High Visceral Fat Area Attenuated the Negative Association between High Body Mass Index and Sarcopenia in Community-Dwelling Older Chinese People

The association between weight-adjusted-waist index and sarcopenia in adults: a population-based study

This study aims to investigate the relationship between weight-adjusted-waist index (WWI), a new body index, and sarcopenia, while also assessing the potential of WWI as a tool for screening sarcopenic patients. The cross-sectional study involved adults who possessed complete data on WWI and appendicular skeletal muscle mass from the 1999-2006 and 2011-2018 National Health and Nutrition Examination Surveys. Weighted multivariate regression and logistic regression analyses were employed to explore the independent relationship between WWI and sarcopenia. The study included 26,782 participants. The results showed that WWI demonstrated a positive correlation with sarcopenia risk. In the fully adjusted model, with each 1 unit increase in WWI, the risk of developing sarcopenia rose 14.55 times higher among males (OR: 14.55, 95% CI 12.33, 17.15) and 2.86 times higher among females (OR: 2.86, 95% CI 2.59, 3.15). The optimal cutoff values of WWI for sarcopenia were 11.26 cm/√kg for males and 11.39 cm/√kg for females. Individuals with a higher WWI have an increased risk of developing sarcopenia, and a high WWI functions as a risk factor for sarcopenia. Assessing WWI could assist in identifying individuals at risk of sarcopenia.

Effects of resistance training on muscular strength, endurance, body composition and functional performance among sarcopenic patients: a systematic review

Background

Sarcopenia, a gradual loss of muscle mass and strength associated with ageing, contributes to a decline in physical abilities, increase in disability and frailty and loss of functional independence. This functional deterioration which comes with ageing, can be slowed in pace with exercise.

Objective

The objective of the current review was to thoroughly search for literature assessing impact of RT on physical performance, body composition, muscle strength and endurance in sarcopenic elderly patients.

Methods

PubMed, Scopus, Web of Science, and PEDro databases were brought in use for a thorough search for articles published from 2010 to 2023. Two researchers independently retrieved data from studies that complied with the inclusion and exclusion criteria, while they also evaluated quality of the evidence.

Results

In total, 14 studies with 742 patients with mean age of 72.4 ± 9.22 years were included in the analysis for this review. Results indicate, RT improves body composition (p = 0.001), functional performance (p 0.001), postural stability (p = 0.005) and muscle strength (p 0.001) in elderly sarcopenic patients.

Conclusion

A promising intervention for the management of sarcopenia is RT. To yield RT's positive effects, a well-designed prescription is the need of the hour, just like it is with other treatment strategies.

Alternative skeletal muscle index for sarcopenia diagnosis in elderly patients with type 2 diabetes mellitus: A pilot study

PURPOSE

To determine an alternative skeletal muscle index (a-SMI), easy diagnosis of sarcopenia in elderly patients with type 2 diabetes mellitus (T2DM).

PATIENTS AND METHODS

This cross-sectional study included 223 inpatients with T2DM (100 males, age range 60-89; 123 females, age range 60-87). Screening for grip strength and gait speed, measuring SMI by dual-energy X-ray absorptiometry (d-SMI) for sarcopenia diagnosis, according to the Asian Working Group for Sarcopenia (AWGS) 2019 consensus. The a-SMI was established by binary logistic regression analysis with positive screening population. To assess the conformance of the new diagnostic approach with the AWGS 2019.

RESULTS

Sarcopenia was present in 36.3% of the study population. 59 had normal d-SMI and 81 had low d-SMI in screening patients with probable sarcopenia. In univariate analyses for all positive screening population, body mass index (BMI), 25-hydroxyvitamin D (25 - (OH) VitD), high density lipoprotein cholesterol (HDL-C), hypertension (HTN), and gender were correlates of d-SMI. Binary logistic regression analysis revealed that male (B = 2.463, 95%CI: 3.640 ~ 37.883, p = 0.000), HTN (B = 1.404, 95%CI: 1.599 ~ 10.371, p = 0.003), BMI (B = -0.344, 95%CI: 0.598 ~ 0.839, p = 0.000), 25-(OH) VitD (B = -0.058, 95%CI: 0.907 ~ 0.982, p = 0.004) were independent factors for d-SMI detection. Based on the extracted four correlates, the a-SMI was determined. The area under receiver operating characteristic (ROC) curve was 0.842, sensitivity and specificity for the new diagnostic approach were 84.0% and 84.5%. In a statistical measure of agreement between the AWGS 2019 and the new diagnostic approach, the kappa coefficient was 0.669 (p < 0.001).

CONCLUSION

The a-SMI - based on gender, obesity status, 25-(OH) VitD, and HTN history - can be used in the absence of the d-SMI to supplement the algorithm for sarcopenia diagnosis in elderly patients with T2DM.

Association of Different Obesity Phenotypes with Sarcopenia in Han Chinese Middle-Aged and Elderly with Type 2 Diabetes Individuals

PURPOSE

To investigate the relationship between different obesity phenotypes and sarcopenia in hospitalized Chinese patients with type 2 diabetes mellitus (T2DM).

METHODS

This cross-sectional study included 385 men. Anthropometric measurements including applied the determination method of Dual-energy X-ray absorptiometry (DXA) determination of limb skeletal muscle mass index (ASMI) and blood samples were analyzed. The people were divided into four groups according to body mass index (BMI) (≥24kg/m²) and waist circumference (WC) (female ≥85cm, male ≥90cm). Group A (BMI and WC were normal), Group B (BMI was normal and high WC), Group C (high BMI and WC were normal), and Group D (BMI and WC were abnormal).

RESULTS

The prevalence rates of sarcopenia and abdominal obesity were 32.2% and 74.0%, respectively. The detection rate of lower ASMI decreased gradually from Group A to Group D(74.6% vs 68.3% vs 54.5% vs 51.6%, χ 2 =14.243, P=0.003). Logistic analysis showed that the risk of lower ASMI were decreased by 62.4% (95% CI: 0.149-0.950, P = 0.039) in Group C and 68.8% (95% CI: 0.165-0.593, P = 0.000) in Group D compared with Group A, respectively. The risk of lower ASMI were increased 4.153-fold (95% CI: 2.623-6.576, P = 0.000) in male. Male (OR = 4.065, 95% CI: 2.246-7.356, P = 0.000) and WC (OR = 1.053, 95% CI: 1.004-1.104, P = 0.033) were risk factors for lower ASMI, but the risk of lower ASMI was decreased by 32% (95% CI: 0.5744-0.804, P = 0.000) by elevated BMI in the overweight and obese group (Group C and Group D).

CONCLUSION

The prevalence of sarcopenia and abdominal obesity was elevated in han Chinese middle-aged and elderly patients with T2DM. Being overweight or obesity as defined by BMI protect against sarcopenia, while abdominal obesity increases the risk of sarcopenia.

Association of high body mass index, waist circumference, and body fat percentage with sarcopenia in older women

BACKGROUND

Age-related obesity and body composition changes include loss of muscle mass and increased body fat. This study aimed to investigate sex differences in the impact of sarcopenia, defined by the Asian Working Group for Sarcopenia (AWGS), on obesity in Korean older adults.

METHODS

In this 2-year longitudinal study, 3014 participants were excluded based on AWGS sarcopenia parameters (if any one of the sarcopenic parameter criteria was satisfied), including low handgrip strength (HGS), low appendicular skeletal muscle mass index (ASMI), and low short physical performance battery (SPPB). A total of 926 non-sarcopenic participants were recruited for the study. The obese and non-obese groups were compared according to the sarcopenia parameters. The following variables were selected for obesity analysis: body mass index (BMI), waist circumference (WC), and body fat percentage. Unadjusted and fully adjusted logistic regression analyses were performed for each variable to predict sarcopenia and sarcopenic obesity according to sex.

RESULTS

Among the sarcopenia parameters, reduction in ASMI was significantly lower in the obese group with high WC and percentage of body fat (PBF) in both men and women (P < 0.01). Multivariable analysis revealed that different obesity parameters were associated with AWGS criteria: women in the high BMI group presented significantly lower ASMI and sarcopenia (ASMI, OR = 0.289, 95% CI = 0.174-0.480; sarcopenia, OR = 0.152, 95% CI = 0.048-0.483). Women in the high WC group had significantly lower ASMI and sarcopenia (ASMI, OR = 0.307, 95% CI = 0.189-0.500; sarcopenia, OR = 0.262, 95% CI = 0.106-0.649). Women in the high PBF group had a lower incidence of sarcopenia (OR = 0.214, 95% CI = 0.068-0.278).

CONCLUSIONS

Our study identified that high BMI had a protective effect on the reduction of muscle mass in men and women. However, obesity parameters including BMI, WC, and PBF were positively correlated with a lower incidence of sarcopenia only in women. Obesity in older women may have a protective effect in reducing ASMI and the incidence of sarcopenia.

Effects of resistance training in healthy older people with sarcopenia: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

We conducted a meta-analysis to analyze the effects of resistance training on measures of body composition, muscle strength, and muscle performance in older people with sarcopenia.

METHODS

All randomized controlled trials on the effects of resistance training on outcome variables in older people with sarcopenia were searched on Pubmed, Embase, Cochrane Library, the China National Knowledge Infrastructure (CNKI), and Wanfang. Data from January 2010 to October 2020 were reviewed. Two researchers extracted data and evaluated the quality of the studies that met the inclusion criteria independently. Meta-analysis for pre-post changes were calculated as standardized mean difference (SMD) with 95% confidence intervals (CI).

RESULTS

Fourteen studies meeting inclusion criteria included 561 healthy older adults (age 65.8 to 82.8) with sarcopenia. Compared with the control group, resistance training had positive effects on body fat mass (SMD = -0.53, 95% CI - 0.81 to - 0.25, p = 0.0002, I² = 0%), handgrip strength (SMD = 0.81, 95%CI 0.35 to 1.27, p = 0.0005, I² = 81%), knee extension strength (SMD = 1.26, 95% CI 0.72 to 1.80, p < 0.0001, I² = 67%), gait speed (SMD = 1.28, 95%CI 0.36 to 2.19, p = 0.006, I² = 89%), and the timed up and go test (SMD = -0.93, 95% CI - 1.30 to - 0.56, p < 0.0001, I² = 23%). Resistance training had no effects on appendicular skeletal muscle mass (SMD = 0.25, 95% CI - 0.27 to 0.78, p = 0.35, I² = 68%), skeletal muscle mass (SMD = 0.27, 95% CI - 0.02 to 0.56, p = 0.07, I² = 0%) and leg lean mass (SMD = 0.12, 95% CI - 0.25 to 0.50, p = 0.52, I² = 0%). Old people with sarcopenia of different ages, genders or diagnostic criteria and weights have different gains in muscle mass, handgrip strength, knee extension strength and muscle performance after different intervention duration, frequencies, mode and intensity resistance training.

CONCLUSION

Resistance training is an effective treatment to improve body fat mass, muscle strength, and muscle performance in healthy older people with sarcopenia.