Predictive value of percentage body fat in aging people with low muscle mass: A 2.2-year longitudinal study

Association between different skeletal muscle mass indices, physical function, and inflammation in obese pre-frail older adults

OBJECTIVES

There is lack of consensus on measurement of muscle mass and quality in obese older adults. We aim to evaluate the association of four muscle mass indices (appendicular skeletal muscle mass (ASM) over height2(ASMIht), ASM/weight (ASMwt), ASM/body fat percentage (ASMbfp)and ASM/body mass index (BMI) ASMIbmi) with physical function and inflammation in pre-frail obese older adults.

METHODS

Cross-sectional study of 407 community dwelling pre-frail older adults. Data on demographics, cognition, and physical function(gait speed, handgrip strength (HGS) and Short Physical Performance Battery (SPPB) test), body composition and inflammation biomarkers were collected. Participants were analysed based on BMI tertiles(T1 lowest,T3 highest).

RESULTS

The mean age was 72.67 years, mean BMI 25.42 kg/m2 and 59.5 % were females. Participants in T3 had a mean BMI of 30.75 kg/m2, younger with lower education levels, multimorbidity, polypharmacy and lower prevalence of sarcopenia. In BMI T3, ASMIbmi was significantly associated with EQ-5D index (β 0.53, 95 % CI 0.04 to 1.03, p = 0.033),HGS (β 5.28, 95 % CI 0.27 to 10.29, p = 0.039), SPPB (β 2.19, 95 % CI 0.47 to 3.91, p = 0.013) and IL-6 (β -4.13, 95 % CI -7.46 to -0.81, p = 0.017). ASMIwt was associated with EQ-5D index (β 0.17, 95 % CI 0.02 - 0.33, p = 0.047). ASMbfp was associated with HGS (β 6.97, 95 % CI 0.051 to 13.92, p = 0.049). There was significant association of HGS with all muscle mass indices in BMI T2, and ASMbfpin BMI T1.

CONCLUSION

ASMIbmi was significantly associated with SPPB, HGS, EQ-5D index and IL-6 in BMI T3. ASMbfp was associated with HGS in all the tertiles. Our results need further validation at population level.

Sarcopenia, Obesity, Sarcopenic Obesity and Risk of Poor Nutritional Status in Polish Community-Dwelling Older People Aged 60 Years and Over

Poor nutritional status (PNS) is a modifiable factor determining abnormalities in body composition-sarcopenia, obesity, and sarcopenic obesity (SO). We aimed to assess the prevalence of these conditions and their association with PNS in 211 community-dwelling older adults. Sarcopenia was diagnosed based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) recommendations. Obesity was diagnosed with the Percent Body Fat (>42% in women and >30% in men). Subjects fulfilling the criteria for obesity and concomitantly with reduced lower and/or upper limbs muscle strength and muscle mass (ALM/BMI < 0.512 in women and <0.789 in men) were classified as SO phenotype. Participants without obesity and sarcopenia were categorized as ‘normal’ phenotype. Nutritional status was estimated with the Mini Nutritional Assessment, and a score of <24 indicated PNS. In total, 49.8% participants had abnormal body composition (60.7% men and 42.5% women; p = 0.001). Sarcopenia, obesity, and SO were diagnosed in 10%, 32.7%, and 7.1% of subjects. PNS was found in 31.3% of the study sample. Its prevalence differed between phenotypes: 81% in sarcopenia, 60% in SO, 14.5% in obesity, and 28.3% in the ‘normal’ phenotype group (p = 0.000). Based on the results, abnormal body composition is prevalent in elderly subjects. Sarcopenia and SO are often associated with PNS.

Value of appendicular skeletal muscle mass to total body fat ratio in predicting obesity in elderly people: a 2.2-year longitudinal study

BACKGROUND

Obesity is a disease characterized by much fat accumulation and abnormal distribution, which was related to cardiovascular diseases, diabetes mellitus (DM) and muscular skeletal diseases. The aim of this study was to evaluate the usefulness of appendicular skeletal muscle mass to total body fat ratio (ASM/TBF) in screening for the risk of obesity in elderly people.

METHODS

A prospective study was carried out with 446 participants (non-obese elderly people with body mass index (BMI) < 28 kg/m²) who underwent baseline and an average around 2.2-year follow-up health check-up examinations.

RESULTS

The mean age at baseline was 63.6 years. The incidence of new obesity was 5.4% during follow-up. Linear regression demonstrated that baseline ASM/TBFs were negatively correlated with follow-up BMIs in both men and women (β = - 1.147 (- 1.463--0.831) for men and - 4.727 (- 5.761--3.692) for women). The cut-off points of baseline ASM/TBF in elderly people for obesity were 1.24 in men and 0.90 in women which were identified by Classification and Regression Tree (CART). Logistic regression showed that both men and women with decreased ASM/TBF had higher risks of obesity over the follow-up period (Relative Risk (RRs) = 5.664 (1.879-17.074) for men and 34.856 (3.930-309.153) for women).

CONCLUSIONS

Elderly people with a low ASM/TBF had a higher risk of new obesity, which suggested that ASM/TBF should be considered in obesity management in the elderly.