Sarcopenic Obesity Group Research Articles

Association among the Prevalence of Sarcopenia without Obesity, Nonsarcopenic Obesity, Sarcopenic Obesity, and Metabolic Syndrome in Cancer Survivors: Based on Korea National Health and Nutrition Examination Survey

Objective:In this study, we aimed to investigate the association among the prevalence of sarcopenia without obesity, nonsarcopenic obesity, sarcopenic obesity, and metabolic syndrome in cancer survivors using data from the 4th and 6th Korea National Health and Nutrition Examination Survey (KNHANES), a nationally representative data source.Methods:The 4th and 6th KNHANES was conducted in 2008–2011. Data from cancer survivors were obtained including 133 obese patients without sarcopenia, 98 obese patients with sarcopenia, and 87 patients with sarcopenia but without obesity. SPSS 22.0 was used for statistical analysis with complex sample survey modules and commands.Results:The prevalence of metabolic syndrome was 25.3% in the sarcopenia without obesity group, 61.7% in the nonsarcopenic obesity group, and 67.3% in the sarcopenic obesity group, showing the highest rate in the sarcopenic obesity group, with a significant difference among the three groups (P < 0.001).Conclusions:In this study, the prevalence of metabolic syndrome was 25.3%, 61.7%, and 67.3% in the sarcopenia without obesity, nonsarcopenic obesity, and sarcopenic obesity groups, respectively, showing that the sarcopenic obesity group had the highest metabolic syndrome rate. Based on these results, various education programs for the prevention and treatment of metabolic syndrome should be developed for cancer patients.

Effects of Sarcopenic Obesity and Its Confounders on Knee Range of Motion Outcome after Total Knee Replacement in Older Adults with Knee Osteoarthritis: A Retrospective Study.

Sarcopenic obesity is closely associated with knee osteoarthritis (KOA) and has high risk of total knee replacement (TKR). In addition, poor nutrition status may lead to sarcopenia and physical frailty in KOA and is negatively associated with surgery outcome after TKR. This study investigated the effects of sarcopenic obesity and its confounding factors on recovery in range of motion (ROM) after total knee replacement (TKR) in older adults with KOA. A total of 587 older adults, aged ≥60 years, who had a diagnosis of KOA and underwent TKR, were enrolled in this retrospective cohort study. Sarcopenia and obesity were defined based on cutoff values of appendicular mass index and body mass index for Asian people. Based on the sarcopenia and obesity definitions, patients were classified into three body-composition groups before TKR: sarcopenic-obese, obese, and non-obese. All patients were asked to attend postoperative outpatient follow-up admissions. Knee flexion ROM was measured before and after surgery. A ROM cutoff of 125 degrees was used to identify poor recovery post-surgery. Kaplan-Meier curve analysis was performed to measure the probability of poor ROM recovery among study groups. Cox multivariate regression models were established to calculate the hazard ratios (HRs) of postoperative poor ROM recovery, using potential confounding factors including age, sex, comorbidity, risk of malnutrition, preoperative ROM, and outpatient follow-up duration as covariates. Analyses results showed that patients in the obese and sarcopenic-obese groups had a higher probability of poor ROM recovery compared to the non-obese group (all p < 0.001). Among all body-composition groups, the sarcopenic-obese group yielded the highest risk of postoperative physical difficulty (adjusted HR = 1.63, p = 0.03), independent to the potential confounding factors. Sarcopenic obesity is likely at the high risk of poor ROM outcome following TKR in older individuals with KOA.

Significant Association of Diabetes With Mortality of Chronic Hemodialysis Patients, Independent of the Presence of Obesity, Sarcopenia, and Sarcopenic Obesity

This retrospective cohort study investigated the association of diabetes with mortality in hemodialysis patients with regard to obesity, sarcopenia, and sarcopenic obesity, along with examining the prevalence of each group and diabetes. Muscle strength, muscle mass, and fat mass were evaluated using a hand dynamometer and dual-energy X-ray absorptiometry, respectively, in 308 chronic hemodialysis patients (age 58.0±11.9years, hemodialysis duration 6.5±6.0years, males 60.1%, diabetes 32.8%). Sarcopenia was defined according to the new criteria established by the Asian Working Group on Sarcopenia 2019. Obesity was defined by percent body fat mass (males ≥25%, females ≥35%). The enrolled patients were divided into the normal (38.7%), obesity (18.8%), sarcopenia (26.9%), and sarcopenic obesity (15.6%) groups. The prevalence of diabetes was significantly skewed among the 4 groups (χ2 test, P=.0057), being higher in the sarcopenic obesity group (54.2%) compared to the others (25.9-33.7%). Multivariate regression analysis revealed that diabetes was significantly and independently associated with sarcopenic obesity (odds ratio 3.495, 95% confidence interval 1.683-7.255, P=.0008) after adjustments for several cofounders, but not significantly associated with sarcopenia. During the follow-up period of 76±35 months, 100 patients died. Those in the sarcopenia and sarcopenic obesity groups had significantly higher rates of all-cause mortality compared to patients in the normal and obesity groups (P=.0004, log-rank test). Furthermore, multivariate Cox proportional hazards analysis revealed that presence of diabetes was significantly associated with higher all-cause mortality in all 308 patients, after adjustments for several factors, including the presence of each group in 4 models. Sarcopenic obesity is highly prevalent in chronic hemodialysis patients. Diabetes was found to be a significant and independent contributor to the presence of sarcopenic obesity. Diabetes was shown to be a significant predictor of all-cause mortality, independent of the present normal, obesity, sarcopenia, and sarcopenic obesity groups.

The Association Between Estimated Cardiorespiratory Fitness and Sarcopenic Obesity in Middle-Aged and Older Adults

PURPOSE:This study aimed to examine the association between estimated cardiorespiratory fitness (eCRF) and sarcopenic obesity in Korean middle-aged and older adults.METHODS:This study used the data from the 2008–2011 Korea National Health and Nutrition Examination Survey involving 8,252 Korean adults aged ≥50 years (56.6% women). Participants were classified into normal, sarcopenia, obesity, and sarcopenic obesity groups based on the presence of sarcopenia and/or obesity phenotypes. eCRF was assessed using sex-specific algorithms and classified as low (lowest 25%), middle (middle 50%), and high (highest 25%) categories. Logistic regression analyses were used to estimate the odds ratio (OR) and 95% confidence interval (CI) for the risk of sarcopenic obesity according to eCRF categories.RESULTS: The middle and low eCRF groups had a significantly higher risk of sarcopenia (OR=1.688, 95% CI=1.438–1.981 and OR=2.877, 95% CI=2.366–3.498; respectively) than the high eCRF group (OR=1), a significantly higher risk of obesity (OR=1.810, 95% CI=1.533–2.137 and OR=5.103, 95% CI=4.234–6.151; respectively) than the high eCRF group (OR=1), and a significantly higher risk of sarcopenic obesity (OR=2.852, 95% CI=2.371–3.429 and OR=12.008, 95% CI=9.866–14.616; respectively) than the high eCRF group (OR=1). The risks of sarcopenia, obesity, and sarcopenic obesity in the middle and low eCRF groups remained statistically significant after adjusting for all the measured covariates.CONCLUSION: The results suggest that eCRF is an independent predictor of sarcopenic obesity in Korean middle-aged and older adults, implying the importance of promotion of CRF as a preventive measure against sarcopenic obesity.

The association between TP53 rs1625895 polymorphism and the risk of sarcopenic obesity in Iranian older adults: a case-control study

BackgroundAging and obesity are the two major global health concerns. Sarcopenia, an age-linked disease, wherein a progressive loss of muscle volume, muscle strength, and physical activity occurs. In this study we evaluated the association of TP53 rs1625895 polymorphism with the susceptibility to sarcopenic obesity in Iranian old-age subjects.MethodsTotal of 176 old individuals (45 sarcopenic and 131 healthy) were recruited in this research and genotyped by PCR–RFLP. BMI, Skeletal Muscle Mass Index, body composition, Handgrip Strength, Gait Speed (GS), and biochemical parameters were measured. Chi-square test was done for genotypes and alleles frequency. Linear regression was applied to find the correlation between TP53 rs1625895 polymorphism, and biochemical and anthropometric parameters. The correlation between TP53 rs1625895 and the risk of sarcopenia and sarcopenic obesity was investigated by logistic regression.ResultsG allele was significantly higher in sarcopenic obesity group [P = 0.037, OR (CI 95%) = 1.9 (1.03–3.5)] compared to A allele. BMI (P = 0.049) and LDL (P = 0.04) were significantly differed between genotypes when GG was compared to AA/AG genotype. The results revealed when GG genotype compared to AA/AG genotype in adjusted model for age, the risk of sarcopenic obesity [P value = 0.011, OR (CI 95%); 2.72 (1.25–5.91)] increased. Similarly, GG/AG genotype increased the risk of sarcopenic obesity [P value = 0.028, OR (CI 95%); 2.43 (1.10–5.36)] in adjusted model for age compared to AA genotype.ConclusionsWe suggested that TP53 rs1625895 polymorphism may increase the risk of sarcopenic obesity in Iranian population.

Sarcopenic Obesity and Amino Acids: Concord Health and Ageing in Men Project.

Although characteristic changes in amino acid concentrations occur in obesity and sarcopenia, amino acids concentrations have not been reported in sarcopenic obesity. We studied n = 831 men aged 75 years and older from the 5-year follow-up of the Concord Health and Ageing in Men Project. Sarcopenia was defined using the Foundation of the National Institutes of Health criteria and obesity was defined as >30% fat mass. There were 31 men (3.7%) who had sarcopenic obesity. Branched chain amino acids were elevated in the obese (but not sarcopenic) group (n = 348) but reduced in both the sarcopenic (but not obese) (n = 44) and the sarcopenic obese groups. Apart from this, most of the amino acid concentrations were between those for the obese and the sarcopenic groups. Yet despite low concentrations of branched chain amino acids, the sarcopenic obese group had indications of insulin resistance and diabetes mellitus (fasting glucose and insulin concentrations, homeostatic model assessment, and percentage of participants taking diabetes medications) that were similar to the obese group. In summary, sarcopenic obese participants did not have a unique amino acid signature. In obesity, elevated branched chain amino acids are not a prerequisite for insulin resistance and diabetes if obesity is associated with sarcopenia.

The association of obesity and sarcopenia in older adults: Sarcopenic Obesity

INTRODUCTION: Sarcopenia is associated with recurrent falls, limited mobilization, depression, increased risk of morbidity and mortality in geriatric patients. It has been reported that the risk of frailty and disability increases more when obesity and sarcopenia coexist. The aim of this study is to investigate the relationship between obesity and sarcopenic obesity with functionality and geriatric syndromes in geriatric patients. METHODS: A total of 432 patients underwent a comprehensive geriatric assessment and whose file records were reached were included in the study. Skeletal muscle mass obtained by bioimpedance analysis, walking speed with a 4-meter walking test, and muscle strength measurements with a hand dynamometer were recorded in all patients. The diagnosis of sarcopenia was made according to the criteria of the European Working Group on Sarcopenia in Older People. In addition, patients with a body mass index&gt; 30 kg / m2 were considered obese and divided into two groups as sarcopenic obesity and non-sarcopenic obesity. RESULTS: 69.9% of the patients were women, the mean age of them was calculated as 75.40±7.35. 20.4% of all participants were sarcopenic obesity(n = 88), 22.5% were non-sarcopenic obesity(n = 97) and the rest were from the control group without sarcopenia and obesity (n = 246). It was determined that age was higher and hypertension was more common in sarcopenic obese patients. It was observed that falls and urinary incontinence were more common in obese patients(p &lt;0.05). Cognitive test scores, gait and balance scores, activities of daily living and nutritional scores were found to be worse in the sarcopenic obesity group compared to the other two groups (p &lt;0.05). DISCUSSION AND CONCLUSION: The association of sarcopenia and obesity in elderly patients is associated with poorer functionality and cognitive functions in patients. Therefore, obese cases should be evaluated in terms of sarcopenia and necessary interventions should be made in the early period.

Effects of low skeletal muscle mass and sarcopenic obesity on albuminuria: a 7-year longitudinal study

We aimed to identify the association between low skeletal muscle, sarcopenic obesity, and the incidence of albuminuria in the general population using a longitudinal study. Data from 29,942 subjects who underwent two or more routine health examinations from 2006 to 2013 were retrospectively reviewed. Relative skeletal muscle mass was presented using the skeletal muscle mass index (SMI), a measure of body weight-adjusted appendicular skeletal muscle mass estimated by bioelectrical impedance analysis. The cumulative incidence of albuminuria was 981 (3.3%) during the 7-year follow-up period. The hazard ratio of incident albuminuria was 1.44 (95% CI: 1.22–1.71, p for trend <0.001) in the lowest SMI tertile relative to the highest SMI tertile after multivariable adjustment. After additionally adjusting for general and central obesity, the hazard ratio was 1.35 (95% CI: 1.13–1.61, p for trend = 0.001) and 1.30 (95% CI: 1.08–1.56, p for trend = 0.003), respectively. Furthermore, the risk of developing albuminuria was much higher in the sarcopenic obesity group (HR: 1.49, 95% CI: 1.21–1.81, p for trend <0.001) compared to the other groups. Sarcopenic obesity, as well as low skeletal muscle, may lead to albuminuria in general populations.

Impact of Sarcopenia on the Risk of Erosive Esophagitis

An association between obesity and erosive esophagitis has been reported, but the effects of sarcopenia and obesity on erosive esophagitis are unknown. This study examined the relationship between obesity, sarcopenia, sarcopenic obesity, and erosive esophagitis in a large population of asymptomatic men and women. This study analyzed 32,762 subjects who underwent a comprehensive health check-up, which included upper gastrointestinal endoscopy, from August 2006 to December 2011 by a cross-sectional study. Sarcopenia was defined as a decrease in the appendicular skeletal muscle mass (ASM)/body weight value of two SD or more below the normal means for a younger reference group. The study was carried out on four groups according to obesity and sarcopenic status: normal, obesity, sarcopenic, and sarcopenic obese group. In a multivariable model, the risk of erosive esophagitis was higher in the obese (adjusted OR [aOR] 1.35, 95% CI 1.22-1.49), sarcopenic (aOR 2.12, 95% CI 1.40-3.19), and sarcopenic obese groups (aOR 1.54, 95% CI 1.27-1.87) than in the normal group. The risk of erosive esophagitis was higher in the sarcopenic and sarcopenic obese groups than the obese group; the ORs were 1.63 (95% CI 1.08-2.47) and 1.22 (95% CI 1.01-1.46), respectively. In dose-response analysis, increasing sarcopenia severity showed a positive and graded relationship with the overall, Los Angeles (LA)-B or higher grade, and LA-C erosive esophagitis. This study suggests that sarcopenia is strongly and progressively associated with erosive esophagitis.

Sarcopenic obesity and its association with frailty and protein-energy wasting in hemodialysis patients: preliminary data from a single center in Japan

BackgroundThis study investigated the prevalence of sarcopenia or sarcopenic obesity and their association with frailty and protein-energy wasting (PEW) in hemodialysis patients.MethodsThe present study enrolled 117 adult hemodialysis patients (35% female, 64 ± 12 years old) from single units of a hemodialysis center. The patients were divided into four groups: normal, obese, sarcopenia, and sarcopenic obesity. Sarcopenia was diagnosed by Asian Working Group for Sarcopenia (AWGS) criteria, and obesity was defined as an extensive percent body fat mass greater than 40% in females and 30% in males. Skeletal muscle mass and percent fat mass were evaluated by multifrequency whole-body bioimpedance electrical analysis after a midweek dialysis session. Handgrip strength and a short physical performance battery (SPPB) were assessed before a dialysis session as indicators of muscle strength and physical performance. Moreover, participants completed the Kihon Checklist and the criteria proposed by the International Society of Renal Nutrition and Metabolism expert panel to classify frailty and PEW. We performed multivariate logistic regression analysis to identify the clinical risk of frailty and PEW in patients with sarcopenia or sarcopenic obesity.ResultsForty-six (39.3%) patients were classified as normal; 18 (15.4%), as obese; 35 (29.9%), as having sarcopenia; and 18 (15.4%), as having sarcopenic obesity. The sarcopenia or sarcopenic obesity group had significantly lower handgrip strength than the normal or obesity group (all p < 0.05). In addition, the sarcopenia and sarcopenic obesity groups had significantly lower SPPB scores than the normal group (p < 0.05, respectively). In the multivariate analysis, the sarcopenic obesity group had a significantly higher risk of frailty than the normal group in the multivariate analysis after adjusting for age and gender (OR 4.518, 95%CI 1.218–16.752, p = 0.024). However, sarcopenic obesity was not associated with a higher likelihood of PEW, and sarcopenia imposed a significantly higher risk of PEW (OR 4.272, 95%CI 1.157–15.778, p = 0.029) than that in the normal group after adjusting for confounding factors.ConclusionSarcopenic obesity was closely associated with frailty compared with the normal condition in HD patients. However, sarcopenic obesity was not associated with a higher likelihood of PEW.

1601-P: Sarcopenic Obesity and Its Association with Reduced Cognitive Performance in Type 2 Diabetes in Singapore

Introduction: Little is known of association between sarcopenic obesity (SO) and cognition. We aim to examine body composition, and association between SO and cognitive performance in type 2 diabetes (T2D). Methods: This was a cross-sectional study on 1,317 patients with mean age 61.7±8.2 years and T2D attending both primary and secondary diabetes care in Singapore. Sarcopenia was defined using multi-frequency bio-impedence estimated appendicular skeletal muscle mass divided by height2 with cut-off for Asians (&amp;lt;5.7 kg/m2 in females; &amp;lt;7 kg/m2 in males). Waist circumference (wc)≥80 cm (females) and 90 cm (males) was used to define abdominal obesity. SO was defined as (1) co-existence of sarcopenia and obesity; or (2) fat mass to fat-free mass (FM/FFM) ratio&amp;gt;0.8. Cognition was assessed using Repeatable Battery for the Assessment of Neuropsychological Status. Results: The distribution by body composition based on definition muscle mass and wc was: nonsarcopenic nonobese, 20.3%; nonsarcopenic obese, 55.1%; sarcopenic nonobese, 13.2%; sarcopenic obese, 11.4%. In contrast, the prevalence of sarcopenic obesity based on FM/FFM ratio was 20.2%. The sarcopenic obese group had the lowest total and index RBANS scores(p&amp;lt;0.05). Multiple linear regression showed SO defined by FM/FFM ratio was significantly associated with reduced total score even after adjusting for demographics with β=-1.66 (95% CI -2.74 to -0.59; p=0.002), and demographics, education and clinical covariates with β=-1.14 (95% CI -2.14 to -0.14; p=0.026). SO was significantly associated with reduced index scores for immediate memory and language in fully adjusted models with β=-1.81 (95% CI -3.46 to -0.16; p=0.032) and β =-2.34 (95% CI -4.06 to -0.062; p=0.008) respectively. Conclusions: The differing prevalence of SO based on different measures calls for need to standardize definition. SO was associated with reduced cognitive performance and should be considered in management of cognition in patients with T2D. Disclosure K. Low: None. S. Lim: None. K. Ang: None. S. Tavintharan: None. C. Sum: None. Funding National Medical Research Council of Australia (NMRC/CIRG/1398/2014)

여자 노인의 근육량 및 비만도와 대사증후군, 신체활동 및 식이요인과의 관련성 연구 : 제4-5기 국민건강영양조사(2008-2011년도)자료를 이용하여

This study examined the relationships among muscle mass and obesity, metabolic syndrome, and physical activity in elderly women. The 4SUPth/SUP-5SUPth/SUP (2008 to 2011) Korean national health and nutrition examination survey data were analyzed using the SPSS 23.0 package program. The results showed that sarcopenic obese group had significantly higher metabolic syndrome parameters, such as waist circumference, diastolic blood pressure, fasting blood glucose, and triacylglyceride, compared to non-sarcopenic non-obese group. The sarcopenic non-obese group showed a 2 times higher risk of metabolic syndrome, and the non-sarcopenic obese and sarcopenic obese groups showed a 6 times higher risk of metabolic syndrome than the non-sarcopenic non-obese group. The non-sarcopenic groups showed higher amounts of high intensity, moderate intensity, and total physical activities than the sarcopenic groups. In addition, non-sarcopenic groups participated more in high-intensity exercise but less in flexibility exercise than the sarcopenic groups. Furthermore, the participants had a carbohydrate dependent diet with a low intake of vitamins and mineral. These results suggest that the elderly women should consistently participate in physical activities and eat a balanced diet to decrease the risk of metabolic syndrome by maintaining their body weight and muscle mass to normal levels. Therefore, to reduce metabolic syndrome in elderly women, it is important develop and promote exercise and nutritional education programs to reduce metabolic syndrome in elderly women.

Sarcopenic obesity associated with high-sensitivity C-reactive protein in age and sex comparison: a two-center study in South Korea

ObjectivesTo evaluate the association between high-sensitivity C-reactive protein (hs-CRP) and sarcopenic obesity, and to determine age or sex differences underlying the relationship between hs-CRP and sarcopenic obesity.DesignObservational study.ParticipantsThe study included...

Health-related quality of life and fall risk associated with age-related body composition changes; sarcopenia, obesity and sarcopenic obesity.

Sarcopenia, obesity, and sarcopenic obesity are various features of the ageing process that can cause important health issues. The present study was undertaken to investigate the interrelationship between those body composition changes, including their clinical components and the quality-of-life variables. A total of 423 individuals aged 65 years or older was included in this cross-sectional study. Sarcopenia was diagnosed according to The European Working Group on Sarcopenia in Older People criteria. Body composition parameters were measured with a bioelectrical impedance analyser, and Turkish population-based cut-off points were preferred for diagnosis of sarcopenia. Comprehensive geriatric assessment was performed on all patients. A logistic regression analysis was performed to identify important factors for sarcopenia and sarcopenic obesity. The prevalence of sarcopenic, obese and sarcopenic obese subjects was 14%, 35% and 11% respectively. The lowest mean gait speed and hand grip strength values were seen in the sarcopenic obese group (0.6 ± 0.3 m/s and 19.7 ± 9.8 kg respectively). Sarcopenic obese participants were associated with the highest rate for fall risk. The scores for domains of health-related quality of life were worse in both obesity and sarcopenic obesity when compared to others. Body mass index (BMI), number of drugs used, total body fat ratio and geriatric depression scale-short form scores were negatively correlated with all dimensions of SF-36 quality-of-life scale. Sarcopenia, obesity and sarcopenic obesity are associated with many negative health outcomes, such as high fall risk and low health-related quality of life in geriatric population.

Associations between lean mass and leptin in men with chronic spinal cord injury: Results from the FRASCI-muscle study.

Leptin is an adipo-myokine that regulates appetite and energy expenditure by a neuroendocrine feedback loop. Leptin levels are positively correlated with BMI in the spinal cord injury population and leptin levels are greater in individuals with spinal cord injury compared to uninjured controls. Leptin is produced in multiple tissues, including fat, bone, and skeletal muscle and is a putative biomarker of sedentary behavior in older adults. We assessed body composition leptin, adiponectin, and IL-6 levels in 205 men with chronic spinal cord injury. We found no association between age, injury duration, injury level, injury completeness, or walking status and leptin. There was a significant positive association between lean mass and leptin in men with SCI that was independent of fat. Adjusting for body composition, leptin levels were positively associated with IL-6 and negatively associated with adiponectin levels. When considering men with SCI and sarcopenic obesity, only fat mass remained positively associated with leptin. We found no association between IL-6, adiponectin, or lean mass and leptin in the sarcopenic obesity group. Our findings suggest that lean mass is an under recognized, but substantial, source of circulating leptin. Furthermore, SCI-related sarcopenic obesity may result in dysregulated adipo-myokine metabolism with local and systemic physiologic effects.

Association between Sarcopenia, Sarcopenic Obesity, and Chronic Disease in Korean Elderly.

BackgroundIt is a very important social issue for Korea to have a healthy old age as an aged society. Aging causes a lot of physical changes, especially sarcopenia. Sarcopenia is defined as a persistent decrease in skeletal muscle and muscle strength. Sarcopenic obesity is a phenomenon in which fat is replaced instead of muscle. The purpose of this study was to examine the prevalence of sarcopenia and sarcopenic obesity in Korean elderly and to analyze the relationship with chronic disease.MethodsData from the 2008 to 2011 the Korea National Health and Nutrition Survey were used. A total of 3,492 patients were classified into 3 groups (non-sarcopenia, sarcopenia, sarcopenic obesity), and general, anthropometry, health behavior, nutrient intake and chronic disease status were compared by the statistical analysis.ResultsThe rate of moderate exercise was significantly lower in the sarcopenia and sarcopenic-obesity group than in the non-sarcopenia group (P=0.007). The sarcopenic obesity group had significantly higher energy (P=0.005), protein (P=0.046) and fat (P=0.001) intake than the sarcopenic group. The sarcopenic-obesity group had the highest ratio of diabetes (P=0.023) and dyslipidemia (P=0.004) in the 3 groups. Compared with the non-sarcopenia group, in the sarcopenia and sarcopenic obesity groups, the odds ratios (ORs) of diabetes was increased by 1.24 and 2.16 while the ORs of dyslipidemia was increased by 1.12 and 1.50, respectively.ConclusionsRegular exercise and adequate nutrient intake (energy, protein and fat) are essential for the prevention of sarcopenia in Korean elderly, and management of chronic disease in sarcopenic obesity elderly is important.

Relationship between osteosarcopenic obesity and dietary inflammatory index in postmenopausal Korean women: 2009 to 2011 Korea National Health and Nutrition Examination Surveys.

Osteosarcopenic obesity syndrome is a condition including osteopenia, sarcopenia and obesity. A pro-inflammatory dietary pattern has been reported to be associated with obesity and osteoporosis. However, studies on the association of dietary inflammatory index with osteosarcopenic obesity syndrome in the Korean population are lacking. The aim of this study was to analyze the relationship between dietary inflammatory index and osteosarcopenic obesity syndrome among Korean postmenopausal women. We analyzed the 2009–2011 Korea National Health and Nutrition Examination Survey, consisting of 1,344 postmenopausal women aged 50 years or older. Body composition was evaluated by dual-energy X-ray absorptiometry. Dietary inflammatory index was estimated after analyzing 36 nutrients and 9 foods using a 24-h dietary recall data. The association between dietary inflammatory index levels and the body composition was analyzed by logistic regression models with dietary inflammatory index fit as a dichotomous variable. The dietary inflammatory index was −0.96 ± 0.22 in the normal group, 0.12 ± 0.16 in the osteopenic obesity group, 0.00 ± 0.18 in the osteosarcopenia group, 0.12 ± 0.33 in the sarcopenic obesity group, and −0.02 ± 0.14 in the osteosarcopenic obesity group (p<0.001). After adjusting for potential covariates, women with higher dietary inflammatory index scores were more likely to have risk of osteopenic obesity (OR = 2.757, 95% CI: 1.398–5.438, p<0.01) and that of osteosarcopenic obesity (OR = 2.186, 95% CI: 1.182–4.044, p<0.05). The results indicate that pro-inflammatory diet was associate with increased odds of the osteosarcopenic obesity in postmenopausal Korean women. Therefore, studies are needed to identify the effects of anti-inflammatory diets, which can reduce the degree of inflammation through dietary intake.

Differences in body composition and physical function related to pure sarcopenia and sarcopenic obesity: A study of community-dwelling older adults in Japan.

We compared skeletal muscle mass and physical function between older adults with sarcopenia and those with sarcopenic obesity. Body composition and physical and cognitive function were measured for 1283 community-dwelling older adults. Participants responded to questionnaires about pain and exercise. The pure sarcopenia group (PS) included individuals with sarcopenia only. The sarcopenic obesity group (SO) included individuals with both sarcopenia and obesity. Groups were compared after adjusting for sex, age and height through propensity score matching. The PS and SO included 129 and 105 individuals, respectively. Comorbidities were more frequent in the SO (P<0.001). The SO had higher upper limb muscle mass (P<0.001), and had lower ratios of lower limb muscle mass to upper limb muscle mass (P<0.001) and of lower limb muscle mass to weight (P<0.001). The SO also had poorer grip power (P=0.007), gait times (usual pace, P=0.001; maximum speed, P=0.001), Timed Up and Go test (P<0.001), and time standing on one foot (P=0.005) than the PS. The SO had a higher frequency of gonalgia (P=0.013). After adjusting for covariates, comorbidities, upper limb muscle mass, lower limb muscle mass to upper limb muscle mass ratio, lower limb muscle mass to weight ratio, gait time, Timed Up and Go test, time standing on one foot, and gonalgia differed significantly between the PS and SO. Sarcopenic obesity decreases the ratio of lower limb muscle mass to weight by increasing weight. It affects physical function in older Japanese adults with low weight. Decreased relative lower limb muscle mass is an important function-limiting factor in sarcopenic obesity. Geriatr Gerontol Int 2017; 17: 2602-2609.

MPS 10-04 THE COMBINATION OF OBESITY AND SARCOPENA IS ASSOCIATED WITH COGNITIVE DECLINE IN ELDERLY HYPERTENSIVE INDIVIDUALS

The combination of obesity and sarcopenia, defined as sarcopenic obesity, may contribute to cognitive decline more than the two conditions exist solely. This study aimed to investigate the risk of cognitive impairment associated with the sarcopenia, obesity, and its combination among elderly hypertensive individuals. A total of 348 elderly hypertensive subjects (175 men and 173 women, 69.5 ± 2.9 years of age), was enrolled in this study. We evaluated the cognitive functioning of individuals based on the 12-signs version of the Observations List for early signs of Dementia (OLD). Bioelectrical impedance analysis was performed to estimate appendicular skeletal muscle mass (ASM). A value of ASM was normalized for height and conversed to an ASM index. Subject with an ASM index of less than the gender-specific lowest quartiles was classified as sarcopenic. Obesity was defined as waist circumference greater than 85 cm for men and 90 cm for women. Based on the cutoffs, four categorical groups were created as solely sarcopenic (sarcopenic non-obese), solely obese (non-sarcopenic obese), sarcopenic obese, and normal. The OLD score was highest (namely, cognitive functioning was lowest) among the sarcopenic obese group (5.3 ± 0.7 points), followed by non-sarcopenic obese group (3.3 ± 0.2 points), the sarcopenic non-obese group (3.4 ± 0.3 points), and normal group (2.8 ± 0.2 points) after adjusting for confounding factors (p for trend <.001). When a cognitive decline was defined as the OLD score of 5 points or above, 25.9% of the subjects met the criteria. Multiple logistic regression analysis revealed that the sarcopenic obese condition was significantly associated with the increased risk for cognitive decline (odds ratio, 4.0; 95% CI, 1.3–12.0; P<.05), independent of age, gender, education level, and use of anti-hypertensive agents. In elderly hypertensive individuals, the combination of obesity and sarcopenia may contribute to the acceleration of cognitive decline relative to the condition that they exist solely.

Differential Effects of Sarcopenic Obesity on Markers of Protein Synthesis in Hearts of C57BL/6J Mice

In 1990, 23.6% of the elderly population (60+ years old) was obese (≥30 BMI). By 2010, it increased to 39.5%. Pathological, cardiac hypertrophy is highly associated with both age and obesity. As the prevalence of obesity in the elderly population continues to rise, a firmer understanding of how age and obesity interact to affect cardiac function is needed. PURPOSE: To examine how sarcopenic obesity affects markers of protein synthesis. METHODS: Twenty-four C57BL/6J mice were evenly distributed into either a normal chow (17% kcals from fat) or high-fat (60% kcals from fat) diet after weaning. Six mice from each diet were euthanized at 3-4 months of age (young) or 22-24 months of age (aged). The classification of the 4 groups is as follows: Young Lean (YL), Young Obese (YO), Aged Lean (AL), Aged Obese (AO). Hearts were excised, snap-frozen, and processed for protein expression via western blot. All protein targets are reported as a ratio of phosphorylated to total protein. RESULTS: There was an interaction of age and obesity on heart mass:tibia length. Heart mass:tibia length was 11 % higher in YO compared to YL and 37% greater in AO compared to AL (p < 0.05). Also, AO heart mass:tibia length was 40% greater compared to YO (p < 0.05). There was a main effect of age to increase both pAkt/Akt (p < 0.05) and pmTOR/mTOR (p < 0.05). There was an interaction of age and obesity on p4EBP-1/4EBP-1 expression. p4EBP-1/4EBP-1 was lower in YO compared to YL, AL, and AO (p < 0.05). We detected an interaction of age and obesity on pp70S6K/p70S6K expression. pp70S6K/p70S6K was 47% higher in YO compared to YL (p < 0.05); however, pp70S6K/p70S6k expression was not different between AL and AO mice. We observed an interaction of age and obesity on pAMPK/AMPK expression. pAMPK/AMPK expression was 329% higher (p < 0.05) in YL compared to YO but 46% lower (p < 0.05) in AO compared to AL. CONCLUSION: Sarcopenic obesity induced differential expression of protein synthesis markers. Obesity mediates cardiac hypertrophy through different pathways in the aging and young groups. Cardio protective processes may be downregulated in the sarcopenic obese group as represented by the loss of AMPK in that group. This work was supported by a grant from the American Biosciences Institute and the animals were a kind gift from Rigel Pharmaceuticals.