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Liu HW, Lee OKS. Effects of resistance training with elastic bands on bone mineral density, body composition, and osteosarcopenic obesity in elderly women: A meta-analysis. J Orthop 2024; 53:168-175. [PMID: 38633989 PMCID: PMC11018988 DOI: 10.1016/j.jor.2024.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 03/30/2024] [Indexed: 04/19/2024] Open
Abstract
Background Elastic band exercises can improve bone density, muscle quality, and body fat in elderly patients with Sarcopenic Obesity Syndrome (SOS), a common diagnosis. Encouraging this exercise can bring significant benefits. Methods We conducted a comprehensive search until April 1, 2023, covering UpToDate, PubMed, and Web of Science databases. The analysis focused on osteosarcopenic obesity and resistance training, involving four randomized controlled trials with 108 participants. After collecting key information, the methodological quality was assessed using the PEDro scale. Outcome quality was graded using the GRADE technique, and bias risk was evaluated using the Cochrane Bias Risk tool. Statistical analysis was performed using Review Manager 5.4. Results After a 12-week elastic band resistance training regimen, the meta-analysis revealed significant improvement. The study focused on age-related osteoporosis and obesity in older women, evaluating parameters such as bone mineral density (BMD) (P < 0.001, I2 = 98 %, CI: 0.39-0.71), decreased body fat percentage (BFP) (CI: -262.55-260.11, P < 0.001, I2 = 100 %), and skeletal muscle mass index (SMI) (P < 0.001, I2 = 98 %, CI: 0.31-0.71). T-score (P < 0.001, I2 = 97 %, CI: -2.85-1.27), Time to Chair Rise (TCR) (P < 0.001, I2 = 100 %, CI: -24.28-23.44), and Gait Speed (GS) (P < 0.001, I2 = 100 %, CI: 9.84-9.88) were also evaluated. Conclusion Following a 12-week elastic band resistance exercise regimen, older women showed notable improvements, particularly those with age-related osteoporosis and obesity.
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Affiliation(s)
- Hsuan-Wei Liu
- Department of Public Health, China Medical University, 406, Taichung City, Beitun District, Taiwan
| | - Oscar Kuang-Sheng Lee
- School of Medicine (Department of Orthopedics), China Medical University, 406, Taichung City, Beitun District, Taiwan
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2
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Ilich JZ, Pokimica B, Ristić-Medić D, Petrović S, Arsić A, Vasiljević N, Vučić V, Kelly OJ. Osteosarcopenic adiposity (OSA) phenotype and its connection with cardiometabolic disorders: Is there a cause-and-effect? Ageing Res Rev 2024; 98:102326. [PMID: 38734146 DOI: 10.1016/j.arr.2024.102326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/23/2024] [Accepted: 05/05/2024] [Indexed: 05/13/2024]
Abstract
The objectives were to examine if there is a causal relationship between osteosarcopenic adiposity (OSA) syndrome (coexistence of osteopenia/osteoporosis, sarcopenia, and excess adiposity) and cardiometabolic disorders or if these disorders initiate the development of OSA and its worsening. The search was conducted in PubMed, Scopus, and Web of Science to include articles up to the end of 2023. Of n=539 articles retrieved, n=15 met the eligibility criteria. Only studies conducted in adults and with all three body composition compartments (bone, muscle/lean, adipose) measured were considered. The results revealed that several cardiometabolic disorders, namely, hypertension, dyslipidemia (elevated total and LDL-cholesterol, lower HDL-cholesterol), insulin resistance, hyperglycemia, lower serum vitamin D, and some inflammatory markers were accompanied by OSA. In most cases, the OSA phenotype was associated with worse outcomes than cases with healthy or less impaired body composition. Our initial questions about the reciprocal cause-and-effect relationships could be surmised with more certainty for the OSA and some cardiovascular risks (hypertension, dyslipidemia) and some metabolic abnormalities (several inflammatory markers). The results of this review underscore the importance of body composition in health and from a clinical perspective, all three body composition compartments should be measured by standardized technologies using regulated diagnostic criteria to identify OSA. Randomized trials and prospective studies in diverse groups of older and younger individuals are necessary to determine if the relationships between OSA and clinical endpoints are causal and reversible through intervention and to uncover the mechanisms.
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Affiliation(s)
- Jasminka Z Ilich
- Institute for Successful Longevity, Florida State University, Tallahassee, Florida 32306, United States.
| | - Biljana Pokimica
- Group for Nutritional Biochemistry and Dietology, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia; Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia
| | - Danijela Ristić-Medić
- Group for Nutritional Biochemistry and Dietology, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia; Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia
| | - Snjezana Petrović
- Group for Nutritional Biochemistry and Dietology, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia; Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia
| | - Aleksandra Arsić
- Group for Nutritional Biochemistry and Dietology, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia; Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia
| | - Nadja Vasiljević
- Institute of Hygiene and Medical Ecology, Medical Faculty University of Belgrade, Belgrade 11000, Serbia
| | - Vesna Vučić
- Group for Nutritional Biochemistry and Dietology, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia; Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia
| | - Owen J Kelly
- Department of Molecular and Cellular Biology, College of Osteopathic Medicine, Sam Houston State University, 925 City Central Avenue, Conroe, Texas 77304, USA
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Moroni A, Perna S, Azzolino D, Gasparri C, Zupo R, Micheletti Cremasco M, Rondanelli M. Discovering the Individualized Factors Associated with Sarcopenia and Sarcopenic Obesity Phenotypes-A Machine Learning Approach. Nutrients 2023; 15:4536. [PMID: 37960189 PMCID: PMC10650113 DOI: 10.3390/nu15214536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
The literature shows how sarcopenia often occurs along with different phenotypes based either on the concomitant presence of adipose tissue excess (i.e., sarcopenic obesity, SO), or osteopenia/osteoporosis (osteosarcopenia, OS), or the combination of the two conditions, so-called osteosarcopenic obesity (OSO). This research aimed to assess the prevalence of sarcopenia phenotypes (SO, OS, OSO), their associated risk factors and their health impact in a population of out- and inpatients living in the North of Italy. Male and female subjects aged ≥18 years were enrolled for the study. A blood sample was collected to measure targeted blood makers. A comprehensive anthropometric clinical assessment (height, weight, Body Mass Index, BMI and Dual Energy X-ray Absorptiometry, DXA) was performed to measure ponderal, bone, fat, and muscle status. A total of 1510 individuals participated to the study (females, n = 1100; 72.85%). Sarcopenia was the most prevalent phenotype (17%), followed by osteosarcopenia (14.7%) and sarcopenic obesity. Only 1.9% of the sample was affected by OSO. According to logistic regression analysis, sarcopenia was associated with age, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) (positively) and BMI, Iron (Fe), Total Cholesterol, albumin (%), albumin (g), and gamma proteins (negatively). Sarcopenic obesity was associated with age, ferritin, ESR, CRP (positively) and BMI, Fe, and albumin (%) (negatively). Osteosarcopenia was associated with age, ESR (positively) and BMI, Total Cholesterol, albumin (%), albumin (g), and Ca (negatively). Osteosarcopenic obesity was associated with glycemia and gamma-glutamyl transferase (gGT) (positively). According to random forest analysis, a higher BMI was the most important protective factor for sarcopenia, for sarcopenic obesity (along with Iron) and for osteosarcopenia (along with albumin). Moreover, osteosarcopenic obesity was positively associated with GgT and glycaemia. The possibility of gaining such information, especially in the younger population, could help to prevent the onset of such diseases and best fit the patient's needs, according to a precision-medicine approach.
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Affiliation(s)
- Alessia Moroni
- Endocrinology and Nutrition Unit, Azienda di Servizi Alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy;
| | - Simone Perna
- Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, University of Milan, 20133 Milan, Italy
| | - Domenico Azzolino
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, 20122 Milan, Italy
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi Alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy;
| | - Roberta Zupo
- Department of Interdisciplinary Medicine (DIM), University “Aldo Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy;
| | | | - Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
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Abidin NZ. Comparison of Muscle, Bone and Fat Indices between Stages of Sarcopenia in Postmenopausal Malaysian Women. Malays J Med Sci 2023; 30:91-105. [PMID: 37928789 PMCID: PMC10624439 DOI: 10.21315/mjms2023.30.5.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 12/16/2022] [Indexed: 11/07/2023] Open
Abstract
Background The cumulative health impact of sarcopenia when it overlaps with obesity and osteoporosis is poorly understood. This cross-sectional study compared the muscle, bone and fat indices between stages of sarcopenia and determined the association of sarcopenia stages with adiposity and bone density in Malaysian postmenopausal women. Methods One hundred and thirty-six postmenopausal Malaysian women from Semenyih and Kuala Lumpur, Malaysia participated in the study. Muscle mass and body fat percentages (BFP) were assessed using a bioelectrical impedance analyser. Bone density was assessed using quantitative calcaneal ultrasonography. Handgrip strength (HGS) was assessed using a handgrip dynamometer. Gait speed was assessed using the 6-m walk test. The sarcopenia stage was classified into pre-sarcopenia, sarcopenia and severe sarcopenia. Results The overall prevalence of participants with various stages of 'sarcopenia' was 29.4%. The rates of low bone density were 13.7%, 12.5%, 17.4% and 85.7% in the non-sarcopenic, pre-sarcopenic, sarcopenic and severe sarcopenic groups, respectively (P < 0.000). Age, adiposity, muscle mass, gait speed and bone density differed significantly between the reference (non-sarcopenic) and 'severe sarcopenic' groups. The 'sarcopenic' and 'severe sarcopenic' groups had common impairments whereby no significant differences were found in HGS and gait speed between them. Conclusion The results showed significant correlations between sarcopenia stages and age, body weight, adiposity and bone density. Individuals with 'sarcopenia' had the same level of HGS and gait speed as those with severe forms of the disorder, implying that individuals with sarcopenia and severe sarcopenia were at the same level in terms of strength and endurance.
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Affiliation(s)
- Nurdiana Zainol Abidin
- School of Biosciences, Faculty of Science and Engineering, University of Nottingham Malaysia, Selangor, Malaysia. Department of Community Health, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Pulau Pinang, Malaysia
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Lim HS, Kim DK, Gil HI, Lee MY, Lee HS, Lee YT, Yoon KJ, Park CH. Association of Pulmonary Function with Osteosarcopenic Obesity in Older Adults Aged over 50 Years. Nutrients 2023; 15:2933. [PMID: 37447259 DOI: 10.3390/nu15132933] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Osteosarcopenic obesity (OSO) is a newly described coexistence of osteopenia/osteoporosis, sarcopenia, and obesity. We examined the association between pulmonary function, OSO, and its composition in adults aged ≥ 50 years. A total of 26,343 participants (8640 men; 17,703 women) were classified into four groups based on the number of abnormal body compositions (osteopenia/osteoporosis, sarcopenia, and obesity): 0 (control), 1+, 2+, and 3+ (OSO) abnormal body compositions. The values of forced volume vital capacity (FVC)%, forced expiratory volume in 1 s (FEV1%), and FEV1/FVC% were significantly decreased by increasing the number of adverse body compositions (p < 0.0001). Although the prevalence of restrictive spirometry pattern (RSP) was positively associated with a higher number of abnormal body composition parameters (p < 0.001), obstructive spirometry pattern (OSP) had no association with adverse body composition. In multivariate analyses, the adjusted odds ratios (ORs) for RSP compared to the control group were 1.36 in 1+, 1.47 in 2+, and 1.64 in 3+ abnormal body compositions (p for trend < 0.001). Multiple abnormal body composition, especially osteosarcopenic obesity, was independently associated with poor lung function showing RSP in older adults over 50 years. The coexistence of these abnormal body compositions may be a predisposing factor for pulmonary function deterioration.
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Affiliation(s)
- Han-Sol Lim
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Dong-Kun Kim
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Hyun-Il Gil
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Mi-Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Hyun-Seung Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Yong-Taek Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Kyung Jae Yoon
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Chul-Hyun Park
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
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6
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Liu Y, Song Y, Hao Q, Wu J. Global prevalence of osteosarcopenic obesity amongst middle aged and older adults: a systematic review and meta-analysis. Arch Osteoporos 2023; 18:60. [PMID: 37129731 DOI: 10.1007/s11657-023-01247-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/14/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE Osteosarcopenic obesity syndrome (OSO) is a recently recognized disorder encompassing osteopenia/osteoporosis, sarcopenia, and obesity. However, evidence in pooling knowledge regarding the prevalence of OSO worldwide is scarce. Hence, this review aimed to determine the pooled prevalence of OSO in middle-aged and older adults. METHODS We conducted systematic searches in Scopus, Embase, PubMed Central, MEDLINE, ScienceDirect, and Google Scholar from inception until October 2022. We evaluated the quality of the included studies using the Newcastle-Ottawa scale. The meta-analysis results using a random-effects model included the pooled prevalence and 95% confidence intervals (CIs). RESULTS We included 20 studies with a total of 23,909 participants. Most of the studies were of good quality. The final pooled prevalence of OSO in middle-aged and older adults worldwide was 8% (95% CI: 6%-11%; n = 20). Females (pooled prevalence = 9%; 95% CI:7%-12%; n = 17) had a higher burden of OSO than males (pooled prevalence = 5%; 95% CI:3%-8%; n = 11). We also found that the burden was higher among studies reporting OSO prevalence only in the elderly population (pooled prevalence = 13%; 95% CI: 9%-17%). The asymmetric nature of the funnel plot indicates the presence of publication bias. Additional sensitivity analysis did not reveal any significant variation in the pooled effect size estimation. CONCLUSION Approximately one in ten middle-aged and older adults suffer from OSO. The burden was highest among females and older adults. Diagnostic and intervention packages targeting such patients should be developed and implemented in high-risk settings.
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Affiliation(s)
- Ying Liu
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yi Song
- Early Phase Clinical Research Unit, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Qinjian Hao
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jinhui Wu
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Walowski CO, Herpich C, Enderle J, Braun W, Both M, Hasler M, Müller MJ, Norman K, Bosy-Westphal A. Determinants of bone mass in older adults with normal- and overweight derived from the crosstalk with muscle and adipose tissue. Sci Rep 2023; 13:5030. [PMID: 36977715 PMCID: PMC10050471 DOI: 10.1038/s41598-023-31642-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Lower bone mass in older adults may be mediated by the endocrine crosstalk between muscle, adipose tissue and bone. In 150 community-dwelling adults (59-86 years, BMI 17-37 kg/m2; 58.7% female), skeletal muscle mass index, adipose tissue and fat mass index (FMI) were determined. Levels of myokines, adipokines, osteokines, inflammation markers and insulin were measured as potential determinants of bone mineral content (BMC) and density (BMD). FMI was negatively associated with BMC and BMD after adjustment for mechanical loading effects of body weight (r-values between -0.37 and -0.71, all p < 0.05). Higher FMI was associated with higher leptin levels in both sexes, with higher hsCRP in women and with lower adiponectin levels in men. In addition to weight and FMI, sclerostin, osteocalcin, leptin × sex and adiponectin were independent predictors of BMC in a stepwise multiple regression analysis. Muscle mass, but not myokines, showed positive correlations with bone parameters that were weakened after adjusting for body weight (r-values between 0.27 and 0.58, all p < 0.01). Whereas the anabolic effect of muscle mass on bone in older adults may be partly explained by mechanical loading, the adverse effect of obesity on bone is possibly mediated by low-grade inflammation, higher leptin and lower adiponectin levels.
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Affiliation(s)
- Carina O Walowski
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany
| | - Catrin Herpich
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
- Department of Geriatrics and Medical Gerontology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Nutrition and Gerontology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany
| | - Janna Enderle
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany
| | - Wiebke Braun
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany
| | - Marcus Both
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Campus Kiel, Germany
| | - Mario Hasler
- Applied Statistics, Faculty of Agricultural and Nutritional Sciences, Christian-Albrechts-University, Kiel, Germany
| | - Manfred J Müller
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany
| | - Kristina Norman
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
- Department of Geriatrics and Medical Gerontology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Nutrition and Gerontology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Anja Bosy-Westphal
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany.
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Chung SJ, Lim HS, Lee MY, Lee YT, Yoon KJ, Park CH. Sex-Specific Associations between Serum Ferritin and Osteosarcopenic Obesity in Adults Aged over 50 Years. Nutrients 2022; 14:nu14194023. [PMID: 36235680 PMCID: PMC9570979 DOI: 10.3390/nu14194023] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
We investigated the sex-specific association between ferritin and adverse body composition in adults aged over 50 years in a population-based cohort. A total of 25,546 participants (16,912 women; 8634 men) were stratified into three groups by the tertiles of ferritin. The number of adverse body compositions was categorized as 0 (without osteopenia/osteoporosis, low muscle mass, or obesity), 1 (having one of the components), 2 (two), and 3 (all three; osteosarcopenic obesity). As ferritin tertile increased, the prevalence of one, two, or three simultaneous adverse body compositions increased, significant only in women (p < 0.0001), not in men (p = 0.125). Among women, the prevalence of osteosarcopenic obesity gradually increased from 1.7% in the lowest, to 2.2% in the middle, and 2.5% in the highest tertile. Using multivariate-adjusted analysis, women in the higher tertile had an increased likelihood of having multiple adverse body compositions compared with those in the lowest tertile. Women in the highest tertile had a 1.52 times increased risk of osteosarcopenic obesity than those in the lowest tertile. A high ferritin level was associated with an increased risk of having multiple adverse body compositions, especially for osteosarcopenic obesity in women aged >50 years, suggesting its potential use for detecting osteosarcopenic obesity.
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Affiliation(s)
- Sung-Joon Chung
- Department of Physical and Rehabilitation Medicine, Kyunghee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea
- Department of Medicine, Graduate School, Kyunghee University, Seoul 02447, Korea
| | - Han Sol Lim
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea
| | - Mi-Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea
| | - Yong-Taek Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea
| | - Kyung Jae Yoon
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06355, Korea
| | - Chul-Hyun Park
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea
- Correspondence: ; Tel.: +82-2-2001-2284
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Laskou F, Patel H, Cooper C, Dennison E. Functional capacity, sarcopenia, and bone health. Best Pract Res Clin Rheumatol 2022; 36:101756. [PMID: 35691825 DOI: 10.1016/j.berh.2022.101756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Bone and muscle are recognised as interacting tissues, the so-called 'muscle-bone unit', in which these two tissues communicate to coordinate their development (chemically and metabolically), as well as their response to loading or injury. Musculoskeletal disorders of ageing, specifically osteoporosis and sarcopenia, are highly prevalent in older individuals. They signify a significant burden for older people affecting their mobility, confidence, and quality of life, as well as being a major cost to healthcare systems worldwide. This review considers the coexistence of osteoporosis and sarcopenia in individuals and describes risk factors, clinical consequences, approaches to management, and the link with functional capacity.
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Affiliation(s)
- Faidra Laskou
- MRC Lifecourse Epidemiology Centre, Southampton, SO16 6YD, UK, USA.
| | - Harnish Patel
- MRC Lifecourse Epidemiology Centre, Southampton, SO16 6YD, UK, USA.
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, Southampton, SO16 6YD, UK, USA.
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Centre, Southampton, SO16 6YD, UK, USA.
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Ultrasonografically-Assessed Osteosarcopenic Obesity is Associated With Frailty In Community-Dwelling Older Adults. Nutrition 2022; 103-104:111827. [DOI: 10.1016/j.nut.2022.111827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 07/17/2022] [Accepted: 08/07/2022] [Indexed: 11/22/2022]
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Hernández-Martínez P, Olmos JM, Llorca J, Hernández JL, González-Macías J. Sarcopenic osteoporosis, sarcopenic obesity, and sarcopenic osteoporotic obesity in the Camargo cohort (Cantabria, Spain). Arch Osteoporos 2022; 17:105. [PMID: 35906442 PMCID: PMC9338160 DOI: 10.1007/s11657-022-01146-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 07/11/2022] [Indexed: 02/03/2023]
Abstract
The associations of sarcopenia with osteoporosis or obesity have a very low prevalence. No trend towards an association between osteoporosis and sarcopenia is observed. Sarcopenia and obesity tend not to coincide, as if they were antagonistic disorders. PURPOSE To know (a) the prevalence in our region of sarcopenic osteoporosis (association of sarcopenia and osteoporosis (T-score < - 2.5)), sarcopenic obesity, and the association of osteoporosis, sarcopenia, and obesity; (b) the tendency of osteoporosis, sarcopenia, and obesity to associate with each other; and (c) the bone mineral density (BMD), the components of sarcopenia, and the prevalence of fragility fractures in these associations. METHODS The study was performed in the Camargo cohort. Osteoporosis was diagnosed by DXA, sarcopenia by the EWGSOP-1 criteria, and obesity by body mass index (BMI) and fat percentage. Fractures were verified radiographically or by consulting the medical records. RESULTS The prevalence of sarcopenic osteoporosis was 2.8% and the OR for this association 1.03 (p = 0.89). The prevalence of sarcopenic obesity by BMI was 1.4% and by fat percentage 5.9% (corresponding ORs: 0.18 (p < 0.0001) and 0.58 (p < 0.003) respectively). The prevalence of the association of osteoporosis, sarcopenia, and obesity was 0.0% when assessed by BMI and 0.8% when assessed by fat percentage. Patients with sarcopenic osteoporosis have less muscle mass and more fragility fractures than sarcopenic patients overall. In patients with sarcopenic obesity by fat percentage, muscle mass and strength, as well as physical performance, were similar to those of sarcopenic patients overall. Neither BMD nor fracture prevalence showed differences between patients with sarcopenic obesity and patients with sarcopenia or obesity in general. CONCLUSION Our study supports the idea that the prevalence of the mixed disorders studied is low. No significant association between osteoporosis and sarcopenia was found. Sarcopenia and obesity seem to tend to occur in different people, as if suffering from one of them hinders suffering from the other.
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Affiliation(s)
| | - José M Olmos
- Department of Internal Medicine, Bone Metabolic Unit, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla s/n. 39008, Santander, Cantabria, Spain. .,IDIVAL (Instituto de Investigación Marqués de Valdecilla), Santander, Cantabria, Spain. .,Universidad de Cantabria, Santander, Spain.
| | - Javier Llorca
- Universidad de Cantabria, Santander, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - José L Hernández
- Department of Internal Medicine, Bone Metabolic Unit, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla s/n. 39008, Santander, Cantabria, Spain.,IDIVAL (Instituto de Investigación Marqués de Valdecilla), Santander, Cantabria, Spain.,Universidad de Cantabria, Santander, Spain
| | - Jesús González-Macías
- IDIVAL (Instituto de Investigación Marqués de Valdecilla), Santander, Cantabria, Spain.,Universidad de Cantabria, Santander, Spain
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12
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Effects of resistance training on body composition and physical function in elderly patients with osteosarcopenic obesity: a systematic review and meta-analysis. Arch Osteoporos 2022; 17:82. [PMID: 35654981 PMCID: PMC9163017 DOI: 10.1007/s11657-022-01120-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/13/2022] [Indexed: 02/03/2023]
Abstract
Osteosarcopenic obesity (OSO) is a complex disease commonly seen in the elderly. We found that resistance training may improve bone mineral density, skeletal muscle mass, and body fat percentage in patients with OSO. Therefore, resistance training is beneficial for elderly OSO patients and is worth being promoted. PURPOSE Investigate effects of resistance training on body composition and physical function in elderly osteosarcopenic obesity (OSO) patients. METHODS PubMed, Web of Science, Embase, Cochrane Library, Medline, SinoMed, CNKI, and Wanfang Database were searched from inception until October 13, 2021.Two independent researchers extracted the key information from each eligible study. The methodological quality of included studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. The Cochrane Risk of Bias Tool was used to assess the risk of bias. Grading of Recommendations Assessment Development and Evaluation (GRADE) was used to evaluate the quality of the outcomes. Sensitivity analysis indicated the stability of the results. Statistical analysis was performed using Review Manager 5.3. RESULTS Four randomized controlled studies meeting the inclusion criteria were included, with 182 participants. Twelve weeks of resistance training improved bone mineral density (BMD, mean difference (MD) = 0.01 g/cm2, 95% confidence interval (CI): 0.001, 0.02, P = 0.03, I2 = 0%), skeletal muscle mass (SMM, MD = 1.19 kg, 95% CI: 0.50, 1.89, P = 0.0007, I2 = 0%), Z score, timed chair rise test (TCR), and body fat percentage (BFP, MD = - 1.61%, 95% CI: - 2.94, - 0.28, P = 0.02, I2 = 50%) but did not significantly affect skeletal muscle mass index (SMI, MD = 0.20 kg/m2, 95% CI: - 0.25, 0.64, P = 0.38, I2 = 0%) or gait speed (GS). CONCLUSIONS Resistance training is a safe and effective intervention that can improve many parameters, including BFP, SMM, and Z score, among OSO patients and is a good option for elderly individuals to improve their physical fitness.
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13
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Di Filippo L, De Lorenzo R, Giustina A, Rovere-Querini P, Conte C. Vitamin D in Osteosarcopenic Obesity. Nutrients 2022; 14:1816. [PMID: 35565781 PMCID: PMC9100750 DOI: 10.3390/nu14091816] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 02/07/2023] Open
Abstract
Osteosarcopenic obesity is a unique clinical condition where low bone and muscle mass coexist in individuals with obesity. Alterations in adipose tissue, skeletal muscle and bone are strictly interconnected, and vitamin D plays key roles in several metabolic pathways that are involved in maintaining musculoskeletal health and glucose homeostasis. We reviewed the available literature on mechanisms underlying osteosarcopenic obesity, with a focus on the role of vitamin D in the pathogenesis and treatment of the condition. We found that, although evidence from large observational studies and pre-clinical experiments strongly supports a role of vitamin D deficiency in the pathogenesis of osteosarcopenic obesity, the common belief that vitamin D improves musculoskeletal health lacks solid clinical evidence, as trials specifically aimed at assessing the effects of vitamin D supplementation in patients with osteosarcopenic obesity are not available, and trials that investigated the role of vitamin D on muscle and bone health in other patient populations either showed no or even detrimental effects. We conclude that large observational and interventional studies including individuals with osteosarcopenic obesity representative of different sex, age and race are needed to better define the role of vitamin D in the pathogenesis and treatment of this condition.
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Affiliation(s)
- Luigi Di Filippo
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 00132 Milan, Italy; (L.D.F.); (R.D.L.); (A.G.); (P.R.-Q.)
- Institute of Endocrine and Metabolic Sciences, IRCCS San Raffaele Hospital, Via Olgettina 60, 00132 Milan, Italy
| | - Rebecca De Lorenzo
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 00132 Milan, Italy; (L.D.F.); (R.D.L.); (A.G.); (P.R.-Q.)
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Via Olgettina 60, 00132 Milan, Italy
| | - Andrea Giustina
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 00132 Milan, Italy; (L.D.F.); (R.D.L.); (A.G.); (P.R.-Q.)
- Institute of Endocrine and Metabolic Sciences, IRCCS San Raffaele Hospital, Via Olgettina 60, 00132 Milan, Italy
| | - Patrizia Rovere-Querini
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 00132 Milan, Italy; (L.D.F.); (R.D.L.); (A.G.); (P.R.-Q.)
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Via Olgettina 60, 00132 Milan, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta 247, 00166 Rome, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, 20900 Milan, Italy
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14
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Rinonapoli G, Pace V, Ruggiero C, Ceccarini P, Bisaccia M, Meccariello L, Caraffa A. Obesity and Bone: A Complex Relationship. Int J Mol Sci 2021; 22:ijms222413662. [PMID: 34948466 PMCID: PMC8706946 DOI: 10.3390/ijms222413662] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 12/29/2022] Open
Abstract
There is a large literature on the relationship between obesity and bone. What we can conclude from this review is that the increase in body weight causes an increase in BMD, both for a mechanical effect and for the greater amount of estrogens present in the adipose tissue. Nevertheless, despite an apparent strengthening of the bone witnessed by the increased BMD, the risk of fracture is higher. The greater risk of fracture in the obese subject is due to various factors, which are carefully analyzed by the Authors. These factors can be divided into metabolic factors and increased risk of falls. Fractures have an atypical distribution in the obese, with a lower incidence of typical osteoporotic fractures, such as those of hip, spine and wrist, and an increase in fractures of the ankle, upper leg, and humerus. In children, the distribution is different, but it is not the same in obese and normal-weight children. Specifically, the fractures of the lower limb are much more frequent in obese children. Sarcopenic obesity plays an important role. The authors also review the available literature regarding the effects of high-fat diet, weight loss and bariatric surgery.
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Affiliation(s)
- Giuseppe Rinonapoli
- Orthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (V.P.); (P.C.); (A.C.)
- Correspondence:
| | - Valerio Pace
- Orthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (V.P.); (P.C.); (A.C.)
| | - Carmelinda Ruggiero
- Orthogeriatric Service, Geriatric Unit, Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, 06156 Perugia, Italy;
| | - Paolo Ceccarini
- Orthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (V.P.); (P.C.); (A.C.)
| | - Michele Bisaccia
- Department of Orthopaedics and Traumatology, AORN San Pio “Gaetano Rummo Hospital”, Via R.Delcogliano, 82100 Benevento, Italy; (M.B.); (L.M.)
| | - Luigi Meccariello
- Department of Orthopaedics and Traumatology, AORN San Pio “Gaetano Rummo Hospital”, Via R.Delcogliano, 82100 Benevento, Italy; (M.B.); (L.M.)
| | - Auro Caraffa
- Orthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (V.P.); (P.C.); (A.C.)
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15
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Lee K. Bone Mediated and Moderated the Associations Between Sarcopenic Obesity Indices and Cardiovascular Disease Risk Scores. Calcif Tissue Int 2021; 109:490-498. [PMID: 33974097 DOI: 10.1007/s00223-021-00861-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/26/2021] [Indexed: 11/26/2022]
Abstract
To evaluate mediation and moderation of bone on the association of sarcopenic obesity (SO) indices using the metabolic load-capacity model with the 10-year cardiovascular disease risk scores (CVDR). In 2905 men and 3622 women (age ≥ 30 years), dual-energy X-ray absorptiometry was used to measure bone indicators [total bone mineral content percentage(TBM%), bone mineral density of femur neck (BMD_FN) and lumbar spines(BMD_LS)], total muscle (TMM) and fat mass (TFM), appendicular skeletal muscle mass (ASM), and truncal fat mass (TrFM). Two SO indices were TMM/TFM and ASM/TrFM. The Framingham model was used to calculate CVDR. Sex-specific mediation and moderation effects of bone indicators in the associations between the SO indices and the CVDR were analyzed. After adjusting for age, education, income, alcohol use, and physical activity, the SO indices inversely associated with the CVDR and TBM% inversely mediated those associations in both sexes. BMD inversely mediated those associations in men, while the mediation effects of BMD in women were non-significant or positive. In those aged ≥ 60, the mediation effects were found in TBM% and BMD_LS , but not in BMD_FN. The moderation analysis shows stronger inverse associations between the SO indices and the CVDR in those with low bone indicators in women and in men (for the relationship between ASM/TrFM and TBM%), while bone indicators did not moderate these associations in those aged ≥ 60. Bone mass mediated the associations between the SO indices and the CVDR in Korean men and women and moderated these associations in women.
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Affiliation(s)
- Kayoung Lee
- Department of Family Medicine, Busan Paik Hospital, College of Medicine, Inje University, 75, Bokji-ro, Busanjin-gu, Busan, 47392, Republic of Korea.
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16
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Hong YS, Kim H. Hand grip strength and health-related quality of life in postmenopausal women: a national population-based study. Menopause 2021; 28:1330-1339. [PMID: 34547005 DOI: 10.1097/gme.0000000000001863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Muscle strength progressively decreases after menopause. Hand grip strength (HGS) reflects overall muscle strength and may be associated with health-related quality of life (HRQoL). We aimed to assess the association between HGS and HRQoL in postmenopausal women. METHODS We used nationally representative data on 6,059 postmenopausal women from the Korea National Health and Nutrition Examination Survey (2014-2018). HGS was determined as the maximum value in kilograms (kg) achieved using either hand. HRQoL was estimated using the European Quality of Life Questionnaire-Five Dimensions (EQ-5D) questionnaire. The prevalence ratios of having moderate/severe problems on the EQ-5D were evaluated with adjustment for covariates using complex survey analysis. RESULTS The prevalence of having a problem in at least one of the HRQoL dimensions among postmenopausal women was 43.6%. Compared with participants with the lowest quintile of HGS, women in the highest quintile had a significantly lower prevalence of moderate/severe problems in most dimensions (fully adjusted prevalence ratios [95% confidence intervals]; 0.73 [0.60-0.89], 0.45 [0.28-0.72], 0.52 [0.38-0.71], 0.74 [0.63-0.87], and 0.91 [0.70-1.18] for mobility, self-care, usual activity, pain/discomfort, and anxiety/depression, respectively). The associations between HGS and EQ-5D index were stronger among the participants who were older (65-79 y), had a higher body mass index (≥ 25.0 kg/m2), had low physical activity, had a longer duration since menopause (≥ 10 y), and had a chronic disease. CONCLUSIONS Higher HGS was associated with a lower prevalence of moderate/severe problems in each dimension of the EQ-5D in postmenopausal women. These associations were more apparent in individuals who were older, had higher body mass index, or had a chronic disease.
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Affiliation(s)
- Yun Soo Hong
- Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Hoon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Jongno-gu, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Jongno-gu, Seoul, Korea
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17
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Runkel M. Author's Reply: The Role of Visceral Obesity, Sarcopenia and Sarcopenic Obesity on Surgical Outcomes After Liver Resections for Colorectal Metastases. World J Surg 2021; 45:3469-3470. [PMID: 34406454 PMCID: PMC8476454 DOI: 10.1007/s00268-021-06282-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Mira Runkel
- Department of General and Visceral Surgery, Medical Center- University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany.
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18
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Buch A, Marcus Y, Shefer G, Zimmet P, Stern N. Approach to Obesity in the Older Population. J Clin Endocrinol Metab 2021; 106:2788-2805. [PMID: 34406394 DOI: 10.1210/clinem/dgab359] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Indexed: 12/14/2022]
Abstract
Until recently, weight loss in older obese people was feared because of ensuing muscle loss and frailty. Facing overall increasing longevity, high rates of obesity in older individuals (age ≥ 65 years) and a growing recognition of the health and functional cost of the number of obesity years, abetted by evidence that intentional weight loss in older obese people is safe, this approach is gradually, but not unanimously, being replaced by more active principles. Lifestyle interventions that include reduced but sufficient energy intake, age-adequate protein and micronutrient intake, coupled with aerobic and resistance exercise tailored to personal limitations, can induce weight loss with improvement in frailty indices. Sustained weight loss at this age can prevent or ameliorate diabetes. More active steps are controversial. The use of weight loss medications, particularly glucagon-like peptide-1 analogs (liraglutide as the first example), provides an additional treatment tier. Its safety and cardiovascular health benefits have been convincingly shown in older obese patients with type 2 diabetes mellitus. In our opinion, this option should not be denied to obese individuals with prediabetes or other obesity-related comorbidities based on age. Finally, many reports now provide evidence that bariatric surgery can be safely performed in older people as the last treatment tier. Risk-benefit issues should be considered with extreme care and disclosed to candidates. The selection process requires good presurgical functional status, individualized consideration of the sequels of obesity, and reliance on centers that are highly experienced in the surgical procedure as well as short-term and long-term subsequent comprehensive care and support.
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Affiliation(s)
- Assaf Buch
- The Sagol Center for Epigenetics of Aging and Metabolism, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
- The Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Yonit Marcus
- The Sagol Center for Epigenetics of Aging and Metabolism, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
- The Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Gabi Shefer
- The Sagol Center for Epigenetics of Aging and Metabolism, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
- The Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Paul Zimmet
- The Sagol Center for Epigenetics of Aging and Metabolism, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria 3004, Australia
| | - Naftali Stern
- The Sagol Center for Epigenetics of Aging and Metabolism, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
- The Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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19
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Gandham A, Mesinovic J, Jansons P, Zengin A, Bonham MP, Ebeling PR, Scott D. Falls, fractures, and areal bone mineral density in older adults with sarcopenic obesity: A systematic review and meta-analysis. Obes Rev 2021; 22:e13187. [PMID: 33491333 DOI: 10.1111/obr.13187] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/14/2020] [Accepted: 11/15/2020] [Indexed: 12/23/2022]
Abstract
Sarcopenia and obesity are common conditions in older adults that may have differing effects on falls and fracture risk. This systematic review and meta-analysis aimed to determine whether older adults with sarcopenic obesity have increased risk of falls and fractures or lower bone mass compared with older adults with sarcopenia, obesity, or neither condition. Twenty-six studies (n = 37,124) were included in the systematic review and 17 (n = 31,540) were included in the meta-analysis. Older adults with sarcopenic obesity had lower femoral neck areal bone mineral density (aBMD) compared with those with obesity alone but had higher femoral neck aBMD compared with counterparts with sarcopenia alone (both P < 0.05). Older adults with sarcopenic obesity had higher nonvertebral fracture rates (incidence rate ratio: 1.88; 95% confidence intervals: 1.09, 3.23; based on two studies), compared with those with sarcopenia alone, and also had higher falls risk compared with controls (risk ratio: 1.30; 95% confidence intervals: 1.10, 1.54) and obesity alone (risk ratio: 1.17; 95% confidence intervals: 1.01, 1.36). In conclusion, this systematic review and meta-analysis has demonstrated that older adults with sarcopenic obesity are at increased risk of adverse musculoskeletal outcomes compared with individuals with obesity, sarcopenia, or neither condition. These data support the need for developing interventions to improve bone health and physical function in this population.
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Affiliation(s)
- Anoohya Gandham
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Paul Jansons
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Maxine P Bonham
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.,Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, Victoria, Australia
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20
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Gutiérrez-López L, Olivares-Corichi IM, Martínez-Arellanes LY, Mejía-Muñoz E, Polanco-Fierro JA, García-Sánchez JR. A moderate intensity exercise program improves physical function and oxidative damage in older women with and without sarcopenic obesity. Exp Gerontol 2021; 150:111360. [PMID: 33878422 DOI: 10.1016/j.exger.2021.111360] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 04/02/2021] [Accepted: 04/16/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES The excess of body fat and muscle mass loss in adulthood results in sarcopenic obesity, which is associated with disability and poor physical condition. A relationship among obesity, sarcopenia and oxidative stress also has been established. These aspects limit a good muscle function which is crucial in the independence of older women with and without sarcopenic obesity. This study had as objective to design a moderate intensity exercise program for older women with sarcopenic obesity, and to examine its effects on oxidative damage and physical function. We hypothesized that the exercise program will reduce oxidative damage and to improve the physical function of older women with sarcopenic obesity. METHODS Thirty healthy women (68 ± 5.05 years old) and 30 women with sarcopenic obesity (68.06 ± 5.75 years old) from the Integral Development of the Family rest home participated in the evaluation. The participants underwent evaluations of body composition, physical fitness (timed up-and-go [TUG] test, reaction time, gait speed, flexibility and muscle strength) and oxidative stress (oxidative damage to lipid and protein as well as evaluation of the antioxidant system) before and after of moderate intensity exercise program. The program consisted of warm-up, flexibility; aerobic exercises of moderate intensity (VO2 max and HR max between 60% and 70%); isotonic exercises of low intensity with progressive weight (250 g of initial weight, with increase every two weeks until reaching 750 g of final weight) and global stretching at the end of each section. The program was monitored on a personal basis and undertaken three times a week over three months. RESULTS In both groups, the program induced a five-fold increase in muscle strength, an increase in flexibility and improvement of fragility parameters (TUG and gait speed) (P ≤ 0.001, respectively). Furthermore, this exercise program decreased oxidative damage and increased antioxidant defense (P ≤ 0.001) to a greater extent in the sarcopenic group. CONCLUSION It was concluded that moderate intensity exercise is an effective approach to promote changes in body composition, physical fitness and to reduce oxidative damage in older women with and without sarcopenic obesity. These findings might have important implications for the prevention or treatment of sarcopenic obesity in older people.
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Affiliation(s)
- Liliana Gutiérrez-López
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - Ivonne M Olivares-Corichi
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - Liliam Y Martínez-Arellanes
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - Eduardo Mejía-Muñoz
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - José A Polanco-Fierro
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - José R García-Sánchez
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México, Mexico.
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21
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Osteosarcopenic adiposity syndrome update and the role of associated minerals and vitamins. Proc Nutr Soc 2021; 80:344-355. [DOI: 10.1017/s0029665121000586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The objectives are to present an updated synopsis on osteosarcopenic adiposity (OSA) syndrome and evaluate the roles of selected micronutrients in its prevention and management. OSA refers to the concurrent deterioration of bone (osteopenia/osteoporosis), muscle (sarcopenia) and adipose tissue expansion. It portrays the most advanced stage in a continuum of body composition disorders. Although OSA has been widely studied involving the populations of different backgrounds, its prevalence is hard to collate because different methodologies and criteria were used for its diagnosis. Another critical health aspect is the presence of low-grade chronic inflammation (LGCI) which contributes to OSA and vice versa. Nutrition is important in the prevention and management of both OSA and LGCI. Although micronutrients act in numerous metabolic and physiological processes, their roles here are presented in relation to OSA (and its components) and LGCI in general and relevant to the COVID-19 pandemic. These include calcium, magnesium, phosphorus, potassium, sodium and vitamins D and K; their interactions, physiological ratios and synergism/antagonism are discussed as well. In conclusion, calcium, magnesium and vitamin D have a profound impact on OSA and its components, and the latter two also on LGCI. Potassium and vitamin K are vital in bone, muscle functioning and possibly adipose tissue modification. Both, but particularly vitamin D, surfaced as important modulators of immune system with application in COVID-19 infections. While both phosphorus and sodium have important roles in bone, muscle and can impact adiposity, due to their abundance in food, their intake should be curbed to prevent possible damaging effects.
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22
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Determination of Cutoff Values for the Screening of Osteosarcopenia in Obese Postmenopausal Women. Curr Gerontol Geriatr Res 2021; 2021:6634474. [PMID: 33790963 PMCID: PMC7997768 DOI: 10.1155/2021/6634474] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/03/2021] [Accepted: 02/27/2021] [Indexed: 11/30/2022] Open
Abstract
Osteosarcopenic obesity (OSO) describes the concurrent presence of obesity, low bone mass, and low muscle mass in an individual. Currently, no established criteria exist to diagnose OSO. We hypothesized that obese individuals require different cut-points from standard cut-points to define low bone mass and low muscle mass due to their higher weight load. In this study, we determined cutoff values for the screening of osteosarcopenia (OS) in obese postmenopausal Malaysian women based on the measurements of quantitative ultrasound (QUS), bioelectrical impedance analysis (BIA), and functional performance test. Then, we compared the cutoff values derived by 3 different statistical modeling methods, (1) receiver operating characteristic (ROC) curve, (2) lowest quintile of the study population, and (3) 2 standard deviations (SD) below the mean value of a young reference group, and discussed the most suitable method to screen for the presence of OS in obese population. One hundred and forty-one (n = 141) postmenopausal Malaysian women participated in the study. Bone density was assessed using calcaneal quantitative ultrasound. Body composition was assessed using bioelectrical impedance analyzer. Handgrip strength was assessed using a handgrip dynamometer, and physical performance was assessed using a modified Short Physical Performance Battery test. ROC curve was determined to be the most suitable statistical modeling method to derive the cutoffs for the presence of OS in obese population. From the ROC curve method, the final model to estimate the probability of OS in obese postmenopausal women is comprised of five variables: handgrip strength (HGS, with area under the curve (AUC) = 0.698 and threshold ≤ 16.5 kg), skeletal muscle mass index (SMMI, AUC = 0.966 and threshold ≤ 8.2 kg/m2), fat-free mass index (FFMI, AUC = 0.946 and threshold ≤ 15.2 kg/m2), broadband ultrasonic attenuation (BUA, AUC = 0.987 and threshold ≤ 52.85 dB/MHz), and speed of sound (SOS, AUC = 0.991 and threshold ≤ 1492.15 m/s). Portable equipment may be used to screen for OS in obese women. Early identification of OS can help lower the risk of advanced functional impairment that can lead to physical disability in obese postmenopausal women.
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Lee YH, Lee PH, Lin LF, Liao CD, Liou TH, Huang SW. Effects of progressive elastic band resistance exercise for aged osteosarcopenic adiposity women. Exp Gerontol 2021; 147:111272. [PMID: 33549820 DOI: 10.1016/j.exger.2021.111272] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 01/06/2023]
Abstract
PURPOSE Osteosarcopenic adiposity (OSA), which is described as the concurrent occurrence of osteopenia, sarcopenia, and adiposity, can lead to frailty and increase the risk of physical disability in elderly women. Progressive elastic band resistance exercise training (peRET) is considered a safe and feasible exercise intervention for elderly women with sarcopenic obesity. This study investigated the effects of elastic band resistance exercise on the physical capacity and body composition of elderly women with osteosarcopenic adiposity. METHOD A total of 15 and 12 women were randomly assigned to the experimental (12 weeks of resistance exercise) and control groups (no exercise intervention), respectively. Lean mass (measured using a dual-energy X-ray absorptiometer) and physical capacity assessments (such as timed up and go test and single leg stance tests) were conducted at baseline, 12 weeks (end of intervention), and 6 months after the intervention. Outcome differences within the study and control groups were analyzed using repeated-measures analysis of variance with a post-hoc test. The Mann-Whitney U test was used to examine differences between groups at different time points. RESULTS After the intervention, no body composition changes in muscle mass and fat were observed between the study and control groups. Moreover, muscle mass and fat body composition did not significantly differ at different time points. The bone density was higher in the study group, with a higher T-score than their baseline values, but did not significantly differ compared with the control group. The study group exhibited more improved physical function than the control group, but the effect did not last after 6 months of follow-up. CONCLUSIONS A 12-week progressive elastic band resistance training program effectively increased the physical capacity and improved the bone density; however, without persistent training, the positive effect diminished at 6-month follow-up.
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Affiliation(s)
- Yu-Hao Lee
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Pi-Hsia Lee
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 10675, Taiwan
| | - Li-Fong Lin
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Institute of Gerontology and Health Management, Taipei Medical University, Taipei, Taiwan
| | - Chun-De Liao
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan.
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24
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Ahn KH, Lee Y, Sohn TY, Kim DY, Ryu M, Gym H, Lee S. Association between Relative Handgrip Strength and Osteoporosis in Older Women: The Korea National Health and Nutrition Examination Survey 2014-2018. Ann Geriatr Med Res 2021; 24:243-251. [PMID: 33389972 PMCID: PMC7781960 DOI: 10.4235/agmr.20.0076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/18/2020] [Indexed: 02/03/2023] Open
Abstract
Background While handgrip strength is associated with osteoporosis in the older population and muscle weakness is related to a reduction in bone mineral density, no study has yet assessed the association between relative hand grip strength (RHGS) and osteoporosis in the older Korean population. This study assessed the associations between RHGS and osteoporosis in Korean older women aged over 60 years. Methods We used data of 4,179 older women from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2014 to 2018. We applied binomial logistic regression to identify an association between RHGS and osteoporosis while controlling for other covariates such as age; socioeconomic status; smoking behavior; alcohol consumption, laboratory test results; and the prevalence of hypertension, diabetes mellitus, thyroid disease, and obesity. Results RHGS was significantly associated with osteoporosis of the left hand in older Korean women. RHGS levels 2 and 4 of the left hand showed an inverse association with the prevalence of osteoporosis in female participants aged 60–69 years (odds ratio [OR]=0.637; 95% confidence interval [CI], 0.452–0.898; p=0.010; and OR=0.496; 95% CI, 0.258–0.956; p=0.036, respectively) but not in those aged over 70 years and in the right hand. Conclusion osteoporosis was significantly associated with left-hand RHGS in 60–69-year-old women, and the osteoporosis risks decreased by approximately 36.3% and 50.4% in women with RHGS levels 2 and 4, respectively. RHGS may be used to predict osteoporosis in pre-clinical settings such as public health care institutes.
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Affiliation(s)
- Kwang-Ho Ahn
- Uijeongbu Seoul-Chuk Hospital, Uijeongbu, Korea.,Institute on Aging, Ajou University Medical Center, Suwon, Korea
| | - Yunhwan Lee
- Institute on Aging, Ajou University Medical Center, Suwon, Korea.,Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Tae-Yong Sohn
- Department of u-Health Service Administration, Yuhan University, Bucheon, Korea
| | | | - Mikyung Ryu
- Institute on Aging, Ajou University Medical Center, Suwon, Korea.,Department of Sports and Health Science, College of Human-Centered Convergence, Kyonggi University, Suwon, Korea
| | - Ho Gym
- Department of BBKO Research Center, BBKO Co. Ltd., Seoul, Korea.,Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Sol Lee
- Department of BBKO Research Center, BBKO Co. Ltd., Seoul, Korea.,Department of Health Policy and Management, Korea University, Seoul, Korea
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25
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Ilich JZ. Nutritional and Behavioral Approaches to Body Composition and Low-Grade Chronic Inflammation Management for Older Adults in the Ordinary and COVID-19 Times. Nutrients 2020; 12:nu12123898. [PMID: 33419325 PMCID: PMC7767148 DOI: 10.3390/nu12123898] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022] Open
Abstract
As more insight is gained into personalized health care, the importance of personalized nutritional and behavioral approaches is even more relevant in the COVID-19 era, in addition to the need for further elucidation regarding several diseases/conditions. One of these concerning body composition (in this context; bone, lean and adipose tissue) is osteosarcopenic adiposity (OSA) syndrome. OSA occurs most often with aging, but also in cases of some chronic diseases and is exacerbated with the presence of low-grade chronic inflammation (LGCI). OSA has been associated with poor nutrition, metabolic disorders and diminished functional abilities. This paper addresses various influences on OSA and LGCI, as well as their mutual action on each other, and provides nutritional and behavioral approaches which could be personalized to help with either preventing or managing OSA and LGCI in general, and specifically in the time of the COVID-19 pandemic. Addressed in more detail are nutritional recommendations for and roles of macro- and micronutrients and bioactive food components; the microbiome; and optimal physical activity regimens. Other issues, such as food insecurity and nutritional inadequacy, circadian misalignment and shift workers are addressed as well. Since there is still a lack of longer-term primary studies in COVID-19 patients (either acute or recovered) and interventions for OSA improvement, this discussion is based on the existing knowledge, scientific hypotheses and observations derived from similar conditions or studies just being published at the time of this writing.
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Affiliation(s)
- Jasminka Z Ilich
- Institute for Successful Longevity, Florida State University, Tallahassee, FL 32306, USA
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26
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Obesity Associated with Low Lean Mass and Low Bone Density Has Higher Impact on General Health in Middle-Aged and Older Adults. J Obes 2020. [DOI: 10.1155/2020/8359616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
It is believed that the phenomenon of simultaneous changes in body composition could have a higher negative impact on general health. Thus, we aimed to investigate the prevalence of concomitant body composition disturbances and evaluate the association with dietary intake, sedentary behaviour, muscle strength, and performance. This is a cross-sectional study with 218 community-dwelling adults, aged 63 (59–69) years, both sexes (52% female) recruited from the Health Survey of the City of São Paulo. Assessments include appendicular lean mass (LM), fat mass and bone mineral density (BMD) by DXA, grip strength, time spent sitting, and dietary intake. Subjects were clustered into 8 groups: (1) normal, (2) osteopenia (OP), (3) low LM, (4) obesity, (5) OP + low LM, (6) obesity + OP, (7) obesity + low LM, and (8) obesity + OP + low LM. Statistical analyses include ANCOVA, the chi-square test, and linear regression models. 52 (23%) individuals presented obesity associated with another body composition change, with 14 (6%) having the combination of the 3 conditions (obesity + OP + low LM). All groups with obesity showed lower protein intake (
); however, those with obesity or obesity + low LM spent more time in a sitting position (
), and the group with obesity + OP + low LM had the lowest grip strength. The combination of obesity with low LM and OP presented the aggravating factor of being associated with lower grip strength. In a context of demographic and nutrition transition, the findings represent a demand for longitudinal investigations.
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Choi MK, Bae YJ. Protein intake and osteosarcopenic adiposity in Korean adults aged 50 years and older. Osteoporos Int 2020; 31:2363-2372. [PMID: 32638050 DOI: 10.1007/s00198-020-05529-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 06/30/2020] [Indexed: 12/19/2022]
Abstract
UNLABELLED Intake of plant-based protein and recommended protein intake are associated with a lower risk of osteosarcopenic adiposity (co-occurrence of osteopenia/osteoporosis, sarcopenia, and adiposity) in elderly Korean men. INTRODUCTION Osteosarcopenic adiposity (OSA) syndrome is defined as the concurrent presence of osteopenia/osteoporosis, sarcopenia, and adiposity and leads to negative functional and metabolic outcomes in late adulthood. This study aimed to investigate the association between OSA and protein intake in adults aged 50 or older. METHODS A population-based, cross-sectional survey was conducted using the Korea National Health and Nutrition Examination Survey 2008-2009 data and included 645 men and 706 women aged 50 or older. Subjects were classified into normal and OSA groups. Protein intake was analyzed using the 24-h recall method. RESULTS There was no significant difference in the intake of total protein and animal-based protein between normal and OSA groups. However, in males, the intake of plant-based protein (p = 0.0031) was significantly lower in the OSA group than that in the normal group. Further, the protein intake in the OSA group was 0.96 g/kg/day, which was significantly lower than that in the normal group (1.06 g/kg/day; p = 0.0203). After adjusting for confounding factors, men over 65 years old who consumed less than the recommended nutrient intake (RNI) of 0.91 g/kg/day had 5.82 times higher risk of OSA compared with subjects consuming protein equal to or greater than the RNI amount (95% CI 1.81-18.66). CONCLUSION In conclusion, a protein intake of RNI or more is associated with a lower risk of OSA in Korean elderly men.
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Affiliation(s)
- M-K Choi
- Division of Food Science, Kongju National University, Yesan, South Korea
| | - Y-J Bae
- Division of Food Science and Biotechnology, Korea National University of Transportation, Jeungpyeong, South Korea.
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Kolbaşı EN, Demirdağ F. Prevalence of osteosarcopenic obesity in community-dwelling older adults: a cross-sectional retrospective study. Arch Osteoporos 2020; 15:166. [PMID: 33079259 DOI: 10.1007/s11657-020-00829-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/25/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED In our study investigating the prevalence of osteosarcopenic obesity (OSO) in community-dwelling older adults and possible factors responsible for falls, we have found that prevalence of OSO is 10.7%. OSO does not significantly increase the odds of falling, whereas lower handgrip strength, ALMi and gait speed were independent factors associated with falls. PURPOSES The purposes of the study were (a) to determine the prevalence of osteosarcopenic obesity (OSO) in community-dwelling older adults and (b) to investigate the association between falls and possible factors in individuals with and without OSO. METHODS Medical records of patients aged ≥ 65 years were retrospectively reviewed. Individuals were diagnosed with OSO based on their T-score assessed by dual x-ray absorptiometry, handgrip strength, appendicular lean mass index (ALMi), gait speed and body fat percentile. Comorbidities, history of falls, depressive state, medications and anthropometric measures were also noted. RESULTS A sample of 460 individuals were assessed (337 females; 123 males) and 49 patients were diagnosed with OSO. There was no statistically significant difference in falls between the two groups (OR: 0.768, 95% CI: 0.409-1.440, p: 0.41) and the presence of OSO was not significantly associated with increased odds of falling (OR: 1.755, 95% CI: 0.547-5.628, p: 0.344). Handgrip strength (OR: 0.931, 95% CI: 0.893-0.971, p: 0.001), ALMi (OR: 0.799, 95% CI: 0.708-0.901, p < 0.0001) and gait speed (OR: 0.529, 95% CI: 0.283-0.988, p: 0.046) were independently associated with falls in overall group, whereas interaction analysis did not reveal any significant moderator effect of OSO vs. non-OSO in the associations between risk factors and falls. CONCLUSION The prevalence of OSO was 10.7%. OSO was not associated with elevated odds of falling, whereas lower handgrip strength, ALMi and gait speed were independent factors associated with falls. Further prospective research is needed to clarify the effect of OSO on odds of falling, in consideration with possible risk factors. TRIAL REGISTRATION NUMBER AND DATE NCT04288401 /26.02.2020.
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Affiliation(s)
- Esma Nur Kolbaşı
- Department of Physiotherapy and Rehabilitation, Istanbul Medeniyet University, Cevizli Campus, Atalar, Şht. Hakan Kurban Cd. No:44, 34862, Kartal/Istanbul, Turkey.
| | - Filiz Demirdağ
- Ümraniye Training and Research Hospital/Palliative Care Unit, University of Health Sciences, Istanbul, Turkey
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29
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Use of the Handgrip Strength Test in the Identification of Osteosarcopenic Obesity in Older Women. TOPICS IN GERIATRIC REHABILITATION 2020. [DOI: 10.1097/tgr.0000000000000284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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The role of body composition assessment in obesity and eating disorders. Eur J Radiol 2020; 131:109227. [DOI: 10.1016/j.ejrad.2020.109227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/29/2020] [Accepted: 08/14/2020] [Indexed: 12/12/2022]
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31
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Lee K. Association of osteosarcopenic obesity and its components: osteoporosis, sarcopenia and obesity with insulin resistance. J Bone Miner Metab 2020; 38:695-701. [PMID: 32335754 DOI: 10.1007/s00774-020-01104-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/28/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION To evaluate the differences in the associations of combinations of co-existent osteopenia, obesity, and/or sarcopenia with insulin resistance (IR) according to different criteria of obesity. MATERIALS AND METHODS Among 4500 Korean men and postmenopausal women who were aged ≥ 50 years and did not have diabetes mellitus, osteopenia, sarcopenia, and obesity were defined using bone mineral density, skeletal mass index, and body fat % (or BMI). Body composition groups were generated based on the combinations of these components. IR was defined using the HOMA-IR ≥ 2.5. RESULTS When obesity was defined by body fat % and the relationships were adjusted for age, sex, education, and health behaviors, the odds ratios (ORs) for IR was highest in the groups with obesity and osteopenic obesity, followed by sarcopenic obesity and osteosarcopenic obesity, followed by osteopenia and sarcopenia, and followed by osteosarcopenia. When BMI was additionally adjusted, the ORs for IR were not significantly different between body composition groups except for osteopenia: those groups had higher ORs for IR compared to osteopenia. When obesity was defined by BMI, obesity co-existent groups had higher ORs for IR than the obesity non-coexistent groups. The ORs for IR were not significantly different within obesity co-existent groups or obesity non-coexistent groups. CONCLUSIONS Combinations of co-existent osteopenia, obesity, and/or sarcopenia had different associations with IR according to obesity classification methods and consideration of BMI adjustment. Osteosarcopenic obesity may not have a stronger association with IR compared to obesity only and obesity co-existent other conditions.
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Affiliation(s)
- Kayoung Lee
- Department of Family Medicine, Busan Paik Hospital, College of Medicine, Inje University, 75, Bokji-ro, Busanjin-gu, Busan, 47392, Republic of Korea.
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Ma Y, Zhang W, Han P, Kohzuki M, Guo Q. Osteosarcopenic Obesity Associated with Poor Physical Performance in the Elderly Chinese Community. Clin Interv Aging 2020; 15:1343-1352. [PMID: 32848375 PMCID: PMC7429206 DOI: 10.2147/cia.s257739] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/27/2020] [Indexed: 12/12/2022] Open
Abstract
Objective The aims of this study were to investigate the association between osteosarcopenic obesity (OSO) and physical performance in Chinese elderly communities. Methods Our study population is comprised of residents of the Township Central Hospital in the suburban of Tianjin, China. Participants (n=303; percent body fat (PBF): ≥25% for men and ≥32% for women) were assessed using the direct segmental multi-frequency bioelectrical impedance analysis (BIA) for body composition. Sarcopenia was defined as the lower 20th percentile of appendicular skeletal muscle mass/height2 (ASMI). A quantitative ultrasound scan of each participants’ calcaneus with a T score≤−1.0 was used to identify the prevalence of osteopenia/osteoporosis (OP). We divided people into four groups: obesity only (O), osteopenic obesity (OO), sarcopenic obesity (SO), and osteosarcopenic obesity (OSO). We assessed the physical performance by grip strength, 4-m walk test (WS) and timed up and go test (TUGT). Results A total of 303 participants had completed data (89 men, 214 women; mean age of 68.8±6.0 years). The prevalence of OSO was 10.2% (men: 15.70%, women: 7.9%). After multiple adjustments, WS was significantly declined in OSO group when compared with the O group in men (mean value 95% CI was 0.84 (0.69, 0.99)) and women (mean value 95% CI was 0.93 (0.84, 1.02)). TUGT was significantly poorer in men (mean value 95% CI was 13.3 (10.6, 15.9)) and women (mean value 95% CI was 12.4 (11.2, 13.7)) with OSO when compared with the O group. Furthermore, the OSO group in women also had a significantly poorer TUGT compared with the OO group. The result of grip strength decreased significantly in women SO and OSO groups when compared with the O group (mean value 95% CI was 16.4 (14.5, 18.2) and 16.1 (13.9, 18.3)). But the results of grip strength in men showed no significant differences in any of the group. Conclusion In Chinese community-dwelling elderly, slower WS and lower balance function were associated with OSO in men and women. Lower grip strength was associated with SO and OSO in women.
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Affiliation(s)
- Yixuan Ma
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Wen Zhang
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Tohoku University, Sendai, Japan.,Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, People's Republic of China
| | - Peipei Han
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Masahiro Kohzuki
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Qi Guo
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
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Kim YM, Kim S, Bae J, Kim SH, Won YJ. Association between relative hand-grip strength and chronic cardiometabolic and musculoskeletal diseases in Koreans: A cross-sectional study. Arch Gerontol Geriatr 2020; 92:104181. [PMID: 32971397 DOI: 10.1016/j.archger.2020.104181] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES This study evaluated clinical and cardiometabolic markers associated with relative hand-grip strength (HGS), and investigated odds ratios (ORs) for chronic cardiometabolic and musculoskeletal diseases according to relative HGS. METHODS This cross-sectional observational study enrolled subjects from the Korea National Health and Nutrition Examination Survey who were 50 years and older (N = 2451). Information on chronic diseases was taken by individual surveys and other proper criteria were applied for undiagnosed subjects. Absolute HGS was calculated from the maximal bilateral HGS (kg) as measured by a dynamometer and relative HGS was calculated by dividing absolute HGS by body mass index (BMI). Associated clinical and cardiometabolic markers to relative HGS were investigated and ORs for chronic diseases according to relative HGS tertiles were estimated from multivariate linear or logistic regression analyses. RESULTS The mean relative HGS (kg/BMI) was 3.1 ± 0.6 for men and 1.9 ± 0.5 for women. Insulin-resistance parameters and high-sensitivity C-reactive protein were negatively and high-density lipoprotein cholesterol was positively related with relative HGS in both sexes adjusting for age and lifestyle factors, while systolic blood pressure showed negative relationship in women. High ORs for various chronic diseases were observed in the lowest relative HGS tertile of both sexes, but high OR for hyperlipidemia was observed only in women. CONCLUSIONS Relative HGS is a convenient measure for overall muscle strength according to body size and may have an influence on chronic disease development or aggravation. Thus, relative HGS might be a cost-effective and useful tool to screen for prevalent chronic diseases in elderly population.
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Affiliation(s)
- Yoo Mee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, South Korea
| | - Sunghoon Kim
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jaehyun Bae
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, South Korea
| | - Se Hwa Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, South Korea
| | - Young Jun Won
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, South Korea.
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Obesity, dynapenia, and their combination: Implications for bone mineral density in Brazilian adults-the Pró-Saúde study. Nutrition 2020; 81:110898. [PMID: 32739661 DOI: 10.1016/j.nut.2020.110898] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 05/07/2020] [Accepted: 05/16/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES This study aimed to evaluate bone mineral density (BMD) in the presence or absence of dynapenia or obesity in Brazilian adults. METHODS This is a cross-sectional study conducted in 502 adults (age: 33-81 y; 51% women) participating in the Pró-Saúde study, a cohort of civil servants at the university campuses in Rio de Janeiro, Brazil. Body composition and BMD were determined by dual energy x-ray absorptiometry. Handgrip strength was measured using a dynamometer. According to measures of handgrip strength (≤19 kg for women; ≤32 kg for men) and fat mass (>30% for men; >40% for women), participants were classified into four groups: non-obese non-dynapenic, obese non-dynapenic, non-obese dynapenic, and obese dynapenic. The association between BMD at each specific bone site and obesity, dynapenia, and their interaction was evaluated using a general linear model. RESULTS The prevalence of dynapenic obesity was 14% in men and 15.2% in women. Dynapenia alone was not associated with BMD at any site in either men nor women. Obesity and dynapenia interacted to influence BMD in women (P < 0.05). Total body, lumbar spine, and femoral neck BMD were higher by 6.3%, 9.3%, and 10.4%, respectively, in dynapenic obese women compared with their non-obese counterparts (P < 0.05). In men, obesity, dynapenia, and their combination were not associated with BMD at any site. CONCLUSIONS Our results suggest that dynapenia, obesity, and their combination may affect BMD in a sex-dependent manner. In the presence of dynapenia, fat mass appears to exert a protective effect on BMD in women, but not in men.
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Ilich JZ, Gilman JC, Cvijetic S, Boschiero D. Chronic Stress Contributes to Osteosarcopenic Adiposity via Inflammation and Immune Modulation: The Case for More Precise Nutritional Investigation. Nutrients 2020; 12:nu12040989. [PMID: 32252359 PMCID: PMC7230299 DOI: 10.3390/nu12040989] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/29/2020] [Accepted: 03/31/2020] [Indexed: 02/07/2023] Open
Abstract
Chronic stress and low-grade chronic inflammation (LGCI) are key underlying factors formany diseases, including bone and body composition impairments. Objectives of this narrativereview were to examine the mechanisms by which chronic stress and LGCI may influenceosteosarcopenic adiposity (OSA) syndrome, originally named as ostoesarcopenic obesity (OSO).We also examined the crucial nutrients presumed to be affected by or cause of stress andinflammation and compared/contrasted them to those of our prehistoric ancestors. The evidenceshows that stress (particularly chronic) and its related inflammatory processes, contribute toosteoporosis, sarcopenia, and adiposity ultimately leading to OSA as a final and most derangedstate of body composition, commencing at the mesenchymal cell lineage disturbance. Thefoods/nutrients consumed by modern humans, as well as their altered lifestyle, also contribute tostress, LGCI and subsequently to OSA. The processes can also go in opposite direction when stressand inflammation impact nutritional status, particularly some micronutrients' levels. Whilenutritional management of body composition and LGCI have been studied, the nutrients (and theirquantities) most affected by stressors and those which may act toward the alleviation of stressfulstate, ultimately leading to better body composition outcomes, need to be elucidated.
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Affiliation(s)
- Jasminka Z. Ilich
- Institute for Successful Longevity, Florida State University, Tallahassee, FL 32306, USA
- Correspondence:
| | | | - Selma Cvijetic
- Institute for Medical Research and Occupational Health, 11000 Zagreb, Croatia;
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Keramidaki K, Tsagari A, Hiona M, Risvas G. Osteosarcopenic obesity, the coexistence of osteoporosis, sarcopenia and obesity and consequences in the quality of life in older adults ≥65 years-old in Greece. J Frailty Sarcopenia Falls 2019; 4:91-101. [PMID: 32300723 PMCID: PMC7155308 DOI: 10.22540/jfsf-04-091] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE We investigated the coexistence of sarcopenia and obesity in older adults≥65 years diagnosed with osteoporosis and the association with Quality of Life (QoL). METHODS A Cross-sectional survey has been performed on a randomized sample of 50 diagnosed osteoporotic elderly people from both sexes (Men=16; Women=34). MEASUREMENTS Quantitative ultrasound was conducted to identify osteoporosis and defined with a T score ≤2.5. Validated anthropometric equations were used in order to estimate body fat percentage and skeletal muscle mass so as to detect the reallocation of body fat and lean muscle. 10m gait speed and hand grip strength was measured in order to diagnose sarcopenia according to European Society for Clinical Nutrition and Metabolism (ESPEN) algorithm. The evaluation of QoL was conducted using a QoL questionnaire specific to osteoporosis. The data were analyzed with descriptive statistics and a chi-square test was performed to examine if Osteosarcopenic Obesity (OSO) is sex related and the correlation between OSO and QoL. RESULTS From the 50 participants, 40%(n=19) were classified as people with OSO and 60%(n=31) without OSO. From n=19 people that experienced OSO women represent 20% (n=9) and men 18% (n=9); with the latter had a greater decline in muscle mass than women, while women had lower BMD than men according to the z score. OSO is not related with sex (p>.05) and there is no significant association between OSO and QoL (p> .05 for all the domains of QoL questionnaire). CONCLUSION Osteoporosis in the elderly often coexists with reduced muscle mass and muscle strength as well as an increase in adiposity and was independently associated with QoL. People that experience OSO presenting lower functionality that increases the risk for falls and bone fractures originated from the decline in bone and muscle mass, and increased adiposity. Increased awareness of OSO may help develop efficient interventions and public health policies for healthier and more active elderly people.
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Affiliation(s)
- Konstantia Keramidaki
- Outpatient Οbesity Clinic, EASO accredited Center for Obesity Management (COM), 1 Propaedeutic Internal Medicine Department, University Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
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Wang WF, Lin CW, Xie CN, Liu HT, Zhu MY, Huang KL, Teng HL. The association between sarcopenia and osteoporotic vertebral compression refractures. Osteoporos Int 2019; 30:2459-2467. [PMID: 31482304 DOI: 10.1007/s00198-019-05144-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 08/21/2019] [Indexed: 12/24/2022]
Abstract
UNLABELLED Sarcopenia was reported to be significantly associated with osteoporosis. In this study, we reported for the first time that sarcopenia was an independent risk predictor of osteoporotic vertebral compression refractures (OVCRFs). Other risk factors of OVCRFs are low bone mass density T-scores, female sex, and advanced age. INTRODUCTION The purpose of this study was to investigate the association between osteoporotic vertebral compression refractures (OVCRFs) and sarcopenia, and to identify other risk factors of OVCRFs. METHODS We evaluated 237 patients with osteoporotic vertebral compression fracture who underwent percutaneous kyphoplasty (PKP) in our hospital from August 2016 to December 2017. To diagnose sarcopenia, a cross-sectional computed tomography (CT) image at the inferior aspect of the third lumbar vertebra (L3) was selected for estimating muscle mass. Grip strength was used to assess muscle strength. Possible risk factors, such as age, sex, body mass index (BMI), bone mineral density (BMD), location of the treated vertebra, anterior-posterior ratio (AP ratio) of the fractured vertebra, cement leakage, and vacuum clefts, were assessed. The multivariable analysis was used to determine the risk factors of OVCRFs. RESULTS During the follow-up period, OVCRFs occurred in 64 (27.0%) patients. Sarcopenia was present in 48 patients (20.3%), including 21 OVCRFs and 27 non-OVCRFs patients. Sarcopenia was significantly correlated with advanced age, lower BMI, lower BMD, and hypoalbuminemia. Compared with non-sarcopenic patients, sarcopenic patients had higher OVCRFs risk. In univariate analysis, sarcopenia (p = 0.003), female (p = 0.024), advanced age (≥ 75 years; p < 0.001), lower BMD (p < 0.001), lower BMI (p = 0.01), TL junction (vertebral levels at the thoracolumbar junction) (p = 0.01), cardiopulmonary comorbidity (p = 0.042), and hypoalbuminemia (p = 0.003) were associated with OVCRFs. Multivariable analysis revealed that sarcopenia (OR 2.271; 95% CI 1.069-4.824, p = 0.033), lower BMD (OR 1.968; 95% CI 1.350-2.868, p < 0.001), advanced age (≥ 75 years; OR 2.431; 95% CI 1.246-4.744, p = 0.009), and female sex (OR 4.666; 95% CI 1.400-15.552, p = 0.012) were independent risk predictors of OVCRFs. CONCLUSIONS Sarcopenia is an independent risk predictor of osteoporotic vertebral compression refractures. Other factors affecting OVCRFs are low BMD T-scores, female sex, and advanced age.
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Affiliation(s)
- W-F Wang
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - C-W Lin
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - C-N Xie
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - H-T Liu
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - M-Y Zhu
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - K-L Huang
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - H-L Teng
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China.
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Physical activity is associated with functional capacity of older women with osteosarcopenic obesity: 24-month prospective study. Eur J Clin Nutr 2019; 74:912-919. [PMID: 31551532 DOI: 10.1038/s41430-019-0505-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/23/2019] [Accepted: 09/05/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND/OBJECTIVES Physical activity (PA) could be effective in the prevention of functional disability in older women, especially for those with body composition abnormalities. The aim this study was to analyze the association of total PA and in different domains with physical function and functional capacity in older women with or without osteosarcopenic obesity (OSO), as well as to assess the risk of functional disability in osteosarcopenic obesity older women insufficiently active. SUBJECTS/METHODS The study included 152 Brazilian older women, aged 60 years and older. Body composition was measured by dual energy X-ray absorptiometry (DXA) and physical function by physical tests. Functional capacity and PA were self-reported. RESULTS In older women without OSO, the practice of leisure-time exercise (β:-0.23; 95%CI -0.40 to -0.06) and total PA (β:-0.40; 95%CI -0.57 to -0.23) is inversely associated with dependence in ADL. In older women with OSO, the practice of leisure-time exercise was inversely associated with physical function (β:0.88; 95%CI 0.31-1.46) and functional capacity (β:-1.05; 95%CI 1.64 to -0.45), while total PA (β:-1.03; 95%CI -1.93 to -0.13) was inversely associated with functional capacity, independent of control variables. In addition, older women with OSO who remained insufficiently active in leisure-time exercise (HR:2.28; 95%CI 1.04-4.99) and locomotion (HR:2.62; 95%CI 1.28-5.36) domains presented risk for functional disability. CONCLUSIONS PA is inversely associated with physical function and functional capacity in older women with or without OSO, and older women with OSO who are insufficiently active in leisure-time exercise and locomotion domains presented a higher risk for functional disability.
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Bauer JM, Cruz-Jentoft AJ, Fielding RA, Kanis JA, Reginster JY, Bruyère O, Cesari M, Chapurlat R, Al-Daghri N, Dennison E, Kaufman JM, Landi F, Laslop A, Locquet M, Maggi S, McCloskey E, Perna S, Rizzoli R, Rolland Y, Rondanelli M, Szulc P, Vellas B, Vlaskovska M, Cooper C. Is There Enough Evidence for Osteosarcopenic Obesity as a Distinct Entity? A Critical Literature Review. Calcif Tissue Int 2019; 105:109-124. [PMID: 31098729 DOI: 10.1007/s00223-019-00561-w] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 05/02/2019] [Indexed: 12/16/2022]
Abstract
The co-existence of impaired bone health (osteopenia/osteoporosis), reduced muscle mass and strength (sarcopenia), and increased adiposity (obesity) in middle-aged and older people has been identified in recent studies, leading to a proposal for the existence of "osteosarcopenic obesity" as a distinct entity. Evidence for the pathophysiological overlap of these conditions is mounting, although a causal relationship is yet to be established. Each component condition occurs frequently with increasing age, and with shared risk factors in many instances, thus, an overlap of these three conditions is not surprising. However, whether the concurrent existence of sarcopenia, osteoporosis and obesity leads to an increased risk of adverse musculoskeletal outcomes and mortality above and beyond the risks associated with the sum of the component parts remains to be proven and is a question of research interest. In this article, we review evidence for the existence of osteosarcopenic obesity including the current operational definition of osteosarcopenic obesity, prevalence, pathophysiology, outcomes and exploratory approaches to the management of components. We conclude that, there is insufficient evidence to support a discrete clinical entity of osteosarcopenic obesity at this time. To expand knowledge and understanding in this area, there is a need for consensus on a definition of osteosarcopenic obesity which will allow for identification, further epidemiological studies and comparisons between studies. Additionally, studies should assess whether the clinical outcomes associated with osteosarcopenic obesity are worse than the mere addition of those linked with its components. This will help to determine whether defining a person as having this triad will eventually result in a more effective treatment than addressing each of the three conditions separately.
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Affiliation(s)
- Jürgen M Bauer
- Center for Geriatric Medicine, University of Heidelberg, AGAPLESION Bethanien Krankenhaus Heidelberg, Heidelberg, Germany.
| | | | - Roger A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - John A Kanis
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
| | - Matteo Cesari
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Roland Chapurlat
- INSERM, UMR 1033, Université de Lyon, Hôpital E Herriot, 69437, Lyon Cedex 03, France
| | - Nasser Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Jean-Marc Kaufman
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Francesco Landi
- Department of Geriatrics, Neurosciences and Orthopaedics, Orthogeriatric Unit, Teaching Hospital "Agostino Gemelli", Catholic University of the Sacred Heart School of Medicine, Rome, Italy
| | - Andrea Laslop
- Scientific Office, Federal Office for Safety in Health Care, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Médéa Locquet
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
| | | | - Eugene McCloskey
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
- Mellanby Centre for Bone Research and Centre for Integrated Research in Musculoskeletal Ageing, University of Sheffield, Sheffield, UK
| | - Simone Perna
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, P.O. Box 32038, Zallaq, Bahrain
| | - René Rizzoli
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Yves Rolland
- CHU Toulouse, Médecine Gériatrie Gérontopôle, Cité de la Santé, 20 Rue du Pont Saint Pierre, Inserm 1027, 31059, Toulouse, France
| | - Mariangela Rondanelli
- IRCCS Mondino Foundation, Pavia, Department of Public Health, Experimental and Forensic Medicine, Unit of Human Nutrition, University of Pavia, Pavia, Italy
| | - Pawel Szulc
- INSERM, UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France
| | - Bruno Vellas
- CHU Toulouse, Médecine Gériatrie Gérontopôle, Cité de la Santé, 20 Rue du Pont Saint Pierre, Inserm 1027, 31059, Toulouse, France
| | - Mila Vlaskovska
- Medical Faculty, Department of Pharmacology, Medical University Sofia, 2, Zdrave Str, 1431, Sofia, Bulgaria
| | - Cyrus Cooper
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
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Chen X, Kong C, Yu H, Gong J, Lan L, Zhou L, Gong J, Liu P, Xu L, Deng Q. Association between osteosarcopenic obesity and hypertension among four minority populations in China: a cross-sectional study. BMJ Open 2019; 9:e026818. [PMID: 31324680 PMCID: PMC6661579 DOI: 10.1136/bmjopen-2018-026818] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Osteosarcopenic obesity (OSO) may be associated with an increased prevalence of hypertension. The aim of this study was to examine the difference in the prevalence of OSO and hypertension among four minority populations in China and explore the relationship between OSO and hypertension by sex. DESIGN This study adopted a cross-sectional design. PARTICIPANTS In total, 1939 participants aged ≥50 years, including 459 Jing, 514 Maonan, 535 Hmong and 431 Yao participants from Guangxi Province, China, were included using stratified cluster random sampling. MAIN OUTCOME MEASURES The body composition, bone mineral density and blood pressure were measured by an MC-180 body composition analyser, Achilles Express ultrasound bone densitometer and OMRON HEM-1000 electronic sphygmomanometer, respectively. RESULTS The results showed that 65.77% of Hmong men, 58.79% of Hmong women, 54.82% of Maonan men, 50.00% of Maonan women, 41.92% of Jing men, 45.21% of Jing women, 53.66% of Yao men and 42.32% of Yao women suffered from hypertension. Compared with those among the normal group, the adjusted OR and 95% CI of age among the women with OSO was 3.15 (1.13 to 8.78). After adjusting for age, ethnicity, smoking status, alcohol consumption, physical activity and menopausal status, the women with OSO also had a higher OR (OR=3.18, 95% CI 1.14 to 8.88) for hypertension than those in the normal group. However, the ORs (95% CI) for hypertension in men with one or more components were not significant after adjusting for age and ethnicity. CONCLUSION These results suggest that OSO is a risk factor for hypertension, especially in women. Furthermore, the prevalence of OSO and hypertension in the present study displayed sex-specific and ethnic-specific differences among the four minority populations.
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Affiliation(s)
- Xingcai Chen
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Cunqing Kong
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Hongrong Yu
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Jiangu Gong
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Ling Lan
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Lining Zhou
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Jichun Gong
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Peng Liu
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Lin Xu
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
- Guangxi Colleges and Universities Key Laboratory of Human Development and Disease Research, Guangxi Medical University, Nanning, China
| | - Qiongying Deng
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
- Guangxi Colleges and Universities Key Laboratory of Human Development and Disease Research, Guangxi Medical University, Nanning, China
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Kim YM, Kim S, Won YJ, Kim SH. Clinical Manifestations and Factors Associated with Osteosarcopenic Obesity Syndrome: A Cross-Sectional Study in Koreans with Obesity. Calcif Tissue Int 2019; 105:77-88. [PMID: 30997575 DOI: 10.1007/s00223-019-00551-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 04/11/2019] [Indexed: 12/28/2022]
Abstract
Demonstrating the clinical consequences of osteosarcopenic obesity (OSO) is complex. This study evaluated clinical manifestations and factors associated with bone and muscle loss in Koreans with obesity. This cross-sectional observational study enrolled Koreans with obesity aged ≥ 50 years from the Korea National Health and Nutrition Examination Survey. Clinical manifestations were compared among four groups: obesity (O), sarcopenic obesity (SO), osteopenic obesity (OO), and OSO. Factors associated with appendicular skeletal muscle mass (ASM) or bone mineral density (BMD) were evaluated. OSO increases with age in both sexes. Men with SO and OSO had increased cardiometabolic diseases and markers, percentages of body fat (BF %), and trunk fat (TF %), and decreased limb fat percentage (LF %). Women with SO and OSO had increased metabolic markers, BF %, and TF % but those with OSO had increased cardiometabolic diseases and lower LF %. Both sexes with OSO had decreased ASM and vitamin D, and higher vitamin D deficiency. BF % was negatively associated with ASM and femur BMD in both sexes. TF % was negatively and LF % was positively associated with ASM in both sexes and with femur BMD in women. Vitamin D was positively associated with femur BMD in men and with ASM and BMD at all sites in women. ASM and BMD were positively associated with each other. Appendicular muscle loss is metabolically significant regardless of bone loss in men; however, appendicular muscle loss with bone loss is metabolically more significant in women. Regional body composition, fat distribution, and vitamin D deficiency were associated with OSO phenotype in both sexes.
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Affiliation(s)
- Yoo Mee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Simgokro 100Gil 25, Seo-gu, Incheon, 22711, South Korea
- Institute for Translational and Clinical Research, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, South Korea
| | - Sunghoon Kim
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Jun Won
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Simgokro 100Gil 25, Seo-gu, Incheon, 22711, South Korea
- Institute for Bio-Medical Convergence, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, South Korea
| | - Se Hwa Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Simgokro 100Gil 25, Seo-gu, Incheon, 22711, South Korea.
- Institute for Translational and Clinical Research, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, South Korea.
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Mills S, Lane JA, Smith GJ, Grimaldi KA, Ross RP, Stanton C. Precision Nutrition and the Microbiome Part II: Potential Opportunities and Pathways to Commercialisation. Nutrients 2019; 11:E1468. [PMID: 31252674 PMCID: PMC6683087 DOI: 10.3390/nu11071468] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/05/2019] [Accepted: 06/05/2019] [Indexed: 12/11/2022] Open
Abstract
Modulation of the human gut microbiota through probiotics, prebiotics and dietary fibre are recognised strategies to improve health and prevent disease. Yet we are only beginning to understand the impact of these interventions on the gut microbiota and the physiological consequences for the human host, thus forging the way towards evidence-based scientific validation. However, in many studies a percentage of participants can be defined as 'non-responders' and scientists are beginning to unravel what differentiates these from 'responders;' and it is now clear that an individual's baseline microbiota can influence an individual's response. Thus, microbiome composition can potentially serve as a biomarker to predict responsiveness to interventions, diets and dietary components enabling greater opportunities for its use towards disease prevention and health promotion. In Part I of this two-part review, we reviewed the current state of the science in terms of the gut microbiota and the role of diet and dietary components in shaping it and subsequent consequences for human health. In Part II, we examine the efficacy of gut-microbiota modulating therapies at different life stages and their potential to aid in the management of undernutrition and overnutrition. Given the significance of an individual's gut microbiota, we investigate the feasibility of microbiome testing and we discuss guidelines for evaluating the scientific validity of evidence for providing personalised microbiome-based dietary advice. Overall, this review highlights the potential value of the microbiome to prevent disease and maintain or promote health and in doing so, paves the pathway towards commercialisation.
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Affiliation(s)
- Susan Mills
- APC Microbiome Ireland, University College Cork, Cork T12 K8AF, Ireland.
| | - Jonathan A Lane
- H&H Group, Technical Centre, Global Research and Technology Centre, Cork P61 C996, Ireland.
| | - Graeme J Smith
- H&H Group, Technical Centre, Global Research and Technology Centre, Cork P61 C996, Ireland.
| | | | - R Paul Ross
- APC Microbiome Ireland, University College Cork, Cork T12 K8AF, Ireland.
| | - Catherine Stanton
- APC Microbiome Ireland, Teagasc Food Research Centre, Fermoy P61 C996, Co Cork, Ireland.
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Kelly OJ, Gilman JC, Boschiero D, Ilich JZ. Osteosarcopenic Obesity: Current Knowledge, Revised Identification Criteria and Treatment Principles. Nutrients 2019; 11:E747. [PMID: 30935031 PMCID: PMC6520721 DOI: 10.3390/nu11040747] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 02/06/2023] Open
Abstract
Osteosarcopenic obesity (OSO) syndrome describes the simultaneous deterioration of bone, muscle and excess fat, resulting in reduced functionality and systemic metabolic dysregulation. The key component contributing to this may be ectopic fat in the viscera, bone and muscle. OSO research to date is summarized, and the revised criteria for its identification for research purposes are reviewed and proposed, including new criteria to assess visceral fat in males and females. Finally, nutritional and physical activity recommendations are consolidated into a treatment algorithm, which can be validated in future studies and which may also be applied to preventative management.
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Affiliation(s)
| | | | | | - Jasminka Z Ilich
- Institute for Successful Longevity, Florida State University, Tallahassee, FL 32306, USA.
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Balogun S, Winzenberg T, Wills K, Scott D, Callisaya M, Cicuttini F, Jones G, Aitken D. Prospective associations of osteosarcopenia and osteodynapenia with incident fracture and mortality over 10 years in community-dwelling older adults. Arch Gerontol Geriatr 2019; 82:67-73. [PMID: 30716680 DOI: 10.1016/j.archger.2019.01.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/10/2018] [Accepted: 01/26/2019] [Indexed: 11/25/2022]
Abstract
AIM To determine whether older adults with low muscle mass (sarcopenia) and strength (dynapenia), in the presence of osteoporosis/osteopenia, have an increased risk of fracture and mortality over 10 years, compared to those with low muscle or low bone mass alone or with neither condition. METHODS 1032 participants (52% women; mean age 62.9 ± 7.4 years) were prospectively followed for 10 years. Mortality was ascertained from the death registry and fractures were self-reported. Baseline appendicular lean mass (ALM) was assessed using dual-energy X-ray absorptiometry and normalised to body mass index (BMI). Hand grip strength (HGS) was assessed by dynamometer. Osteosarcopenia and osteodynapenia were defined as having T-scores of the total hip and/or lumbar spine bone mineral density (BMD) < -1 combined with being in the lowest 20% of the sex-specific distribution for ALM/BMI or HGS respectively. RESULTS Incident fracture risk was significantly higher in participants who were osteodynapenic (RR = 2.07, 95% CI: 1.26-3.39), dynapenic alone (RR = 1.74, 95% CI: 1.05-2.87), and osteopenic alone (RR = 1.63, 95% CI: 1.15-2.31), compared to those without dynapenia or osteopenia. Mortality risk was significantly higher only in participants with osteosarcopenia (RR = 1.49, 95% CI: 1.01-2.21) compared to those without sarcopenia or osteopenia. However, osteosarcopenia and osteodynapenia did not lead to a significantly greater fracture or mortality risk compared to having these conditions on their own. CONCLUSION These findings suggest that the combined effect of osteopenia and sarcopenia or dynapenia on fracture and mortality risk, respectively, may not be greater than that of each individual condition.
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Affiliation(s)
- Saliu Balogun
- Menzies Institute for Medical Research, University of Tasmania, Australia.
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Australia; Faculty of Health, University of Tasmania, Australia.
| | - Karen Wills
- Menzies Institute for Medical Research, University of Tasmania, Australia.
| | - David Scott
- Menzies Institute for Medical Research, University of Tasmania, Australia; Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, & Peninsula Clinical School, Central Clinical School, Monash University, Clayton, Victoria, 3168, Australia; Australian Institute for Musculoskeletal Science, Melbourne Medical School (Western Campus), the University of Melbourne, St Albans, Victoria, 3021, Australia.
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Australia; Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, & Peninsula Clinical School, Central Clinical School, Monash University, Clayton, Victoria, 3168, Australia.
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Australia.
| | - Dawn Aitken
- Menzies Institute for Medical Research, University of Tasmania, Australia.
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Zhao X, Tsujimoto T, Kim B, Katayama Y, Tanaka K. Increasing Physical Activity Might Be More Effective to Improve Foot Structure and Function Than Weight Reduction in Obese Adults. J Foot Ankle Surg 2019; 57:876-879. [PMID: 29880325 DOI: 10.1053/j.jfas.2018.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Indexed: 02/03/2023]
Abstract
Obesity is reported to be an important factor affecting foot structure and function. For obese individuals, weight reduction or increasing weight physical activity could be an effective approach to improve foot structure and function. The present study sought to determine the effect of weight reduction and increasing physical activity on foot structure and function in obese Japanese and to investigate which intervention is more beneficial. The participants were divided into the weight reduction group (n = 30; body mass index 29.0 ± 2.5 kg/m2), with the intervention consisting of dietary modification, and the increasing physical activity group (n = 15; body mass index 28.2 ± 3.1 kg/m2), with the intervention consisting of walking and jogging. A 3-dimensional foot scanner was used to measure the foot anthropometric data with the participants both sitting and standing. The dorsum height declined and the arch stiffness index increased after the weight reduction intervention, and the truncated foot length decreased and the arch stiffness index increased after the increasing physical activity intervention (p <.05). The arch height index showed a downward trend after the weight reduction intervention (p = .060) and an upward trend after the increasing physical activity intervention (p = .069). Moreover, a greater change was found in the increase of the dorsum height and arch height index and decrease of the truncated foot length in the increasing physical activity group than in the weight reduction group (p <.05). These findings suggest that increasing physical activity might be more effective to improve foot structure and function than weight reduction in obese adults.
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Affiliation(s)
- Xiaoguang Zhao
- Staff, Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Zhejiang, China.
| | | | - Bokun Kim
- Staff, Faculty of Sports Health Care, Inje University, Gimhae, Korea; Staff, Faculty of Foundation for Industry-Academy Cooperation, Dong-A University, Pusan, Korea
| | - Yasutomi Katayama
- Associate Professor, Faculty of Education, Kogakkan University, Ise, Mie, Japan
| | - Kiyoji Tanaka
- Professor, Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
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Buehring B, Hansen KE, Lewis BL, Cummings SR, Lane NE, Binkley N, Ensrud KE, Cawthon PM. Dysmobility Syndrome Independently Increases Fracture Risk in the Osteoporotic Fractures in Men (MrOS) Prospective Cohort Study. J Bone Miner Res 2018; 33:1622-1629. [PMID: 29701911 PMCID: PMC6469960 DOI: 10.1002/jbmr.3455] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/07/2018] [Accepted: 04/13/2018] [Indexed: 12/30/2022]
Abstract
We proposed the term "dysmobility syndrome" (DS) to identify individuals with impaired musculoskeletal health, a risk factor for falls and fractures. Whether DS is associated with increased risk of incident fracture is unknown. The Osteoporotic Fractures in Men (MrOS) study enrolled 5994 men ages ≥65 years, between March 2000 and April 2002. We used baseline data to determine whether DS increased fracture risk, independent of the Fracture Risk Assessment Tool (FRAX). Men met DS criteria at baseline if they had three or more of the following: appendicular lean mass/height2 <7.26 kg/m2 , total body fat >30%, spine or hip T-score ≤ -2.5, grip strength <30 kg, gait speed <1.0 m/s, and one or more fall within 12 months. We examined whether baseline DS increased the risk of hip and major osteoporotic fractures (MOFs) over a median of 14 years (IQR, 9 to 15 years). Among 5834 men mean age 74 ± 6 years, 471 (8%) had DS and 635 (11%) experienced an MOF, including 274 (5%) hip fractures. Age (per SD increase) conferred an HR of 1.72 (95% CI, 1.59 to 1.86), DS conferred an HR of 3.45 (95% CI, 2.78 to 4.29) and FRAX calculated with BMD (per %) conferred an HR of 1.10 (95% CI, 1.08 to 1.11) for MOF. Prediction of MOF using the FRAX score provided a concordance value of 0.67 ± 0.012 (concordance values are mean ± SE). Concordance increased to 0.69 ± 0.012 by adding DS and to 0.70 ± 0.012 by adding DS and age to the multivariate model. Kaplan-Meier curves indicated that men with both DS and a FRAX risk above the National Osteoporosis Foundation (NOF) treatment thresholds had higher MOF (HR 6.23; 95% CI, 3.10 to 12.54) and hip (HR 7.73; 95% CI, 5.95 to 10.04) fracture risk than men with neither condition. We suggest further studies to determine the optimal criteria for DS, and to test DS as a predictor of falls and fractures, especially in women. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Bjoern Buehring
- Osteoporosis Clinical Research Program, Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Karen E Hansen
- Osteoporosis Clinical Research Program, Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Brian L Lewis
- Osteoporosis Clinical Research Program, Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Steven R Cummings
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - Nancy E Lane
- Center for Musculoskeletal Health, University of California-Davis School of Medicine, Davis, CA, USA
| | - Neil Binkley
- Osteoporosis Clinical Research Program, Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Kristine E Ensrud
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Peggy M Cawthon
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA
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TAKAYAMA M, AZUMA K, SHIMIZU-HIROTA R, MAKINO K, SEINO T, YOSHIDA T, KASHIWAGI K, HIROSE H, INOUE N, IWAO Y. Sarcopenic obesity is associated with osteopenia among Japanese elderly women: A cross-sectional study from comprehensive health checkups. ACTA ACUST UNITED AC 2018. [DOI: 10.7143/jhep.45.573] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
| | - Koichiro AZUMA
- Institute for Integrated Sports Medicine, Keio University School of Medicine
| | | | - Kanako MAKINO
- Center for Preventive Medicine, Keio University Hospital
| | - Takashi SEINO
- Center for Preventive Medicine, Keio University Hospital
| | | | | | - Hiroshi HIROSE
- Center for Preventive Medicine, Keio University Hospital
- Health Center, Keio University
| | - Nagamu INOUE
- Center for Preventive Medicine, Keio University Hospital
| | - Yasushi IWAO
- Center for Preventive Medicine, Keio University Hospital
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Siglinsky E, Buehring B, Krueger D, Binkley N, Yamada Y. Could bioelectric impedance spectroscopy (BIS) measured appendicular intracellular water serve as a lean mass measurement in sarcopenia definitions? A pilot study. Osteoporos Int 2018; 29:1653-1657. [PMID: 29574521 DOI: 10.1007/s00198-018-4475-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 03/06/2018] [Indexed: 01/25/2023]
Abstract
UNLABELLED DXA lean mass measurement for sarcopenia diagnosis is not always possible. Bioelectric impedance spectroscopy (BIS), a portable technology, is a potential alternative to DXA-measured lean mass. This pilot study explores the possibility and proposes an arbitrarily chosen potential cut-point for appendicular intracellular water corrected by height (aICW/ht2). INTRODUCTION Sarcopenia definitions often include DXA lean mass measurement. However, DXA is not always available. We explored the potential of a less-expensive mobile method, bioelectric impedance spectroscopy (BIS), to assess lean mass for sarcopenia determination. We hypothesized that BIS-measured appendicular intracellular water (aICW/ht2) would correlate with DXA-measured appendicular lean mass (ALM)/ht2 and with functional parameters. If so, establishing an aICW/ht2 cut-point in sarcopenia definitions may be feasible. METHODS Sixty-one community-dwelling women, mean age 79.9, had BIS and DXA lean mass, grip strength, gait speed, and jumping mechanography assessments. BIS aICW was calculated using limb length and intracellular water resistance. aICW/ht2 was compared to DXA-measured ALM/ht2 by linear regression. The European Working Group ALM/ht2 and an exploratory aICW/ht2 cut-point were utilized. RESULTS In this cohort, ALM/ht2 and aICW/ht2 were moderately correlated, R2 = 0.55, p < 0.0001. Lean mass was low in 7 and normal in 44 by BIS and DXA. Those with low aICW/ht2 had lower grip strength (p = 0.04) and jump power (p = 0.0002) than those with normal aICW/ht2 and ALM/ht2. Subjects with low ALM/ht2 had lower jump power (p = 0.0006) but were not different in gait speed or grip strength. CONCLUSIONS BIS aICW is correlated with DXA-measured ALM directly, and when height adjusted. An aICW/ht2 cut-point of 6.5 L/m2 identified 70% of women with low ALM/ht2. Women with low lean mass by DXA and BIS had poorer function measured by jump power. These pilot data support further evaluation of BIS measurement inclusion into sarcopenia definitions.
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Affiliation(s)
- E Siglinsky
- University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - B Buehring
- University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - D Krueger
- University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - N Binkley
- University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA.
| | - Y Yamada
- University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
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Osteosarcopenic obesity and its relationship with dyslipidemia in women from different ethnic groups of China. Arch Osteoporos 2018; 13:65. [PMID: 29886557 DOI: 10.1007/s11657-018-0481-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 05/04/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To explore the prevalence and ethnic differences of osteosarcopenic obesity (OSO) and dyslipidemia and their relationship among Maonan, Mulam, Hmong, and Yao minorities in China. METHODS A total of 2315 Maonan, Mulam, Hmong, and Yao women aged 20-95 from Guangxi were included in this study. Questionnaire survey was carried out and their blood lipids were tested. Body compositions were measured by bioelectrical impedance analysis, and T-score was assessed by ultrasonic examination, respectively. RESULTS Our study showed ethnic-specific prevalence of OSO. In older women, the incidence rates of OSO in Mulam were 4.9, 12.6, and 11.5% in Maonan, Mulam, and Hmong ethnicity, respectively. In younger group, the incidence rates of OSO were 0.4, 0.4, and 0.6%, respectively. However, there is no prevalence of OSO in Yao women in two groups. The prevalence of dyslipidemia in younger women was 22.86, 29.89, 43.35, and 80.00% in group numbering one, two, and three, respectively. In older women, it was 29.13, 39.02, 41.37, and 52.38%, respectively. Based on logistic regression analysis, after controlling for covariates, dyslipidemia in younger group was positively associated with a higher number of adverse body composition, especially for OSO (OR = 12.53, 95%CI 1.34-116.99). Compared with normal women, OSO women in older group were also more likely to have dyslipidemia (OR = 6.75, 95%CI 3.19-14.31). CONCLUSION OSO may be a risk factor for dyslipidemia in the ethnic groups. Thus, efforts to promote healthy aging should be focused on preventing obesity and maintaining bone health and muscle mass.
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Osteosarcopenic Visceral Obesity and Osteosarcopenic Subcutaneous Obesity, Two New Phenotypes of Sarcopenia: Prevalence, Metabolic Profile, and Risk Factors. J Aging Res 2018; 2018:6147426. [PMID: 29862078 PMCID: PMC5976921 DOI: 10.1155/2018/6147426] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 08/09/2017] [Accepted: 09/06/2017] [Indexed: 12/25/2022] Open
Abstract
Background The main criticism of the definition of “osteosarcopenic obesity” (OSO) is the lack of division
between subcutaneous and visceral fat. This study describes the prevalence, metabolic profile, and risk factors of two new phenotypes of sarcopenia:
osteosarcopenic visceral obesity (OSVAT) and osteosarcopenic subcutaneous obesity (OSSAT).
Methods A standardized geriatric assessment was performed by anthropometric and biochemical measures.
Dual-energy X-ray absorptiometry (DXA) was used to assess body composition, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT),
osteoporosis, and sarcopenia.
Results A sample of 801 subjects were assessed (247 men; 554 women).
The prevalence of osteosarcopenic obesity (OSO) was 6.79%; OSSAT and OSOVAT were, respectively, 2.22%
and 4.56%. OSVAT (versus the others) showed a higher level of inflammation (CRP and ESR, p < 0.05), bilirubin (p < 0.05), and risk of fractures (FRAX index over 15%, p < 0.001). Subjects with OSSAT did not show any significant risk factors associated to obesity.
Conclusions
The osteosarcopenic visceral obesity phenotype (OSVAT) seems to be associated with a higher risk of fractures,
inflammation, and a worse metabolic profile. These conditions in OSVAT cohort are associated with an increase of visceral adipose tissue,
while patients with OSSAT seem to benefit related to the “obesity paradox”.
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