Sarcopenia Obesity Research Articles

Role of Sarcopenia in Nonalcoholic Fatty Liver Disease: Definition Is Crucially Important

Potential conflict of interest: Nothing to report. To the Editor: I read with interest the review by Bhanji et al.1 linking sarcopenia with nonalcoholic fatty liver disease (NAFLD). Muscle dysfunction is expected to promote nonalcoholic steatohepatitis and vice versa. We recently reported the importance of defining sarcopenia when exploring the relationship between sarcopenia and NAFLD.2 Thus, I would like to offer the following comments on this topic. I reviewed the data in several articles,3 exploring sarcopenia and NAFLD (Fig. 1). The results indicate that body mass index (BMI) is higher in the sarcopenic group when studies present a positive correlation between sarcopenia and NAFLD. However, BMI is lower in the sarcopenic group when studies present a positive correlation between sarcopenia and end‐stage liver disease (ESLD). BMI is an important risk factor of NAFLD, and it confounds the relationship between sarcopenia and NAFLD in studies using different definitions of sarcopenia. The studies might actually define a population of sarcopenia obesity instead of true sarcopenia. Therefore, it is important to clarify the definition of sarcopenia. However, the heterogeneity of diagnosis methods may make defining sarcopenia challenging. Furthermore, measurements that define sarcopenia are required to identify pathophysiologic mechanisms for targeted therapeutic strategies to NAFLD.Figure 1: Studies regarding the potential association of sarcopenia and NAFLD. Abbreviations: IQR, interquartile range; SD, standard deviation.The muscle function parameters, such as walking speed and grip strength, are also important components of sarcopenia. Although the 6‐minute walking distance is an important predictive factor in liver transplant candidates, slow gait speeds were not found to be associated with NAFLD after controlling for other confounders in our study. Therefore, the true relationship between muscle function and NAFLD requires further investigation. Based on these results, it might be appropriate to discuss NAFLD and ESLD separately in studies evaluating sarcopenia despite the finding that a fraction of patients with NAFLD will progress to ESLD. In addition, a definition of sarcopenia including low muscle mass and function is critically important for future studies related to NAFLD and ESLD.

The prevalence of muscle wasting (sarcopenia) in peritoneal dialysis patients varies with ethnicity due to differences in muscle mass measured by bioimpedance.

Sarcopenia is associated with increased mortality. European and North American recommended screening for low muscle mass uses gender specific cut points, with no adjustment for ethnicity. We wished to determine whether the prevalence of sarcopenia was altered by ethnicity in peritoneal dialysis (PD) patients. We measured appendicular lean mass indexed to height (ALMI) in PD patients by segmental bioimpedance and determined sarcopenia using different cut off points for reduced muscle mass. We measured ALMI in 434 PD patients, 55.1% males, mean age 55.3 ± 16.2 years, 32.3% diabetic, 54.1% white, 23.7% Asian, 19.1% black. ALMI was lower in Asian women, compared to white and black women (6.4 ± 1.1 vs. 6.6 ± 1.0 and 6.9 ± 1.4 kg/m2), and lower in Asian men (7.5 ± 1.3 vs. 8.5 ± 1.2 and 8.7 ± 1.3 kg/m2), p < 0.001. Depending on the ALM/ALMI cut point; the prevalence of sarcopenia was greater in Asian patients (25.6-41.2% using North American or European cut points) compared to white (12.3-18.7%) and black patients (3.8-15.7%), p < 0.001, but <11% when using Asian-specific cut points. The prevalence of sarcopenia obesity (BMI ≥ 30 kg/m2) was <3%, for all groups. There was no association with duration of PD, dialysis prescription, residual renal function or small solute clearances. There is no universally agreed consensus definition for loss of muscle mass (sarcopenia) and current European and North American recommended cut points for screening are adjusted only for gender. As body composition differs also with age and ethnicity, then ideally cut points should be based on age, gender and ethnicity normative values.

Sarcopenia and diabetes: Hyperglycemia is a risk factor for age-associated muscle mass and functional reduction.

Sarcopenia and diabetes: Hyperglycemia is a risk factor for age-associated muscle mass and functional reduction.

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

ABSTRACTIntroduction: 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 oflife. This study aimed to examine the proportion of SO patients in community and observation the association of physical activity level and physical performance with sarcopenia in elderly obese patientin communityMethods: An analytic observation cross-sectional study with consecutive sampling was carried out. Inclusion criteria included subjects with age ≥ 60 years old, body mass index (BMI) ≥ 25 Kg / m2,able to walk at least 10 meters, and has a good cognitive function. Subjects with pacemaker, using metal implants, history of cancer, acute cardiovascular and respiratory disorders, deformities, or painin 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 physicalperformance using gait speed and timed up and go test (TUG). Sarcopenia is based on criteria from Asian Working Group of Sarcopenia (AWGS) 2019 with body composition assessment using BioelectricImpedance Analysis (BIA)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 physical activity level and physical performances valuesin SO patients were lower than in obesity patient. There were no significant association on physical activity level (p &gt; 0,05) and significant association on physical performance, both in gait speed and TUGtest (p &lt; 0,05).Conclusion: Physical performance is associated with sarcopenia in elderly obese patient in community. Coexistence between sarcopenia and obesity has a syner gistic impact on functional limitations.Keywords: elderly, obesity, physical activity level, physical performance, sarcopenia