Effect of sarcopenia on cardiovascular disease risk factors in obese postmenopausal women

Relative strength as a determinant of mobility in elders 67-84 years of age. a nuage study: nutrition as a determinant of successful aging

This cross-sectional study proposes two relative strength indexes in order to evaluate the risks of lower mobility in healthy older adults: 1) handgrip strength on body mass index and 2) quadriceps strength on body weight. Nine hundred and four men and women aged between 67-84 years old were tested for body composition, muscle strength and mobility function. Individuals in the lowest and middle tertiles of relative handgrip strength were respectively 2.2 (1.3-3.7) and 4.4 (2.6-7.6) more likely to have a lower mobility score. As for relative quadriceps strength, odd ratios for lowest and middle tertiles were respectively 2.8 (1.6-4.9) and 6.9 (3.9-12.1). Relative strength indexes, either using handgrip strength or quadriceps strength, are convenient to use in large scale studies and clinical practice.

Sarcopenic/obesity and physical capacity in older men and women: data from the Nutrition as a Determinant of Successful Aging (NuAge)-the Quebec longitudinal Study

Sarcopenia and obesity have been independently associated with physical capacity impairments. However, few studies have investigated the impact of sarcopenic/obesity on physical capacity in older individuals using objective measures of physical capacity and body composition. This study included 904 older individuals aged between 68 and 82 years old. Body composition (fat mass (FM) and lean body mass (LBM) by dual-energy X-ray absorptiometry (DXA)), physical capacity (timed up and go, chair stands, walking speed at normal and fastest pace, and one leg stand), sum of reported chronic conditions and physical activity level were measured. A global physical capacity score was then calculated giving a maximal score of 20. Finally, four groups were created within genders based on sarcopenia and obesity ((i) nonsarcopenic/nonobese; (ii) sarcopenic/nonobese; (iii) nonsarcopenic/obese; (iv) sarcopenic/obese). The four groups were significantly different for the sit-to-stand test and the one leg stand test (P < 0.05) and only for the one leg stand test in women (P < 0.05). In both genders results for the global physical capacity score revealed that both obese groups (sarcopenic and nonsarcopenic) were similar (P = 0.14 in men and P = 0.19 in women) and had a lower global physical capacity score compared to nonsarcopenic/nonobese individuals (P < 0.05). In addition, sarcopenic women displayed a higher score than both obese nonsarcopenic and obese sarcopenic groups (P < 0.01). Sarcopenic/obese men and women do not display lower physical capacity compared to nonsarcopenic/obese individuals in this cohort of well-functioning older men and women. Obesity per se appears to contribute more to lower physical capacity than sarcopenia.

Sarcopenic-obesity and cardiovascular disease risk in the elderly

OBJECTIVES

To determine: 1) whether sarcopenic-obesity is a stronger predictor of cardiovascular disease (CVD) than either sarcopenia or obesity alone in the elderly, and 2) whether muscle mass or muscular strength is a stronger marker of CVD risk.

DESIGN

Prospective cohort study.

PARTICIPANTS

Participants included 3366 community-dwelling older (>or= 65 years) men and women who were free of CVD at baseline.

MEASUREMENTS

Waist circumference (WC), bioimpedance analysis, and grip strength were used to measure abdominal obesity, whole-body muscle mass, and muscular strength, respectively. Subjects were classified as normal, sarcopenic, obese, or sarcopenic-obese based on measures of WC and either muscle mass or strength. Participants were followed for 8 years for CVD development and proportional hazard regression models were used to compare risk estimates for CVD in the four groups after adjusting for age, sex, race, income, smoking, alcohol, and cognitive status.

RESULTS

Compared with the normal group, CVD risk was not significantly elevated within the obese, sarcopenic, or sarcopenic-obese groups as determined by WC and muscle mass. When determined by WC and muscle strength, CVD risk was not significantly increased in the sarcopenic or obese groups, but was increased by 23% (95% confidence interval: 0.99-1.54, P=0.06) within the sarcopenic-obese group.

CONCLUSION

Sarcopenia and obesity alone were not sufficient to increase CVD risk. Sarcopenic-obesity, based on muscle strength but not muscle mass, was modestly associated with increased CVD risk. These findings imply that strength may be more important than muscle mass for CVD protection in old age.

Metabolic profile and quality of life in class I sarcopenic overweight and obese postmenopausal women: a MONET study

Sarcopenia is believed to be associated with disability and metabolic complications. The objective of this study was to examine the metabolic and quality-of-life profile of sarcopenic overweight and obese postmenopausal women. In this cross-sectional study of 136 healthy overweight and obese postmenopausal women, 9 class I sarcopenic women were identified. Class I sarcopenia was defined as an appendicular lean body mass index (ALBMI) <or= 6.44 kg.m(-2) (appendicular lean body mass/height). Outcome measures were body composition (dual energy X-ray absorptiometry and computed tomography), blood lipids, inflammation markers, blood pressure, insulin sensitivity (homeostasis model assessment and hyperinsulinemic-euglycemic clamp), cardiorespiratory fitness, and quality of life (Medical Outcomes Study General Health Survey questionnaire). By design, class I sarcopenic women (n = 9) had a significantly lower ALBMI and appendicular lean body mass than nonsarcopenic women (n = 127). In addition, class I sarcopenic women tended to have lower levels of insulin resistance (p = 0.070) and fasting glucose (p = 0.054). However, no difference between the groups was observed for quality of life. This study showed that, in our sample of class I sarcopenic overweight and obese postmenopausal women, subjects did not present an unfavourable metabolic or quality-of-life profile, compared with nonsarcopenic overweight and obese postmenopausal women.

Sarcopenic obesity: definition, cause and consequences

PURPOSE OF REVIEW

Older obese persons with decreased muscle mass or strength are at special risk for adverse outcomes. We discuss potential pathways to muscle impairment in obese individuals and the consequences that joint obesity and muscle impairment may have on health and disability. Tantamount to this discussion is whether low muscle mass or, rather, muscle weakness should be used for the definition.

RECENT FINDINGS

Excess energy intake, physical inactivity, low-grade inflammation, insulin resistance and changes in hormonal milieu may lead to the development of so-called 'sarcopenic obesity'. It was originally believed that the culprit of age-related muscle weakness was a reduction in muscle mass, but it is now clear that changes in muscle composition and quality are predominant. We propose that the risk of adverse outcomes, such as functional limitation and mortality, is better estimated by considering jointly obesity and muscle strength rather than obesity and muscle mass and the term 'sarcopenic obesity' should be revisited.

SUMMARY

Recognition of obese patients who have associated muscle problems is an essential goal for clinicians. Further research is needed to identify new target for prevention and cure of this important geriatric syndrome.

Sarcopenic obesity: a new category of obesity in the elderly

BACKGROUND AND AIM

In elderly patients, age-related changes in body composition, as well as the increased prevalence of obesity, determine a combination of excess weight and reduced muscle mass or strength, recently defined as sarcopenic obesity (SO). This review examines the main studies regarding sarcopenic obesity in the elderly.

DATA SYNTHESIS

Definition of SO necessarily combines those of sarcopenia and obesity. The prevalence of sarcopenia and SO increases with age. Muscle and fat mass are strongly interconnected from a pathogenetic point of view. A better understanding of the mechanisms which lead from loss of muscle mass to fat gain or vice versa from fat gain to muscle loss seems to be crucial. Recent data suggest that peptides produced by adipose tissue may play an important role in the pathophysiology of SO, thus more research is needed to better characterize this new area. Obesity and sarcopenia in the elderly may potentiate each other maximizing their effects on disability, morbidity and mortality. Identifying elderly subjects with SO should be mandatory; effective treatment of sarcopenia and SO may attenuate its clinical impact.

CONCLUSION

The concept of SO may help to clarify the relationship between obesity, morbidity and mortality in the elderly.

Is overweight/obesity associated with short sleep duration in older women?

BACKGROUND AND AIM

No study to date has documented the association between short sleep duration and the risk for obesity in older people. Therefore, the aim of this study was to examine cross-sectional associations between short sleep duration and variations in body fat indices in older women.

METHODS

Anthropometric and body composition measurements, resting energy expenditure, daily energy expenditure, daily energy intake, plasma lipid-lipoprotein profile, and self-reported sleep duration were determined in a sample of 90 women of 50 years and above.

RESULTS

The odds ratios for overweight/obesity were comparable in subjects reporting <7 hours and >or=7 hours of sleep per day, with or without adjustment for age, daily energy expenditure and daily energy intake. The results did not permit to observe any significant difference between the two sleeper groups for all the variables investigated. The correlations between sleep duration and adiposity indices were also non significant.

CONCLUSIONS

Short sleep duration does not predict an increased risk of being overweight/obese in older women. This observation, together with our previously reported results in younger subjects, suggests that the sleep-body fat relationship progressively becomes less detectable with increasing in age.