Sarcopenic Obesity Research Articles

Obesity, sarcopenia, sarcopenic obesity and hypertension: mediating role of inflammation and insulin resistance.

This study aimed to assess the association between obesity, sarcopenia, and sarcopenic obesity with hypertension and to explore the potential mediation of inflammation indicators and insulin resistance. Data from the UK Biobank, a large-scale prospective cohort, were utilized. Obesity was defined using percentage of fat mass, while sarcopenia was defined as low muscle mass and low muscle strength. The primary outcome assessed was new-onset hypertension within a 5-year follow-up period. The association analysis was examined using a Cox regression model. A total of 183,091 participants were enrolled in this study. During 5 years of follow-up, 3812 (2.08%) developed hypertension. In the fully adjusted model, compared to men without these conditions, those with obesity, sarcopenia, and sarcopenic obesity had 2.32 times (95% CI, 2.12-2.55), 3.10 times (95% CI, 2.35-4.08), and 3.66 times (95% CI, 2.98-4.50) higher risks of developing hypertension, respectively. Women with obesity, sarcopenia, and sarcopenic obesity had 2.27 times (95% CI, 2.03-2.54), 2.93 times (95% CI, 1.95-4.39), and 4.04 times (95% CI, 3.32-4.91) higher risks of hypertension, respectively. Significant mediating effects of C-reactive protein, neutrophils, white blood cells, triglyceride-glucose index, and triglyceride to high-density lipoprotein cholesterol ratio were found, with mediations ranging from 6% to 13% for men and 2% to 21% for women in the association between sarcopenic obesity and hypertension. Obesity, sarcopenia, and sarcopenic obesity significantly increased the risk of hypertension. Inflammation and insulin resistance appeared to mediate the association between sarcopenic obesity and hypertension.

Body Composition Analysis in Metastatic Non-Small-Cell Lung Cancer: Depicting Sarcopenia in Portuguese Tertiary Care

Background/Objectives: Sarcopenia is an emergent prognostic biomarker in clinical oncology. Albeit increasingly defined through skeletal muscle index (SMI) thresholding, the literature cut-offs fail to discern heterogeneous baseline muscularity across populations. This study assesses the prognostic impact of using cohort-specific SMI thresholds in a Portuguese metastatic non-small-cell lung cancer (mNSCLC) cohort. Methods: Retrospective study including mNSCLC patients treated between January 2017 and December 2022. ImageJ v1.54 g was used to assess cross-sectional CT imaging at the third lumbar vertebra (L3) and calculate L3SMI. Sarcopenia was defined both according to Prado et al. and L3SMI thresholds derived from receiver operating characteristic analysis. Overall survival (OS) was the primary endpoint. Secondary endpoints included first-line (1L) progression-free survival (PFS) and sarcopenia subgroup analysis regarding body mass index impact on OS. Results: The initial cohort included 197 patients. Mean age was 65 years (±11.31). Most tumors were adenocarcinomas (n = 165) and presented with metastasis (n = 154). SMI was evaluable in 184 patients: cohort-specific thresholds (<49.96 cm2/m2 for men; <34.02 cm2/m2 for women) yielded 46.74% sarcopenic patients (n = 86) versus 66.30% (n = 122) per the literature definition. Cohort-specific thresholds predicted both OS (12.75 versus 21.13 months, hazard ratio [HR] 1.654, p = 0.002) and PFS (7.92 versus 9.56 months, HR 1.503, p = 0.01). Among sarcopenic patients, overweight (HR 0.417, p = 0.01) and obesity (HR 2.723, p = 0.039) had contrasting impacts on OS. Conclusions: Amid reclassification of nearly one-fifth of the cohort, cohort-specific thresholds improved sarcopenia prognostication in mNSCLC. Homogeneity regarding both cancer treatment setting and ethnicity could be key to defining sarcopenia based on SMI.

Quality matters: chronic kidney disease progression is associated to reduced muscle strength independently of changes in skeletal muscle mass: an observational study

Abstract Background and hypothesis Chronic kidney disease (CKD) is commonly associated with multifactorial neuromuscular impairments. Few studies have investigated CKD-induced changes in maximal voluntary force (MVF), and even fewer have longitudinal follow-up. The aim of this study is to investigate whether CKD progression modifies the relationship between skeletal muscle mass and force and the prevalence of sarcopenia and sarcopenic obesity. Methods The data used were prospectively collected during routine check-ups in a network of nutritional centres in Mexico and retrospectively analysed. From a dataset of 5430 patients, we selected 1098 patients with available anthropometric, kidney function, handgrip and bioimpedance data. The relationship between appendicular skeletal muscle mass (ASM) and MVF was investigated using mixed models and adjusted for age, sex, BMI, physical activity level and CKD aetiology. Sarcopenia prevalence were tested across period of follow-up using the Cochran-Mantel-Haenzen for repeated measures and across CKD stages using the Chi-2 test. Results After normalization with ASM, MVF was higher in CKD G1-G3 compared to G4 and G5 (p ≤ 0.001, Cohen's d = 0.270–0.576). Slopes between MVF and ASM were lower in CKD G3, G4 and G5 than in CKD G1-G2 (-2.268 [-3.927,-0.609], p = 0.008; -2.694 [-4.593,-0.794], p = 0.006; -3.675 [-5.326,-1.725], p < 0.001, respectively). The prevalence of sarcopenia and sarcopenic obesity did not differ across CKD stages, but recovery was most commonly observed in CKD G1-G2. Slope analysis showed an independent interaction between the slopes of kidney function and ASM on MVF evolution over time. Conclusions CKD negatively, progressively and independently affects the neuromuscular system, and force production is reduced for any given muscle mass as CKD progresses. While no association was found between CKD stage and prevalence of sarcopenia, recovery was more frequent in the early CKD stages. These results suggest the importance of early rehabilitation programs to improve musculoskeletal health, quality of life and survival in CKD patients.

Correction of nutritional status in a comprehensive program for the prevention and treatment of sarcopenic obesity

Sarcopenic obesity is a complex condition characterized by a combination of obesity and sarcopenia. This pathology has a significant impact on the health and quality of life of the elderly and old people, increasing the risk of chronic diseases and impairing physical functions. Nutritional status plays a key role in maintaining the health and functional ability of older people, influencing the development of sarcopenia and obesity. Understanding the relationship between sarcopenic obesity and nutritional status is critical for developing prevention and treatment strategies. Our scientific article covers the various mechanisms of development of sarcopenic obesity and the influence of nutritional status on sarcopenic obesity, and also examines the role of various nutrients and dietary supplements in the management of this condition. Our scientific article highlights the need for a comprehensive approach to the treatment and prevention of sarcopenic obesity among elderly and elderly patients to improve overall health and quality of life.

Assessment of sarcopenic obesity in patients with acromegaly.

Sarcopenic obesity (SO), a condition characterized by the coexistence of obesity and sarcopenia, has primarily been studied in elderly populations. However, it can also affect individuals with chronic diseases. This study aims to evaluate the prevalence of SO in patients with acromegaly. Observational, cross-sectional study, involving patients with acromegaly followed at a tertiary center and controls matched for age and sex. Health assessment questionnaire, physical tests, body composition and bone mineral density assessment, were performed in all participants. SO was diagnosed using criteria from ESPEN and EASO Consensus Statements. 48 patients with acromegaly (acromegaly group - AG, 26 women, mean age 56.3 ± 11.6, mean BMI 31.3 ± 4.9) were compared to 48 controls (control group - CG, 26 women, mean age 56.7 ± 13.7, BMI 25.5 ± 4.7). Despite having greater total and appendicular lean mass, AG showed significant impairments in physical performance, particularly in strength, gait speed and balance (p < 0.05). The prevalence of SO in the AG was 16.7%, compared to 0% in the CG (p = 0.006), and positively correlated with increased fat mass and impaired physical performance. SO is present in patients with acromegaly and is associated with notable functional impairments despite increased muscle mass.

Association between Vitamin D Hypovitaminosis and Sarcopenic Obesity in Patients with Chronic Kidney Disease Stages 3 and 4

The relationship between sarcopenic obesity and hypovitaminosis D in individuals with chronic kidney disease is complex and has significant impacts on muscle and bone health. An observational, cross-sectional, and analytical study was conducted to analyze possible associations between serum vitamin D levels and sarcopenic obesity in patients with chronic kidney disease stages 3 and 4 in a cohort of patients under nephrology care. The presence of sarcopenic obesity was assessed using bioimpedance criteria, and vitamin D levels were measured and recorded for each patient. Statistically significant associations were found between sarcopenic obesity and suboptimal vitamin D levels (p < 0.005) as well as between severe sarcopenia and hypovitaminosis D (p < 0.05) in patients with chronic kidney disease stages 3 and 4. Patients with optimal levels of vitamin D showed better muscle quality and a lower prevalence of sarcopenia and severe sarcopenia. The findings suggest that vitamin D levels play a crucial role in muscle quality in patients with CKD stages 3 and 4. Maintaining optimal levels of vitamin D may help reduce the prevalence of sarcopenic obesity and improve quality of life in these patients.

Sarcopenic obesity is attenuated by E-syt1 inhibition via improving skeletal muscle mitochondrial function.

In aging and metabolic disease, sarcopenic obesity (SO) correlates with intramuscular adipose tissue (IMAT). Using bioinformatics analysis, we found a potential target protein Extended Synaptotagmin 1 (E-syt1) in SO. To investigate the regulatory role of E-syt1 in muscle metabolism, we performed in vivo and in vitro experiments through E-syt1 loss- and gain-of-function on muscle physiology. When E-syt1 is overexpressed in vitro, myoblast proliferation, differentiation, mitochondrial respiration, biogenesis, and mitochondrial dynamics are impaired, which were alleviated by the silence of E-syt1. Furthermore, overexpression of E-syt1 inhibited mitophagic flux. Mechanistically, E-syt1 overexpression leads to mitochondrial calcium overload and mitochondrial ROS burst, inhibits the fusion of mitophagosomes with lysosomes, and impedes the acidification of lysosomes. Animal experiments demonstrated the inhibition of E-syt1 increased the capacity of endurance exercise, muscle mass, mitochondrial function, and oxidative capacity of the muscle fibers in OVX mice. These findings establish E-syt1 as a novel contributor to the pathogenesis of skeletal muscle metabolic disorders in SO. Consequently, targeting E-syt1-induced dysfunction may serve as a viable strategy for attenuating SO.

Possible sarcopenia, sarcopenic obesity phenotypes and their association with diabetes: Evidence from LASI wave-1 (2017-18).

To assess the prevalence of possible sarcopenia and sarcopenic obesity phenotypes and investigate their association with self-reported diabetes among community-dwelling individuals aged 45 or above. Utilizing data from 62,899 individuals in LASI wave-1 (2017-18), the assessment of possible sarcopenia was done on two critical parameters: muscle (handgrip) strength and physical performance (gait speed), following the 2019 guidelines from the Asian working group on sarcopenia (AWGS). BMI, WC, WHR, and WHtR defined sarcopenic obesity phenotypes. Binary logistic regression analysis explored the association of possible sarcopenia and sarcopenic obesity phenotypes with self-reported diabetes. The prevalence of possible sarcopenia and sarcopenic obesity defined by BMI was found to be 44.4% and 10.6%, respectively. Individuals with possible sarcopenia exhibited a 1.18 times higher likelihood of developing self-reported diabetes (p<0.001), while those with sarcopenic obesity by BMI had significantly elevated odds (1.94, 95% CI 1.81-2, p<0.001) for self-reported diabetes. Sarcopenia and sarcopenic obesity phenotypes may increase the risk of developing diabetes as we age. Therefore, it is imperative to formulate targeted preventive and therapeutic strategies to combat sarcopenia and diabetes among the aging population.

328 Coenzyme Q redox poise in sarcopenic obesity

328 Coenzyme Q redox poise in sarcopenic obesity

Optimised Skeletal Muscle Mass as a Key Strategy for Obesity Management

The ‘Body Mass Index’ (BMI) is an anachronistic and outdated ratio that is used as an internationally accepted diagnostic criterion for obesity, and to prioritise, stratify, and outcome-assess its management options. On an individual level, the BMI has the potential to mislead, including inaccuracies in cardiovascular risk assessment. Furthermore, the BMI places excessive emphasis on a reduction in overall body weight (rather than optimised body composition) and contributes towards a misunderstanding of the quiddity of obesity and a dispassionate societal perspective and response to the global obesity problem. The overall objective of this review is to provide an overview of obesity that transitions away from the BMI and towards a novel vista: viewing obesity from the perspective of the skeletal muscle (SM). We resurrect the SM as a tissue hidden in plain sight and provide an overview of the key role that the SM plays in influencing metabolic health and efficiency. We discuss the complex interlinks between the SM and the adipose tissue (AT) through key myokines and adipokines, and argue that rather than two separate tissues, the SM and AT should be considered as a single entity: the ‘Adipo–Muscle Axis’. We discuss the vicious circle of sarcopenic obesity, in which aging- and obesity-related decline in SM mass contributes to a worsened metabolic status and insulin resistance, which in turn further compounds SM mass and function. We provide an overview of the approaches that can mitigate against the decline in SM mass in the context of negative energy balance, including the optimisation of dietary protein intake and resistance physical exercises, and of novel molecules in development that target the SM, which will play an important role in the future management of obesity. Finally, we argue that the Adipo–Muscle Ratio (AMR) would provide a more clinically meaningful descriptor and definition of obesity than the BMI and would help to shift our focus regarding its effective management away from merely inducing weight loss and towards optimising the AMR with proper attention to the maintenance and augmentation of SM mass and function.

Novel evidence of arsenic-related excess adiposity and its implication in the risk of cardiometabolic diseases.

Arsenic exposure is associated with obesity- or excess adiposity-related disorders, including cardiometabolic diseases. Previously, many human studies attempted to establish the association of arsenic exposure with obesity, mainly through body mass index (BMI) but failed to provide any concrete evidence. Our study aimed to investigate the arsenic-related adiposity and its relationship with cardiometabolic diseases. Of the 524 participants, 126 and 398, respectively, were chosen from low- and high-arsenic exposure areas in Bangladesh. Obesity or body fat (adiposity) of the participants was measured by anthropometric measures [BMI, waist circumference (WC), and triceps skinfold thickness (TSFT)] and a serum biomarker, leptin. Sarcopenic characteristics were assessed by lean body mass (LBM) and serum creatinine levels. Insulin resistance, as measured by Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), hypertension, and hyperglycemia, were considered as the risk factors for cardiometabolic diseases. There were significant positive associations between drinking water, hair, and nail arsenic concentrations and the levels of WC and TSFT after adjusting for potential confounders. However, there were no significant associations with BMI. Increased arsenic exposure levels were associated with increased leptin levels [(Regression coefficient (β)=1.00, 95% confidence interval (CI): 0.53, 1.46) for water, (β=1.44, 95% CI: 0.42, 2.46) for hair, and (β=1.47, 95% CI: 0.32, 2.61) for nail arsenic]. Notably, leptin levels had inverse associations with LBM (β=-7.87, 95% CI: -13.30, -2.45) and creatinine levels (β=-15.65, 95% CI: -21.50, -9.81). Furthermore, the elevated leptin levels associated with arsenic exposure were connected to higher HOMA-IR levels (β=0.19, 95% CI: 0.14, 0.24), higher odds of hypertension [Odds ratio (OR)=1.31, 95% CI: 1.12, 1.53], and hyperglycemia (OR=1.30, 95% CI: 1.13, 1.47). Taken together, the results of this study demonstrated a unique association between arsenic exposure and adiposity, which could promote arsenic-induced cardiometabolic disorders by mirroring the distinctive characteristics of age-associated sarcopenic obesity.

Exploring the relationship between glycemic variability and muscle dysfunction in adults with diabetes: A systematic review.

This review is to systematically explore the relationship between muscle dysfunction and diabetes in adults, and to examine the impact of glycemic variability on muscle health and the development of diabetes-related complications. The review was conducted using three databases: MEDLINE, Scopus, and EMBASE, targeting peer-reviewed journal articles written in English and published from January 2014 to September 2024. The methodological quality assessment of the eligible studies was conducted using Joanna Briggs Institute Critical Appraisal Checklists. A total of 17 studies were included. Most studies were undertaken in Asian countries (n = 11) and focused on adults with type 2 diabetes (n = 12). There were 8,392 adults with diabetes, and their mean age ranged from 52 to 75years old. The measurements for muscle function and glycemic variability varied across studies. The research findings regarding the relationship between muscle dysfunction and glycemic variability metrics among adults with diabetes, both with and without complications were inconsistent. For adults with diabetes and sarcopenic obesity, poor glycemic control was identified as an independent risk factor for sarcopenic obesity. Additionally, all included studies were rated as moderate or high quality in relation to their methodology. In conclusion, this review underscores the complex and inconsistent relationship between glycemic variability and muscle dysfunction in older adults with diabetes. Poor glycemic management is a significant risk factor for sarcopenic obesity, highlighting the need for tailored interventions to improve glycemic control and muscle health in this population.

Effects of a Hypocaloric Diet Plus Resistance Training with and Without Amino Acids in Older Participants with Dynapenic Obesity: A Randomized Clinical Trial

Background/Objectives: Exercise and nutrition may be useful strategies in dynapenic and sarcopenic obesity management, but the identification of treatment modalities aimed at improving this condition is still lacking. We compared the effect of a five-month hypocaloric diet plus resistance training (RT) with and without essential amino acids (EAAs) on body composition, physical performance, and muscle strength among older adults with dynapenic obesity (DO). Methods: Older individuals (n = 48) with DO [(BMI ≥ 30 kg/m2 and/or high waist circumference and low handgrip strength (HGS)] were randomized into two double-blind groups (RT without EAAs vs. RT+EAAs). All participants followed a hypocaloric diet (1 g of proteins/kg spread over three meals) and RT for five months. Pre- and post-intervention assessments included the body composition (DXA), Short Physical Performance Battery (SPPB), HGS, one-repetition maximum (1-RM), and maximal isometric torque with an isokinetic dynamometer. Results: Both groups reduced body mass (RT: −4.66 kg; RT+EAAs: −4.02 kg), waist circumference (RT: −4.66 cm; RT+EAAs: −2.2 cm), total fat mass (RT: −3.81 kg; RT+EAAs: −3.72 kg), and compartmental fat mass with no between-group differences. Both groups improved 1-RM strength (33–47%), isometric torque for body mass (RT: 14.5%; RT+EAAs: 10.6%), and functional performance (chair stand (RT: −3.24 s; RT+EAAs: −1.5 s) and HGS (RT: −2.7 kg; RT+EAAs: 2.9 kg)) with no between-group differences. Conclusions: A moderate hypocaloric diet combined with RT improves body composition and physical function in DO participants, but EAA supplementation did not provide additional benefits.

Effect of sarcopenic obesity on treatment results in patients with malignant tumors of the gastrointestinal tract: systematic review

Background. Tumors of the gastrointestinal (GI) tract are characterized by high morbidity and poor prognosis. Over the past decade, sarcopenia (skeletal muscle depletion), myosteatosis, sarcopenic obesity were all shown to have negative prognostic effect in patients with various GI malignancies. However, the role of sarcopenic obesity (SO) in patients with GI tumors remains controversial. We have summarized clinical trial data on the effect of SO on treatment results in patients with malignant GI tumors who underwent surgical and/or drug antitumor treatment.Materials and methods. Thisstudy was conducted in comliance with the Preferred Reporting Itemsfor Systematic Review and Meta-Analyses (PRISMA) guidelines. PubMed and Cochrane Library databases were searched for relevant original studies published between January 2009 and December 2022 reporting postoperative complication rate and mortality, long-term survival and chemotherapy toxicity in SO patients with GI cancers.Results. Twenty four studies with 9,601 patients were included. The percentage of SO patients ranged from 2.6 to 51 %. Due to significant heterogeneity of SO determination methods and varying threshold values, the association between SO and outcomes of interest was inconsistent. SO was significantly associated with development of major postoperative complications in six studies. In contrast, three studies did not show any effect of SO on postoperative complications. Only two studies demonstrated that the mortality rate was significantly higher among patients with SO compared to those without SO. Four studies using multivariate analysis showed statistically significant effect of SO on long-term survival, one study – on disease-free survival. However, three trials contradicted this finding and reported that SO was not a negative prognostic factor of long-term survival in GI cancer patients. Three studies investigating SO effect on the outcomes of drug antitumor treatment showed negative effect of SO on chemotherapy toxicity.Conclusion. There is considerable heterogeneity in methods used to define SO in the literature, and current data is limited. Standardized terminology and deeper understanding of sarcopenic obesity pathophysiology is needed to further understand the effect of obesity and sarcopenia on clinical trajectory of patients with GI cancer.

Effects of sarcopenic obesity on incident chronic kidney disease and rapid kidney function decline: evidence from the China health and retirement longitudinal study.

Evidence on the effects of sarcopenic obesity (SO) on incident chronic kidney disease (CKD) and rapid kidney function decline (RKFD) in the Chinese population is limited. This study aimed to prospectively examine the associations of SO with incident CKD and RKFD among middle-aged and older Chinese adults. This prospective cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative longitudinal study of Chinese adults aged 45 and older. The analysis included 4201 individuals from the 2011 wave, with renal outcomes ascertained from the 2015 wave. The effects of SO on incident CKD and RKFD were assessed using logistic regression models. Robustness was tested through subgroup and sensitivity analyses. Over four years of follow-up, 228 cases of incident CKD and 213 cases of RKFD were observed. After multivariable adjustment, participants in the "sarcopenic obesity" group showed a 78% increased risk of incident CKD (odds ratio [OR] 1.78, 95% confidence interval [CI] 1.09-2.90) and a 79% increased risk of RKFD (OR 1.79, 95% CI 1.03-3.13), compared to the "nonsarcopenia without obesity" group. Consistent results were observed across subgroups stratified by gender, education level, marital status, geographic area, lifestyle factors, and comorbidities, with no significant interactions detected. In a population-based cohort of middle-aged and older Chinese adults, SO was independently associated with elevated risks of incident CKD and RKFD, without interaction effects. These findings underscore the importance of timely intervention for SO to prevent adverse kidney outcomes. Key message What is already known on this topic? The relationship between sarcopenic obesity (SO) and the risk of chronic kidney disease (CKD) and renal function decline has been established in Korean and Japanese individuals with type 2 diabetes mellitus. However, it is uncertain if these findings apply to other populations, particularly those without diabetes. Additionally, the influence of diabetes on these associations needs further exploration, and the link between SO and rapid kidney function decline (RKFD) remains unestablished. Evidence regarding the effects of SO on incident CKD and RKFD in the Chinese population is limited, highlighting the necessity for this study to fill these gaps in knowledge. What this study adds This study is the first to prospectively explore the association of SO with incident CKD and RKFD in middle-aged and older Chinese adults. We identified SO as a significant risk factor for increased incidence of both CKD and RKFD. These findings expand the understanding of the impact of SO beyond individuals with diabetes mellitus, indicating that SO is a universal risk factor for adverse kidney outcomes in aging populations, irrespective of demographic and health characteristics. How this study might affect research, practice, or policy This study identifies SO as an independent risk factor for incident CKD and RKFD in middle-aged and older Chinese adults. The findings suggest that SO is a modifiable risk factor for kidney health, underscoring the necessity for timely interventions to prevent adverse kidney outcomes. Given the rising prevalence of SO and kidney disease in aging populations worldwide, these results highlight the importance of incorporating SO management into public health and clinical strategies. Questions pending answer What role do specific lifestyle factors (e.g. diet, physical activity) play in mitigating or exacerbating kidney function decline in individuals with SO? Are there genetic markers that predispose individuals with SO to a higher risk of incident CKD and RKFD? What are the underlying molecular mechanisms linking SO to incident CKD and RKFD?

Clinical Relevancies of Sarcopenic Obesity in Patients with Metabolic Dysfunction-Associated Fatty Liver Disease (MASLD).

Sarcopenic obesity (SO) is associated with adverse outcomes in diseased patients. This study aimed to examine the prevalence and risks associated with SO, with a focus on the impact of SO on cardiovascular risk in patients with MASLD. In this cross-sectional study, patients with MASLD were prospectively enrolled. Through dual-energy X-ray absorptiometry (DXA) scans, their body compositions were analyzed to identify who had SO and osteopenia/osteoporosis. The primary aim is to investigate risks associated with SO, followed by analyzing the association between SO and cardiovascular disease (CVD). Two hundred and twenty-three patients with MASLD were enrolled. The prevalence of SO was 47.1%, respectively. Patients coexisted with MASLD and SO had increased visceral adipose tissue (VAT), higher fatty liver index (FLI) and fibrosis 4 (FIB-4) score. Regression analysis revealed higher FLI and FIB-4 score, as well as history of hypertension, were risks associated with SO. The 10-year atherosclerotic cardiovascular disease (ASCVD) risk score was higher in patients coexisted with MASLD and SO compared to those without (10.1% vs. 7.3%, p = 0.006). Regression analysis showed that increased VAT and FIB-4 score were associated with raised risk of ASCVD. Prevalence of SO in MASLD patients is considerable. The presence of SO also linked to higher risk of ASCVD. Therefore, the recognition of SO in patients with MASLD is important in clinical care.

Application of rehabilitation programs to patients with chronic heart failure and sarcopenic obesity

Application of rehabilitation programs to patients with chronic heart failure and sarcopenic obesity

Sex-specific response of intramuscular fat to diet-induced obesity in rats

Metabolic abnormalities associated with excess adiposity in obesity contribute to many noncommunicable diseases, including sarcopenic obesity. Sarcopenic obesity is the loss of muscle mass coupled with excess fat mass and fatty infiltrations in muscle tissue called myosteatosis. A diet-induced obesity model was developed to study fat infiltration in muscle tissue. Only male rats have been considered in these investigations neglecting that female rats might respond differently. The objective of this study was to determine if the response to diet-induced obesity can be generalized to both sexes, or whether sex affects the response to the HFS diet, as indicated by markers of metabolic syndrome and changed in muscle integrity. Using a combination of histological staining techniques, quantitative proteomics, and measures of metabolic syndrome and inflammation, it was determined that the diet-induced obesity model in female Sprague-Dawley rats is a viable model with pronounced effects on the musculoskeletal system. We found sex-dependent and muscle-specific differences in intramuscular fat infiltration between male and female rats receiving the obesogenic diet. Including females in research may allow for identifying distinct causes of the mechanistic relationship between diet, obesity, metabolic syndrome, and the sex-dependent differential effects of these factors on adaptation and degeneration of musculoskeletal tissues.

Sarcopenia is not associated with hypertension, but sarcopenic obesity increases risk of hypertension: a 7-year cohort study.

Sarcopenia, sarcopenic obesity, and hypertension are all widespread public health problems in middle-aged and older populations, and their association is controversial. The purpose of this study is to analyze the relationship between obesity, sarcopenia, and sarcopenic obesity with hypertension in a middle-aged and older community population in China through a large-scale longitudinal design. In this cohort study with 7 years of follow-up, the study population was drawn from participants in the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and followed up in 2013, 2015, and 2018. The diagnostic criteria for sarcopenia were based on the consensus recommendations issued by the Asian Working Group for Sarcopenia (AWGS) in 2019. The diagnosis of obesity is based on body mass index and waist circumference. Sarcopenic obesity is defined as the coexistence of sarcopenia and obesity. Cox proportional risk regression models were used to analyze the association of obesity, sarcopenia, and sarcopenic obesity with hypertension. A total of 7,301 participants with a mean age of 58 ± 8.8 were enrolled in the study, and 51.9% females. A total of 1,957 participants had a new onset of hypertension after 7 years of follow-up. In a multifactorial analysis, obesity and sarcopenic obesity were associated with hypertension; hazard ratios (HRs) and 95% confidence intervals (CIs) were 1.67 (1.43 ~ 1.96), p < 0.001, and 1.61 (1.09 ~ 2.37), p = 0.017. Sarcopenia and hypertension were not significantly associated; the HR and 95% CI were 1.17 (0.9 ~ 1.52), p = 0.23. There is no significant correlation between sarcopenia and hypertension, but obesity and sarcopenic obesity increase the risk of hypertension. Targeted management of middle-aged and older people with sarcopenic obesity is needed in public health efforts.

Ratio of Skeletal Muscle Mass to Visceral Fat Area Is a Useful Marker for Assessing Left Ventricular Diastolic Dysfunction among Koreans with Preserved Ejection Fraction: An Analysis of the Random Forest Model.

Although the presence of both obesity and reduced muscle mass presents a dual metabolic burden and additively has a negative effect on a variety of cardiometabolic parameters, data regarding the associations between their combined effects and left ventricular diastolic function are limited. This study investigated the association between the ratio of skeletal muscle mass to visceral fat area (SVR) and left ventricular diastolic dysfunction (LVDD) in patients with preserved ejection fraction using random forest machine learning. In total, 1,070 participants with preserved left ventricular ejection fractions who underwent comprehensive health examinations, including transthoracic echocardiography and bioimpedance body composition analysis, were enrolled. SVR was calculated as an index of sarcopenic obesity by dividing the appendicular skeletal muscle mass by the visceral fat area. In the random forest model, age and SVR were the most powerful predictors of LVDD. Multivariate logistic regression analysis demonstrated that older age (adjusted odds ratio [OR], 1.11; 95% confidence interval [CI], 1.07 to 1.15) and lower SVR (adjusted OR, 0.08; 95% CI, 0.01 to 0.57) were independent risk factors for LVDD. SVR showed a significant improvement in predictive performance and fair predictability for LVDD, with the highest area under the curve noted in both men and women, with statistical significance. In non-obese and metabolically healthy individuals, the lowest SVR tertile was associated with a greater risk of LVDD compared to the highest SVR tertile. Decreased muscle mass and increased visceral fat were significantly associated with LVDD compared to obesity, body fat composition, and body muscle composition indices.