Sarcopenia Obesity Research Articles

Associations of muscle mass, strength, and quality with diabetes and the mediating role of inflammation in two National surveys from China and the United states

AimsThe evidence for joint and independent associations of low muscle mass and low muscle strength with diabetes is limited and mixed. The study aimed to determine the associations of muscle parameters (muscle mass, strength, quality, and sarcopenia) and sarcopenia obesity with diabetes, and the previously unstudied mediating effect of inflammation. Materials and MethodsA total of 13,420 adults from the 2023 China National Health Survey (CNHS) and 5,380 adults from the 2011–2014 National Health and Nutrition Examination Survey (NHANES) were included in this study. Muscle mass was determined using bioelectrical impedance analysis (BIA) in the CNHS, and whole-body dual X-ray absorptiometry (DXA) in the NHANES. Muscle strength was assessed using digital hand dynamometer. Multivariate logistic regression models were used to evaluate the associations of muscle parameters and sarcopenia obesity with diabetes. Inflammatory status was assessed using blood cell counts and two systemic inflammation indices (platelet-to-lymphocyte ratio (PLR) and system inflammation response index (SIRI)). Mediation analysis was conducted to examine inflammation’s role in these associations. ResultsLow muscle mass and strength were independently related to diabetes. Low muscle quality was associated with elevated diabetes risk. Sarcopenia has a stronger association with diabetes compared to low muscle strength alone or mass alone (CNHS, odds ratio (OR) = 1.93, 95 % confidence interval (CI):1.64–2.27; NHANES, OR = 3.80, 95 %CI:2.58–5.58). Participants with sarcopenia obesity exhibit a higher risk of diabetes than those with obesity or sarcopenia alone (CNHS, OR = 2.21, 95 %CI:1.72–2.84; NHANES, OR = 6.06, 95 %CI:3.64–10.08). Associations between muscle parameters and diabetes were partially mediated by inflammation (mediation proportion: 1.99 %-36.64 %, P < 0.05). ConclusionLow muscle mass and muscle strength are independently or jointly associated with diabetes, and inflammation might be a potential mechanism underlying this association. Furthermore, the synergistic effects of sarcopenia and obesity could significantly increase diabetes risk.

Sarcopenic obesity is associated with adverse outcomes after kidney transplantation: a retrospective cohort study.

Sarcopenia was found to be a poor prognostic factor in kidney transplant recipients, but the role of sarcopenia obesity remains unclear. This study aimed to explore the effect of sarcopenic obesity on kidney transplantation. A retrospective analysis was performed on kidney transplant recipients between 2015 and 2019. Pretransplant CT scans were utilized to assess sarcopenia and visceral obesity. Based on the presence or absence of sarcopenia and visceral obesity, the recipients were classified into four distinct groups. The recipients were categorized into four groups based on their characteristics: the nonsarcopenic nonobesity group (n = 493, 49.85%), the nonsarcopenic obesity group (n = 248, 25.08%), the sarcopenic nonobesity group (n = 188, 19.01%), and the sarcopenic obesity group (n = 60, 6.07%). Multivariate analysis, identified sarcopenic obesity was as an independent risk factor for mortality following kidney transplantation (adjusted hazard ratio, 5.861; 95% confidence interval [CI]: 1.627-21.108; P = 0.007). Additionally, sarcopenic obesity was associated with an increased risk of delayed graft function (adjusted odds ratio [aOR], 3.342; 95% CI 1.421-7.745; P = 0.005), perioperative incision infection (aOR, 9.654; 95% CI 1.572-60.648; P = 0.011), perioperative pulmonary infection (aOR, 2.557; 95% CI 1.208-5.215; P = 0.011), and readmission within 3months (aOR, 2.100; 95% CI 1.051-4.017; P = 0.029). While sarcopenic obesity was found to be associated with impaired graft renal function, it did not show a significant correlation with death-censored graft survival or quality of life. The presence of sarcopenic obesity prior to kidney transplantation represents an independent risk factor for mortality, and it is also linked to a range of unfavorable outcomes.

The impact of Helicobacter pylori infection on low skeletal muscle mass risk in Chinese women over 40: a cross-sectional analysis.

Sarcopenia can lead to significant personal, social, and economic burdens. The diagnosis of sarcopenia heavily relies on the identification of Low Skeletal Muscle Mass (LSMM), which is an independent predictor of frailty, disability, and increased risk of death among seniors. Women have physiologically lower levels of skeletal muscle mass than men, and female sarcopenia appears to be more influenced by menopause. They also tend to have higher body fat levels than man, which increases the risk of sarcopenia obesity. On another front, it's also recognized that humans are largely prone to Helicobacter pylori (H. pylori) infection, with global prevalence rates often surpassing 50%. Nevertheless, the interconnection between H. pylori infection and LSMM remains relatively unexplored. Hence, our study specifically targeted women as the research population and sought to explore several risk factors for LSMM. Additionally, we delved into the potential correlation between LSMM and H. pylori infection in women, hoping to gain insights into potential preventative measures or treatment options that may enhance the quality of life for women affected by sarcopenia. We conducted a cross-sectional study among women aged over 18 years undergoing physical examination. We performed 13C-urea breath test (UBT) for diagnosis of H. pylori infection and Bioelectrical impedance analysis (BIA) for the assessment of LSMM. Logistic regression models were used to analyze the associations of H. pylori infection with LSMM. This study enrolled 1984 Chinese women who were undergoing health check-ups. A univariate logistic regression analysis did not reveal a direct correlation between H. pylori infection and LSMM among this female population (OR=1.149, 95% CI 0.904-1.459, p=0.257). Yet, upon dividing the participants into age-based subgroups, an evident link was observed between H. pylori infection and LSMM in women aged 40 or above (OR=1.381, 95%CI 1.032-1.848, p= 0.030). After adjusting for variables including Age, BMI, TP, ALK, Cre, this relationship remained statistically relevant (OR=1.514, 95%CI 1.085-2.113, p= 0.015). Women who are over 40 years old and currently infected with H. pylori have an increased risk of developing LSMM. Therefore, timely treatment for H. pylori eradication is recommended for this group of women to reduce the occurrence of LSMM.

Research Progress on the Effect and Mechanism of Exercise Intervention on Sarcopenia Obesity.

With the increasingly severe situation of obesity and population aging, there is growing concern about sarcopenia obesity (SO). SO refers to the coexistence of obesity and sarcopenia, which imposes a heavier burden on individuals and society compared to obesity or sarcopenia alone. Therefore, comprehending the pathogenesis of SO and implementing effective clinical interventions are vital for its prevention and treatment. This review uses a comprehensive literature search and analysis of PubMed, Web of Science, and CNKI databases, with search terms including "Sarcopenic obesity", "exercise", "cytokines", "inflammation", "mitochondrial quality control", and "microRNA", covering relevant studies published up to July 2024. The results indicate that the pathogenesis of SO is complex, involving mechanisms like age-related changes in body composition, hormonal alterations, inflammation, mitochondrial dysfunction, and genetic and epigenetic factors. Regarding exercise interventions for SO, aerobic exercise can reduce fat mass, resistance exercise can increase skeletal muscle mass and strength, and combined exercise can achieve both, making it the optimal intervention for SO. The potential mechanisms by which exercise may prevent and treat SO include regulating cytokine secretion, inhibiting inflammatory pathways, improving mitochondrial quality, and mediating microRNA expression. This review emphasizes the effectiveness of exercise interventions in mitigating sarcopenic obesity through comprehensive analysis of its multifactorial pathogenesis and the mechanistic insights into exercise's therapeutic effects. Understanding these mechanisms informs targeted therapeutic strategies aimed at alleviating the societal and individual burdens associated with SO.

The role of chicken eggs in modulating sarcopenic obesity and gut microbiota in db/db mice.

Sarcopenia obesity, in which loss of muscle mass and fat accumulation occur simultaneously, is the pathological basis of type 2 diabetes mellitus. The usefulness of chicken eggs in sarcopenia prevention has been reported in several previous studies. The purpose of this study was to determine the beneficial effects of chicken eggs in the prevention of sarcopenic obesity in db/db mice. We raised 8-week-old db/db male mice, a model of sarcopenia obesity, for 8 weeks and fed them a diet mixed with dried whole eggs. The fecal microbiota transplant (FMT) group was treated with antibiotics for 2 weeks, starting at 6 weeks of age, followed by FMT twice a week until 16 weeks of age. Eggs administered to db/db mice showed increased grip strength (p = 0.022) and muscle mass (p = 0.013), decreased visceral fat mass (p = 0.005), and significantly increased physical activity (p < 0.001). The FMT group of egg-fed mice showed a significant improvement in glucose intolerance and sarcopenic obesity. Sequencing of gene expression in the small intestine showed that the gene expression of amino acid transporters such as Slc6a18, Slc6a19, and Slc38a6 was increased in egg-fed mice. 16S rRNA sequencing of the gut microbiota showed an increase in the genus Vampirovibrio in both the egg-fed and FMT groups compared to that in egg-fed mice. The results of this study indicate that egg consumption not only increases the intake of amino acids and other nutrients but also alters the intestinal microbiota and increases amino acid absorption from the intestinal tract, suggesting that eggs might contribute to the ameliorative mechanism of sarcopenic obesity.

Association of Physical Activity and Physical Performance with Sarcopenia in Elderly Obese Patient in Community

Introduction: Sarcopenic obesity (SO) is a condition in which sarcopenia and obesity occur simultaneously. This condition will lead to risk of higher morbidity, mortality, and reduced quality of life. This study aimed to examine the proportion of SO patients in community and investigate the association between physical activity level and physical performance with sarcopenia in elderly obese patient in community&#x0D; Methods: An analytic observation cross-sectional study with consecutive sampling. Inclusion criteria included subjects with age ≥ 60 years old, body mass index ≥ 25 Kg / m2, able to walk at least 10 meters, and has a good cognitive function. Subjects with pacemaker, have metal implants, history of cancer, acute cardiovascular and respiratory disorders, deformities, or pain in extremities and receive regular therapeutic exercise were excluded from this research. Measurement of physical activity level using Physical Activity Scale for Elderly (PASE) questionnaire and physical performance using 6meter walking speed test and timed up and go test (TUG). Sarcopenia is based on criteria from Asian Working Group of Sarcopenia 2019 with body composition assessment using Bioelectric Impedance Analysis (BIA)&#x0D; Results: There were 119 subjects in this study. Proportion of sarcopenia obesity in all subjects was 23,5% with 71,4% was female. The results showed that there was no significant association on physical activity level (p &gt; 0,05) and a significant association on walking speed and TUG test (p &lt; 0,05).&#x0D; Conclusion: This research concluded that there was a significant association between physical performance with sarcopenia in elderly obese patient in the community.&#x0D;

저강도 저항운동이 근감소증과 근감소성 비만인 고령여성의 Fullerton 상급균형능력과 균형자신감 검사에 미치는 영향

The purpose of this study was to investigate any changes in fullerton advanced balance(FAB) and balance efficacy scale(BES) in exercise intervention according to low-intensity resistance exercise for 16 weeks.BRThe subjects of the study were women aged 75 older living in Jin-gu, Busan, who were selected for sarcopenia and sarcopenic obesiry by diagnosis of sarcopenia (ASM/height, kg/h²; 5.38 or less) and sarcopenia obesity (ASM/weight, % ; 25.6% or less, % fat, % ; 30% or less). The participants were randomly assigned into 4 groups; sarcopenia resistance exercise group (S-RG; n=10, 75.7±3.0 yrs), sarcopenia control group (S-G; n=12, 77.2±2.8 yrs), sarcopenia obesity resistance exercise group (n=11, 76.5±3.3 yrs), sarcopenia obesity control group(n=12, 76.1±2.9 yrs).BRFor the statistical analysis, such as t-test, and Two-Way Repeated measures ANOVA was calculated using SPSS Version 27.0. As a result of this study, the interaction effect with the interaction effect was shown in the FAB and BES test.BRBased on the research results, the low intensity resistance exercise program using dumbbells seems to play an important role as an exercise program in improving balance ability and physical activity for elderly women with sarcopenia and sarcopenia obesity in community centers, elderly welfare facilities, and homes.

Evaluation of the Accuracy of Six Simple Screening Tools for Sarcopenia in Schizophrenic Patients.

Our objective was to evaluate if SARC-F, SARC-CalF, SARC-F-EBM, calf circumference (CC), mid-upper-arm circumference (MUAC) and Ishii test can be used to accurately screen for sarcopenia in schizophrenic patients. We enrolled schizophrenic patients aged 50 or older, who were regularly taking antipsychotic medications, at two mental health centres. Bioimpedance-based muscle-mass was analysed with an InBody 770 instrument, while muscle strength was measured with a digital grip-strength dynamometer. The physical performance of the patients was gauged from their gait speed over 6 m. Standard AWGS2019 diagnostic criteria were used, and the accuracies of the six screening methods were indicated by the sensitivity, negative predictive value (NPV), and area under receiver operating characteristic curve (AUC). A total of 339 stable schizophrenic patients were enrolled. The overall prevalence of sarcopenia was 53.1%, and the prevalence was 55.6% and 47.66%, respectively, for males and females. The prevalence of sarcopenia obesity in the total population was 16.22%, and that of males and females was 18.97% and 10.28%, respectively. The SARC-F, SARC-CalF, SARC-F-EBM, CC, MUAC and Ishii test sensitivity/NPV in screening for sarcopenia were 41.86%/0.52, 79.07%/0.7, 28.68%/0.51, 78.3%/0.71, 76.74%/0.7, 89.92%/0.84, respectively, in males and 45.1%/0.59, 94.12%/0.91, 54.9%/0.7, 92.16%/60.91, 74.51%/0.77, 96.08%/0.94, respectively, in females. In males, the AUCs of the SARC-F, SARC-CalF, SARC-F-EBM, CC, MUAC and Ishii test were 0.601 (95%CI, 0.528-0.673), 0.754 (95%CI,0.69-0.817), 0.657 (95%CI,0.588-0.727), 0.8 (95%CI, 0.744-0.856), 0.781 (95%CI, 0.721-0.84) and 0.88 (95%CI, 0.837-0.922), respectively, and in females, they were 0.587(95%CI,0.479-0.696), 0.794 (95%CI,0.709-0.878), 0.799 (95%CI,0.71-0.888), 0.893 (95%CI, 0.833-0.953), 0.843 (95%CI, 0.772-0.915) and 0.855 (95%CI, 0.784-0.926), respectively. The prevalence of sarcopenia in schizophrenic patients is high. Clinical doctors should screen for sarcopenia in schizophrenic patients and provide timely interventions to reduce the occurrence of adverse events. The above six tools can be used as screening tools, and the Ishii test is the most suitable for screening.

Associations of physical activity with sarcopenia and sarcopenic obesity in middle-aged and older adults: the Louisiana osteoporosis study.

BackgroundThis study examined the associations between physical activity, obesity, and sarcopenia in middle-aged and older adults.MethodsWe analyzed the data of 8, 919 study participants aged between 45 to 97 (mean age = 57.2 ± 8.8) from a Southern state in the United States. Self-reported physical activity was classified to regular exercise ≥ 3 times/week, < 3 times/week, and no regular exercise. Associations between physical activity, obesity and sarcopenia were explored with generalized linear models and ordinal logistic regressions stratified by age (middle-aged and older adults) and gender adjusting for covariates.ResultsIn middle-aged and older adults, all examined obesity related traits (e.g., body mass index, waist circumference) were inversely associated with physical activity levels (p < 0.01) in both genders. Exercising ≥ 3 times/week was negatively associated with lean mass indicators (e.g., appendicular lean mass) in middle-aged and older females (p < 0.01), while the negative associations become positive after adjusting for weight. Positive associations between physical activity and grip strength were only found in middle-aged males (p < 0.05). Ordinal logistic regression revealed that those exercising ≥ 3 times/week were less likely to have obesity, sarcopenia, and sarcopenia obesity in all groups (p < 0.01), except for sarcopenia in older males and females (p > 0.05). Positive associations of exercising < 3 times/week with sarcopenia and sarcopenia obesity were only found in middled adults.ConclusionThe associations of exercise frequency with obesity and sarcopenia vary considerably across gender and age groups. Exercise programs need to be individualized to optimize health benefits. Future research exploring physical activity strategies to balance weight reduction and lean mass maintaining is warranted in middle-aged and especially older adults.

Exercise Therapy for People With Sarcopenic Obesity: Myokines and Adipokines as Effective Actors.

Sarcopenic obesity is defined as a multifactorial disease in aging with decreased body muscle, decreased muscle strength, decreased independence, increased fat mass, due to decreased physical activity, changes in adipokines and myokines, and decreased satellite cells. People with sarcopenic obesity cause harmful changes in myokines and adipokines. These changes are due to a decrease interleukin-10 (IL-10), interleukin-15 (IL-15), insulin-like growth factor hormone (IGF-1), irisin, leukemia inhibitory factor (LIF), fibroblast growth factor-21 (FGF-21), adiponectin, and apelin. While factors such as myostatin, leptin, interleukin-6 (IL-6), interleukin-8 (IL-8), and resistin increase. The consequences of these changes are an increase in inflammatory factors, increased degradation of muscle proteins, increased fat mass, and decreased muscle tissue, which exacerbates sarcopenia obesity. In contrast, exercise, especially strength training, reverses this process, which includes increasing muscle protein synthesis, increasing myogenesis, increasing mitochondrial biogenesis, increasing brown fat, reducing white fat, reducing inflammatory factors, and reducing muscle atrophy. Since some people with chronic diseases are not able to do high-intensity strength training, exercises with blood flow restriction (BFR) are newly recommended. Numerous studies have shown that low-intensity BFR training produces the same increase in hypertrophy and muscle strength such as high-intensity strength training. Therefore, it seems that exercise interventions with BFR can be an effective way to prevent the exacerbation of sarcopenia obesity. However, due to limited studies on adipokines and exercises with BFR in people with sarcopenic obesity, more research is needed.

801-P: SGLT2 Inhibitor, Luseogliflozin, Prevent Sarcopenia by Improving Extracellular Lipidome

Aims: It has been reported that there is a close relationship between sarcopenia obesity and metabolic disorder such as lipid metabolism. Here we investigated the effect on lipid metabolism of the sodium glucose cotransporter-2 inhibitor (SGLT-2i) luseogliflozin in skeletal muscle. We preformed microarray analysis of mRNA in skeletal muscle and investigated the lipid profile in skeletal muscle and serum. Methods: Eight-week-old mice were fed a standard diet or a standard diet supplemented with luseogliflozin (0.01% w/w chow) for 8 weeks. Mice were divided into the following three genotype/diet groups: Db/m mice without (w/o) SGLT-2i, Db/Db w/o SGLT-2i, and Db/Db with SGLT-2i. After 8 weeks of diet, in each group, body weight, glucose tolerance, muscle weight and cross-sectional area, free fatty acid concentration, muscle and gene expression in serum were investigated. Results: The ratio of soleus muscle to body weight and the cross-sectional area of soleus muscle were significantly higher in Db/Db mice with SGLT-2i than in Db/Db mice w/o SGLT-2i. In addition, the concentration of saturated fatty acids in skeletal muscle and serum of Db/Db mice with SGLT-2i was significantly lower than that w/o SGLT2i, and the expression of Fasn, Elovl6, and Scd1, which are involved in fatty acid synthesis, in skeletal muscle was significantly increased in Db/Db w/o SGLT-2i compared to Db/m mice with SGLT-2i, and significantly decreased in Db/Db with SGLT-2i compared to mice w/o SGLT-2i. Furthermore, in cell experiments using C2C12 myotube cells, the administration of saturated fatty acid increased the expression of muscle atrophy-related genes. Conclusion: The administration of luseogliflozin suppressed skeletal muscle atrophy and reduced the concentration of saturated fatty acids in skeletal muscle. Based on these findings, we hypothesized that secondary effects, other than the hypoglycemic effects of SGLT2i, might lead to the alleviation of obesity-dependent sarcopenia. Disclosure R. Bamba: None. T. Okamura: None. Y. Hashimoto: None. T. Senmaru: None. M. Hamaguchi: Research Support; Spouse/Partner; AstraZeneca K. K. M. Fukui: None.

Identifying a New Mechanism of Sarcopenia by Autophagy

Sarcopenia is one of the critical factors in reducing Activity of Daily Life and associated with morbidity and mortality. Sarcopenia has also been linked to metabolic syndrome. In recent years, it has been reported that autophagy is one of the mechanisms as a cause of sarcopenia. Therefore, we focused on autophagy as a system that can regulate both sarcopenia and metabolic syndrome in skeletal muscle and revealed that non-receptor tyrosine kinase Fyn not only participates in metabolic syndrome but also regulates autophagy regulating sarcopenia through STAT3 regulation, mainly using transgenic mice (Cell metabolism 2010, Cell Rep. 2012). However, since these were non-physiological studies, we proceeded with further studies and demonstrating that Fyn dependent STAT3 phosphorylation by IL6, which is involved in chronic inflammation and metabolic syndrome, was observed in mouse C2C12 myotube cells. Autophagy was decreased in those cells by both IL6 dependent and Fyn dependent mechanisms. Furthermore, in the denervated mouse model, not only both Fyn and IL6 gene expressions as well as the key muscle specific E3 ubiquitin ligases, Atrogin1 and MuRf1 were increased but the expression and phosphorylation levels of STAT3 were also augmented, while the autophagy activity was decreased. We believe that a denervated mouse model alone is not enough as a model for sarcopenia, thus we next introduced a hind limb suspension mouse model that promotes disuse atrophy by suspending the hind limb. Using this model, we found that muscle atrophy was observed mainly in the soleus muscle, tibialis anterior muscle, and the gastrocnemius muscle with Atrogin1 and MuRf1 increased. Increase of both IL6 and STAT3 expression/phosphorylation were also observed in the muscles of hind limb suspension mice. Autophagy activity, examined by intraperitoneal administration of colchicine, was decreased. These results strongly suggest that Fyn is involved not only in the metabolic syndrome but also in the pathogenesis of sarcopenia, and may lead to a better understanding of the pathology of sarcopenia obesity and the development of therapeutic methods.

Associations between different measurements of sarcopenic obesity and health outcomes among non-frail community-dwelling older adults in Taiwan.

The most important issue for the clinical application of sarcopenic obesity (SO) is the lack of a consensus definition. The aim of the present study was to determine the best measurement for SO by estimating the association between various definitions and the risk of falls and metabolic syndrome (MS). We studied a community of 765 adults aged 65 years and older in 2015-2017. Sarcopenia obesity was measured by sarcopenia (defined by low muscle mass with either low handgrip strength or low gait speed or both) plus obesity (defined by waist circumference, body fat percentage and BMI). The MS was defined according to the National Cholesterol Education Program ATP III. Logistic regression models were constructed to examine the relationships between sarcopenia obesity and risk of fall and MS. In the analysis of the fall risk with SO defined by waist circumference, the participants with non-sarcopenia/non-obesity were treated as the reference group. The OR to fall in participants with SO was 10·16 (95 % CI 2·71, 38·13) after adjusting for confounding covariates. In the analysis of the risk of the MS between participants with individual components of sarcopenia coupled with obesity defined by waist circumference, the risk was statistically significant for low gait speed (OR: 7·19; 95 % CI 3·61, 14·30) and low grip strength (OR: 9·19; 95 % CI 5·00, 16·91). A combination of low grip strength and abdominal obesity for identifying SO may be a more precise and practical method for predicting target populations with unfavourable health risks, such as falls risk and MS.

The prevalence of sarcopenic obesity in community-dwelling healthy Indian adults - The Sarcopenic Obesity-Chandigarh Urban Bone Epidemiological Study (SO-CUBES)

ObjectivesTo determine the prevalence of sarcopenia obesity (SO) in healthy Indian adults and delineate the relative impact of the 3 indices of obesity [body mass index (BMI), waist circumference (WC), fat mass percent (FM%)] with regards to inter-definitional agreement and their relationship with usual gait speed (GS). MethodsApparently healthy adults (aged ≥ 20 years) with no background history of comorbidities were enrolled from the community by door-to-door survey. Following blood investigations, individuals with biochemical abnormalities were excluded. Enrolled participants underwent dual-energy X-ray absorptiometry (DXA). Sarcopenia was defined according to EWGSOP2 consensus based on indigenous cut-offs obtained from the Sarcopenia-Chandigarh Urban Bone Epidemiological Study (Sarco-CUBES). Obesity was defined based on BMI (≥ 25.0 kg/m2) or WC (> 90 cm in men, > 80 cm in women) or DXA-derived FM% (> 32% in men, > 40% in women). ResultsData of 804 participants were analyzed after exclusion. The mean ± SD for BMI, WC, and FM% were 26.5 ± 2.7 kg/m2, 86.8 ± 9.6, and 34.7 ± 7.3%, respectively. Prevalence of sarcopenia was 3.2%. Based on BMI, WC, and FM%, the prevalence of SO in elderly subjects (≥65 years) was 5.4%, 5.4%, and 6.3%, respectively. Using Cohen’s kappa, inter-definitional agreement between the 3 groups was ‘almost perfect’. FM%, and not BMI/WC, emerged as a significant predictor of GS on multiple linear regression analysis. ConclusionsThe prevalence of SO in healthy elderly Indian adults is 5.4%–6.3%. Either BMI/WC/FM% can be used to correctly identify individuals with SO.

Hubungan antara obesitas sentral dengan massa dan fungsi otot ekstremitas pada populasi lanjut usia di kawasan rural Provinsi Bali-Indonesia

Background: Increasing age will affect changes in body composition, increasing the prevalence of obesity and decreasing muscle mass and strength, namely sarcopenia obesity. Visceral fat is often associated with subclinical inflammatory processes in the aging process. Objective: This study aimed to find the relationship between central obesity and limb muscle mass and function in the elderly population in the rural area of Bali. Methods: This study was a cross-sectional study in 3 places in Bali for elderly people over 60 years old by measuring body weight, waist circumference, body composition, muscle strength and functional capacity. Comparison test and correlation test were conducted. Results: The prevalence of obesity was found to be 63 from 203 populations (20%) in which 20 people were men (16%) and 43 women (23%). Of the 63 people, 31 people (49%) who were obese were aged 65 years and over. Visceral fat content had a negative correlation with superior limb muscle mass in both the male and female elderly population (r = -0.4, p &lt; 0.001 and r = -0.74, p &lt; 0.001). Visceral fat content in both elderly men and women had a positive correlation with grip strength (r = 0.242, p = 0.008 and r = 0.173, p = 0.02) and walking speed (r = 0.231, p = 0.01 and r = 0.211, p = 0.04). Conclusion: Central obesity is associated with a decrease in muscle mass, especially muscles of the superior extremities.

Sarcopenic Obesity in Cancer Patients: Focus on Pathogenesis

Introduction: Sarcopenic obesity is an emerging problem in cancer patients. However, this is often difficult to diagnose without the measurement of body composition. Sarcopenic obesity is associated with increased mortality, chemo-toxicity, and other complications in cancer patients. Until now, there is scarce information about sarcopenic obesity in the cancer population.Method: We identified 1955 articles related to sarcopenic obesity in adult cancer patients using PubMed, PubMed Central, and Cochrane Library databases from January 1, 1989, until January 1, 2020. Firstly, we screened the titles and abstracts which mentioned sarcopenic and obesity, especially in pathogenesis. 29 articles could proceed to the next step; then, they were screened for the full text. All steps were reviewed by two authors.Results: At last, they were 9 articles included. Sarcopenic obesity is defined as the coexistence of sarcopenia and obesity, an increase in fat mass in the body. Sarcopenic obesity carried cumulative risks from each of the two individual body compositions. CT-scan offers the highest available precision in determining body composition parameters, especially in the cancer population. Multiple causes and interactions between hormonal changes, aging, disuse, neuronal, poor nutrition, physical inactivity, and low-grade inflammation played roles. Sarcopenic obesity is associated with chemotherapy toxicity. High protein intake should be initiated to ensure adequate protein intake. Resistance training is beneficial in improving muscle mass and strength by focusing on strength training, flexibility, and balance.Conclusions: Sarcopenic obesity is an emerging problem but is often neglected. Further research needs to be conducted especially in explaining the pathogenesis of sarcopenic obesity. The combination of physical exercise and diet modification is the best management to improve sarcopenia obesity in cancer patients.

The impact of sarcopenia on patients undergoing treatment for pancreatic ductal adenocarcinoma

Abstract Introduction: Pancreatic ductal adenocarcinoma (PDAC) is a deadly cancer that disproportionately affects geriatric patients. Combination therapy with surge. ry and chemotherapy is associated with longer survival than medical treatment or supportive care. Preoperative selection of patients for surgical treatment, based on patient-specific factors such as sarcopenia, may help risk-stratify patients and improve outcomes. This paper aims to review the current literature on the impact of sarcopenia and sarcopenic obesity on patients undergoing treatment for PDAC. Outcomes: The impact of sarcopenia and sarcopenia obesity on perioperative and long-term outcomes after treatment for PDAC is variable. Sarcopenia has been associated with high-grade complications, longer length of hospital, and intensive care unit stays, more frequent discharge to skilled nursing facilities and decreased utilization of adjuvant therapy in patients treated with curative intent surgery. Sarcopenic obesity has been associated with more complications, high-grade complications, and hematologic toxicities. Patients with sarcopenic obesity may have even lower overall survival than sarcopenic patients. Discussion: The effect of a pre-treatment diagnosis of sarcopenia or sarcopenic obesity on outcomes for patients undergoing treatment for PDAC remains unknown, in part due to the heterogeneity of studies and definitions. Prehabilitation programs including resistance exercise and nutritional supplementation have shown benefit in sarcopenic patients. Conclusion: PDAC remains a deadly disease and patient-specific factors such as sarcopenia and sarcopenic obesity identified at the time of cancer diagnosis offer potential as risk stratification measures and points of intervention. Currently, a paucity of standardized measurement tools, definitions, and prehabilitation regimens limits the clinical implementation of such knowledge.

1885-P: Fyn Regulates Sarcopenia by Autophagy

Sarcopenia is an important factor in reducing Activity of Daily Life. Sarcopenia has also been linked to insulin resistance. It has been reported that autophagy is one of the mechanisms as a cause of sarcopenia. We focused on autophagy as a system that can regulate both sarcopenia and metabolic syndrome in skeletal muscle and revealed that non-receptor tyrosine kinase Fyn not only participates in metabolic syndrome but also regulates autophagy regulating sarcopenia through STAT3 regulation (Cell metabolism 2010, Cell Rep. 2012). We proceeded with further studies and demonstrating that Fyn-dependent STAT3 phosphorylation by IL6, which is involved in chronic inflammation and metabolic syndrome, was observed in mouse C2C12 myotube cells. Autophagy was decreased in those cells by both IL6-dependent and Fyn-dependent mechanisms. The binding of STAT3 and Fyn was confirmed by immunoprecipitation in an in vitro system. Furthermore, in the denervated mouse model, not only both Fyn and IL6 gene expressions were increased but the expression and phosphorylation levels of STAT3 were also augmented, while the autophagy activity was decreased. We believe that a denervated mouse model alone is not sufficient as a model for sarcopenia, thus we next introduced a hind limb suspension mouse model that promotes disuse atrophy by suspending the hind limb. Using this model, we found that muscle atrophy was observed mainly in the soleus muscle, tibialis anterior muscle, and the gastrocnemius muscle. In addition, the findings are consistent with autophagy failure, and accumulation of glycogen (PAS staining) was observe. Increase of both IL6 and STAT3 expression/phosphorylation were observed in the muscles of those mice. Autophagy activity, examined by intraperitoneal administration of colchicine, was decreased. These results strongly suggest that Fyn is involved not only in the metabolic syndrome but also in the pathogenesis of sarcopenia, and may lead to a better understanding of the pathology of sarcopenia obesity and the development of therapeutic methods. Disclosure E. Yamada: None. R. Uehara: None. Y. Nakajima: None. K. Horiguchi: None. E. Ishida: None. S. Matsumoto: None. S. Okada: None. C.C. Bastie: None. M. Yamada: None.

Sarcopenia, Obesity and Sarcopenia Obesity in Comparison: Prevalence, Metabolic Profile, and Key Differences: Results from WCHAT Study.

To identify the prevalence, lifestyle factors, chronic disease status, and assessing the metabolic profile, comparing key differences in a cohort of subjects with non-sarcopenia/non-obesity (H), sarcopenia/non-obesity (S), non-sarcopenia/obesity (O) and sarcopenia obesity (SO) in a multi-ethnic population in west China. A cross-sectional study. The communities in Yunnan, Guizhou, Sichuan, and Xinjiang provinces. We included 4,500 participants aged 50 years or older who did bioelectrical impedance in our analysis from West China Health and Aging Trend (WCHAT) study. We measured gait speed, handgrip strength and muscle mass by using bioelectrical impedance analysis (BIA) for all participants. We defined sarcopenia using the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia (AWGS). Obesity was defined as the highest sex-specific quintile of the percentage body fat. Different variables like anthropometry measures, life styles, chronic disease and blood test were collected. Analysis of variance and a multinomial logistic regression analysis adjusting for covariates were used to assess the differences of metabolic profiles among different groups. Of 4500 participants aged 50 years old or older, the proportions of H, O, S, SO were 63.0%, 17.7%, 16.7% and 2.6%, respectively. And the prevalence of S subjects in men was 18.3% and 15.7% in women, while the prevalence of SO was 3.7% in men and 2.0% in women. Data showed that the prevalence of S and SO has an aging increase pattern which was opposite with O. Both S and SO tends to be older, lower educational level, without spouse, smoking, comorbidity of chronic disease, poor nutrition status, depression and cognitive decline compared to H and S seems to be worse than SO. Compared to H, S cohort showed a decrease in Vitamin D, triglyceride, albumin, fasting glucose, insulin, creatinine, ALT, nutrition scores and increase in HDL. SO cohort were observed for an increase in cholesterol, LDL, total protein and decrease in vitamin D. While O cohort showed an increase in triglyceride, cholesterol, LDL, total protein, glucose, insulin, WBC, uric acid, ALT and nutrition scores, but a decrease in HDL and vitamin D level. Among individuals aged 50 years old or older in West China. S, O and SO participants demonstrate distinct differences in the life-styles, chronic disease profile, and metabolic profiles. The prevalence of S and SO has an aging increase pattern contrary to O. Both S and SO tend to be older, lower educational level, without spouse, smoking, comorbidity of chronic disease, poor nutrition status, depression and cognitive decline compared to H and S looks like to be worse than SO. Besides, the S subjects seem to have more metabolic index changes than SO compared to H. While O subjects have some contrary metabolic index to S subjects.

Handgrip strength as discriminator of sarcopenia and sarcopenia obesity in adults of the ELSA-Brasil

Handgrip strength as discriminator of sarcopenia and sarcopenia obesity in adults of the ELSA-Brasil