mets.Methods This study was conducted in adherence to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and the data were collated by means of meta-analysis and narrative synthesis.Results Twelve studies including a total of 11,308 adults with overweight or obesity of both genders met the inclusion criteria and were reviewed, revealing two main findings. First, a similar overall prevalence of Mets in individuals with SO (61.49%; 95% CI: 52.19-70.40) when compared to those without SO (56.74%; 95% CI: 47.32-65.93) was identified. Second, the presence of SO appears not to increase the risk of Mets with respect to those without SO (RR = 1.08, 95% CI: 0.99-1.17, p = 0.07).Conclusion No higher prevalence of Mets among individuals with SO when compared to those with obesity only, nor a significant association between SO and a higher risk of Mets was found.

Reduction of Resting Energy Expenditure and Sarcopenic Obesity in Adults with Overweight and Obesity: A Brief Report.

The last decade has seen the emergence of a new condition, describing the coexistence of obesity and sarcopenia, termed Sarcopenic Obesity (SO). The aim of this study was to assess the potential association between SO and reduced Resting Energy Expenditure (REE). Body composition and REE were measured using a bioimpedance analyser (Tanita BC-418) and Indirect Calorimeter (Vmax Encore 229), respectively in 89 adults with overweight or obesity of both genders, referred to the Outpatient Clinic of the Department of Nutrition and Dietetics at Beirut Arab University (Lebanon). Participants were then categorized on the basis of having SO or not. Thirty-nine of the 89 participants met the criteria for SO (43.8%), and these participants displayed a significantly lower REE per unit body weight than those in the group without SO (19.02 ± 2.26 vs. 20.87 ± 2.77; p = 0.001). Linear regression analysis showed that the presence of SO decreases REE by 1.557 kcal/day for each kg of body weight (β = -1.557; CI = -0.261 - (-0.503); p = 0.004), after adjusting for age and gender. SO appears to be present in a high proportion of treatment-seeking adults with overweight or obesity of both genders, and it seems to be associated with a reduced REE, compared with those without SO. Future studies are needed to clarify whether this may influence clinical outcomes.

The effects of sarcopenia and sarcopenic obesity after pancreaticoduodenectomy in patients with pancreatic head cancer

BackgroundRecently, several studies have reported that sarcopenia and sarcopenic obesity (SO) could worsen postoperative complications after PD. This study aims to evaluate the effects of preoperative sarcopenia and SO following PD in pancreatic head cancer (PHD). MethodsPreoperative sarcopenia and SO were assessed in 548 patients undergoing PD for PHC at Samsung Medical Centre between 2007 and 2016. The visceral adipose tissue-to-skeletal muscle ratio was calculated from cross-sectional visceral fat and muscle areas on preoperative CT images. The overall survival (OS) and rate of clinically relevant postoperative pancreatic fistula (CR-POPF) among postoperative complications were extracted from prospectively maintained databases. ResultsPreoperative sarcopenia was present in 252 patients (45.9%). The 5-year survival rates of patients with non-sarcopenia and sarcopenia were 28.4% and 23.4% (p = 0.046). Preoperative SO was present in 202 patients (36.9%). After multivariable analysis, the presence of SO was the only independent risk factor for CR-POPF (p = 0.018). ConclusionSarcopenia can be a risk factor affecting decreased OS after PD in patients with PHC. SO is the only predictive factor for CR-POPF after PD in patients with PHC. More observational studies are needed to evaluate the effects of sarcopenia and SO on survival after PD.

Sarcopenic Obesity Predicts Early Attrition in Treatment-Seeking Patients with Obesity: A Longitudinal Pilot Study.

Attrition is a major cause of failure in obesity treatment, which is still not fully understood. The identification of factors related to this outcome is of clinical relevance. We aimed to assess the relationship between sarcopenic obesity (SO) and early attrition. Early attrition was assessed at six months, and two groups of patients were selected from a large cohort of participants with overweight or obesity enrolled at the Outpatient Clinic of the Department of Nutrition and Dietetics at Beirut Arab University (Lebanon). Body composition was measured using a bioimpedance analyser (Tanita BC-418) and participants at baseline were categorized as having or not having SO. The “dropout group” included 72 participants (cases) compared to 31 participants (controls) in the “completer group”, with the former displaying a higher prevalence of SO than the latter (51.0% vs. 25.8%; p = 0.016). In the same direction, Poisson regression analysis showed that SO increased the relative risk of dropout by nearly 150% (RR = 1.45; 95% CI = 1.10–1.89; p = 0.007) after adjustment for age, gender, body mass index (BMI), age at first dieting, sedentary habits and weight-loss expectation. In conclusion, in a “real-world” outpatient clinical setting, the presence of SO at baseline increases the risk of dropout at six months. New directions of future research should be focused on identifying new strategies to reduce the attrition rate in this population.

Association of Body Composition with Long-Term Survival in Non-metastatic Rectal Cancer Patients.

PurposeWe evaluated the association of body composition with long-term oncologic outcomes in non-metastatic rectal cancer patients.MethodsWe included 1,384 patients with stage(y)0-III rectal cancer treated at Asan Medical Center between January 2005 and December 2012. Body composition at diagnosis was measured using abdomino-pelvic computed tomography (CT). Sarcopenia, visceral obesity (VO), and sarcopenic obesity (SO) were defined using CT measured parameters such as skeletal muscle index (total abdominal muscle area, TAMA), visceral fat area (VFA), and VFA/TAMA. Inflammatory status was defined as a neutrophil-lymphocyte ratio of ≥3. Obesity was categorized by body mass index (≥ 25 kg/m2).ResultsAmong the 1,384 patients, 944 (68.2%) had sarcopenia and 307 (22.2%) had SO. The 5-year overall survival (OS) rate was significantly lower in sarcopenic patients (no sarcopenia vs. sarcopenia; 84% vs. 78%, p=0.003) but the 5-year recurrence-free survival (RFS) rate was not different (77.3% vs. 77.9% p=0.957). Patients with SO showed lower 5-year OS (79.1% vs. 75.5% p=0.02) but no difference in 5-year RFS (p=0.957). Sarcopenia, SO, VO, and obesity were not associated with RFS. However, obesity, SO, age, sex, inflammatory status, and tumor stage were confirmed as independent factors associated with OS on multivariate analysis. In subgroup analysis, association of SO with OS was more prominent in patients with (y)p stage 0-2 and no inflammatory status.ConclusionThe presence of SO and a low body mass index at diagnosis are negatively associated with OS in non-metastatic rectal cancer patients.

Relationships among body composition, muscle strength, and sarcopenia in esophageal squamous cell carcinoma patients.

Relationships among body composition indices assessed by various modalities remain to be addressed in patients with esophageal squamous cell carcinoma (ESCC), in whom being underweight is more strikingly prevalent than in those with other malignancies. We investigated the relationships of body composition parameters with the sarcopenia prevalence of ESCC patients. In this prospective study, we analyzed preoperative data obtained from 75 ESCC patients undergoing esophagectomy. Body composition data included body mass index (BMI), skeletal muscle index (SMI) assessed by computed tomography, and parameters calculated by bioelectrical impedance analysis (skeletal muscle mass (SMM), body fat mass). Muscle strength was evaluated by handgrip strength (HGS). Sarcopenia was defined as having both low SMI and low HGS. The median BMI value was 22.5 (range 15.2-28.7) in our ESCC cohort. BMI correlated significantly with fat mass (r = 0.84, P < 0.001), SMM (r = 0.57, P < 0.001) and SMI (r = 0.49, P < 0.001). Similarly, SMI showed a significant correlation with SMM (r = 0.45, P < 0.001). Meanwhile, HGS was highly correlated with SMM (r = 0.67, P < 0.001), while showing significant but weak associations with both BMI and SMI (r = 0.33, 0.34, respectively, P < 0.001). Notably, sarcopenia prevalence differed markedly according to BMI category; 28.6%, 12.2%, and 0% in the low (< 20), medium (20-25), and high (> 25) BMI groups, respectively. BMI reflects comprehensive information on body composition in ESCC patients, although its correlation with muscle mass and muscle strength was moderate. Decreased BMI might serve as an indicator for sarcopenia in this population, in which the presence of sarcopenic obesity is rare.

Association between sarcopenic obesity and higher risk of type 2 diabetes in adults: A systematic review and meta-analysis.

BACKGROUNDThe coexistence of sarcopenia and obesity is referred to as sarcopenic obesity (SO) and it has been hypothesized that the two components of SO may synergistically increase their negative effects. However, many uncertainties still surround this condition especially with regard to its potential negative effects on health outcomes.AIMTo conduct a systematic review to determine the prevalence of sarcopenia among adults with overweight and obesity and to investigate whether SO was associated with a higher risk of type 2 diabetes (T2D).METHODSThis study was conducted in adherence with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Literature searches, study selection, methodology development and quality appraisal were performed independently by two authors and the data were collated by means of meta-analysis and narrative synthesis.RESULTSOf the 606 articles retrieved, 11 studies that comprised a total of 60118 adults with overweight and obesity of both genders met the inclusion criteria and were reviewed, revealing two main findings. First, the overall prevalence of sarcopenia is 43% in females and 42% in males who are with overweight and obesity. Secondly, the presence of SO increases the risk of T2D by 38% with respect to those without SO (OR = 1.38, 95%CI: 1.27-1.50).CONCLUSIONA high prevalence of sarcopenia has been found among adults with overweight and obesity regardless of their gender and this condition seems to be associated with a higher risk of T2D. Clinician should be aware of this scenario in their clinical practice for the better management of both obesity and T2D.