Impaired oral status is associated with sarcopenic obesity in post-stroke patients

PURPOSE

Oral problems and muscle health are indeed significant concerns in ageing populations. However, there is limited evidence concerning the association between these issues. The study's focus was to investigate the association between oral problems and sarcopenic obesity, wherein sarcopenia and obesity coexist concurrently, in post-stroke patients.

METHODS

This retrospective, observational, cross-sectional study included patients hospitalised for post-stroke rehabilitation. Oral problems were assessed using the Revised Oral Assessment Guide (ROAG). Sarcopenic obesity was diagnosed according to the European Society of Clinical Nutrition and Metabolism/European Association for the Study of Obesity criteria. Multiple linear regression analysis was used to examine the association between the ROAG and sarcopenic obesity after adjusting for confounding factors.

RESULTS

A total of 760 patients were included, with a mean (SD) age of 71 (9) years, of whom 408 (54.7%) were male. The median (interquartile range, 25th and 75th percentiles) ROAG was 11 [9, 13]. Sarcopenic obesity was diagnosed in 16 (3.9%) men, 18 (5.1%) women, and 34 (4.5%) patients overall. Multivariate linear analysis showed that ROAG was significantly and positively associated with sarcopenic obesity (β = .091, P = .023), followed by obesity alone (β = .084, P = .044), and sarcopenia alone (β = .081, P = .037).

CONCLUSION

Oral problems were associated with sarcopenic obesity in post-stroke. Oral assessment and intervention may have a positive impact on ADL and QOL in post-stroke patients with sarcopenic obesity.

Challenges in Identifying Malnutrition in Obesity; An Overview of the State of the Art and Directions for Future Research

(Protein-energy) malnutrition in individuals living with obesity presents complex diagnostic challenges due to the distinctive physiological characteristics of obesity. This narrative review critically examines the identification of malnutrition within the population with obesity, distinguishing malnutrition from related conditions such as sarcopenic obesity. While noting some shared features, the review highlights key differences between these conditions. The review also highlights the limitations of current malnutrition screening tools, which are not designed for individuals living with obesity. These tools primarily rely on anthropometric measurements, neglecting (among others) nutrient intake assessment, which hinders accurate malnutrition detection. Additionally, this review discusses limitations in existing diagnostic criteria, including the Global Leadership Initiative on Malnutrition (GLIM) criteria, when applied to individuals living with obesity. Challenges include the identification of appropriate cut-off values for phenotypic criteria (unintentional weight loss, low body mass index and muscle mass) and etiological criteria such as reduced food intake and inflammation for the population with obesity. Overall, this review emphasises the need for modified screening tools and diagnostic criteria to recognise and assess malnutrition in obesity, leading to improved clinical outcomes and overall well-being.

The agreement of low lean mass with obesity using different definitions and its correlation with hyperuricemia

Background

The agreement on the identification of sarcopenic obesity remains elusive, and its association with hyperuricemia remains unestablished. This study sought to evaluate the agreement of low lean mass (LLM) with obesity and its correlation with hyperuricemia.

Methods

A total of 25,252 study participants, comprising 4,597 individuals with hyperuricemia, were obtained from the National Health and Nutrition Examination Survey spanning the years 1999-2006 and 2011-2018. LLM with obesity was characterized by the coexistence of LLM, determined by the ratio of appendicular lean mass to body mass index (BMI), and three categories of obesity including BMI, body fat percentage (BF%), and waist circumference (WC). We employed Cohen's kappa to evaluate the agreement among the different diagnostic criteria and implemented survey multiple logistic regression and stratified analyses to explicate the connection between LLM with obesity and the risk of hyperuricemia.

Results

When defining obesity using BF%, BMI, and WC, the prevalence of LLM with obesity varied from 6.6 to 10.1%, with moderate-to-strong agreement. In the fully adjusted model, individuals with LLM or any of the three types of obesity exhibited notably elevated odds of developing hyperuricemia. Likewise, participants with LLM and obesity had 2.70 (LLM + BMI), 2.44 (LLM + BF%), and 3.12 (LLM + WC) times the risk of hyperuricemia, respectively, compared with healthy individuals. The association between LLM with obesity and hyperuricemia remained stable and significant across different age and sex subgroups.

Conclusion

When employing the three definitions of obesity, the incidence of LLM with obesity was not high, and the diagnostic agreement was relatively good. The participants with LLM and obesity exhibited an increased risk of hyperuricemia.

Gromwell (Lithospermum erythrorhizon) Attenuates High-Fat-Induced Skeletal Muscle Wasting by Increasing Protein Synthesis and Mitochondrial Biogenesis

Gromwell (Lithospermum erythrorhizon, LE) can mitigate obesity-induced skeletal muscle atrophy in C2C12 myotubes and high-fat diet (HFD)-induced obese mice. The purpose of this study was to investigate the anti-skeletal muscle atrophy effects of LE and the underlying molecular mechanism. C2C12 myotubes were pretreated with LE or shikonin, and active component of LE, for 24 h and then treated with 500 μM palmitic acid (PA) for an additional 24 h. Additionally, mice were fed a HFD for 8 weeks to induced obesity, and then fed either the same diet or a version containing 0.25% LE for 10 weeks. LE attenuated PA-induced myotubes atrophy in differentiated C2C12 myotubes. The supplementation of LE to obese mice significantly increased skeletal muscle weight, lean body mass, muscle strength, and exercise performance compared with those in the HFD group. LE supplementation not only suppressed obesity-induced skeletal muscle lipid accumulation, but also downregulated TNF-α and atrophic genes. LE increased protein synthesis in the skeletal muscle via the mTOR pathway. We observed LE induced increase of mitochondrial biogenesis and upregulation of oxidative phosphorylation related genes in the skeletal muscles. Furthermore, LE increased the expression of peroxisome proliferator-activated receptor-gamma coactivator-1 alpha and the phosphorylation of adenosine monophosphate-activated protein kinase. Collectively, LE may be useful in ameliorating the detrimental effects of obesity-induced skeletal muscle atrophy through the increase of protein synthesis and mitochondrial biogenesis of skeletal muscle.

Influence of Sugar-Sweetened Beverages Intake on Sarcopenic Obesity, Visceral Obesity, and Sarcopenia in Lebanese Patients with MASLD: A Case-Control Study

Chronic liver diseases are a major global health concern.

AIMS

this study investigated the links between medical, clinical, anthropometric, and dietary factors with dysfunction-associated steatotic liver disease (MASLD) in the Lebanese population using a case-control approach to uncover factors influencing visceral obesity, sarcopenia, and sarcopenic obesity.

METHODS AND MATERIALS

a total of 120 participants (20-70 years old) were divided into case and control groups based on liver disease diagnosis. Patient information was gathered through a questionnaire encompassing demographics, medical history, and beverage consumption. Anthropometric and body composition data were collected in a clinical setting.

RESULTS

our findings indicated a clear association between the presence of MASLD and obesity, hypertension, and diabetes. The positive association with higher body mass index and all three conditions remained consistent even when data was stratified by case and control groups. A greater proportion of MASLD patients exhibited sarcopenic obesity. Furthermore, MASLD cases showed higher consumption of sugary beverages and a reduced intake of milk and water in their diets.

CONCLUSIONS

this study shed light on the health attributes and diets of the Lebanese population with liver diseases and suggested more research in this area and in a more ethnically diverse population.

Machine learning-based detection of sarcopenic obesity and association with adverse outcomes in patients undergoing surgical treatment for spinal metastases

OBJECTIVE

The distributions and proportions of lean and fat tissues may help better assess the prognosis and outcomes of patients with spinal metastases. Specifically, in obese patients, sarcopenia may be easily overlooked as a poor prognostic indicator. The role of this body phenotype, sarcopenic obesity (SO), has not been adequately studied among patients undergoing surgical treatment for spinal metastases. To this end, here the authors investigated the role of SO as a potential prognostic factor in patients undergoing surgical treatment for spinal metastases.

METHODS

The authors identified patients who underwent surgical treatment for spinal metastases between 2010 and 2020. A validated deep learning approach evaluated sarcopenia and adiposity on routine preoperative CT images. Based on composition analyses, patients were classified with SO or nonsarcopenic obesity. After nearest-neighbor propensity matching that accounted for confounders, the authors compared the rates and odds of postoperative complications, length of stay, 30-day readmission, and all-cause mortality at 90 days and 1 year between the SO and nonsarcopenic obesity groups.

RESULTS

A total of 62 patients with obesity underwent surgical treatment for spinal metastases during the study period. Of these, 37 patients had nonsarcopenic obesity and 25 had SO. After propensity matching, 50 records were evaluated that were equally composed of patients with nonsarcopenic obesity and SO (25 patients each). Patients with SO were noted to have increased odds of nonhome discharge (OR 6.0, 95% CI 1.69-21.26), 30-day readmission (OR 3.27, 95% CI 1.01-10.62), and 90-day (OR 4.85, 95% CI 1.29-18.26) and 1-year (OR 3.78, 95% CI 1.17-12.19) mortality, as well as increased time to mortality after surgery (12.60 ± 19.84 months vs 37.16 ± 35.19 months, p = 0.002; standardized mean difference 0.86). No significant differences were noted in terms of length of stay or postoperative complications when comparing the two groups (p > 0.05).

CONCLUSIONS

The SO phenotype was associated with increased odds of nonhome discharge, readmission, and postoperative mortality. This study suggests that SO may be an important prognostic factor to consider when developing care plans for patients with spinal metastases.

Sarcopenic Obesity in Cervical Carcinoma: A Strong and Independent Prognostic Factor beyond the Conventional Predictors (ESTHER Study-AFRAID Project)

Locally advanced cervical cancer represents a significant treatment challenge. Body composition parameters such as body mass index, sarcopenia, and sarcopenic obesity, defined by sarcopenia and BMI ≥ 30 kg/m2, have been identified as potential prognostic factors, yet their overall impact remains underexplored. This study assessed the relationship between these anthropometric parameters alongside clinical prognostic factors on the prognosis of 173 cervical cancer patients. Survival outcomes in terms of local control (LC), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) were analyzed using Kaplan regression methods-Meier and Cox. Older age, lower hemoglobin levels, higher FIGO (International Federation of Gynecology and Obstetrics) stages, and lower total radiation doses were significantly associated with worse outcomes. Univariate analysis showed a significant correlation between BMI and the outcomes examined, revealing that normal-weight patients show higher survival rates, which was not confirmed by the multivariate analysis. Sarcopenia was not correlated with any of the outcomes considered, while sarcopenic obesity was identified as an independent negative predictor of DFS (HR: 5.289, 95% CI: 1.298-21.546, p = 0.020) and OS (HR: 2.645, 95% CI: 1.275-5.488, p = 0.009). This study highlights the potential of sarcopenic obesity as an independent predictor of clinical outcomes. These results support their inclusion in prognostic assessments and treatment planning for patients with advanced cervical cancer.

Body composition assessment for sarcopenic obesity and 3-year mortality in older adults: A comparison study

BACKGROUND

There is no universally accepted definition of sarcopenic obesity (SO), and its prevalence is ambiguous. This study aimed to investigate the prevalence of SO in older adults based on different definitions and determine which predicts all-cause mortality.

METHODS

This prospective longitudinal follow-up study included outpatients aged ≥60 years. SO was defined by sarcopenia definition based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria plus obesity. Three different methods were used to define obesity. Body mass index (BMI) ≥ 30 kg/m2 , waist circumference (WC) ≥ 102 cm for men and ≥88.0 cm for women, and body fat percentage (BF%) ≥ 37.3% for men and ≥51.1% for women. Different definitions of SO and their mortality predictions were compared.

RESULTS

The median age of the 584 patients in the study was 70.0 (interquartile range, 66.0-76.0) years. The prevalence of sarcopenia was 38.5% (47.5% in men and 35.7% in women). The prevalence of SO based on BMI, WC, and BF% was 15.3%, 16.4%, and 10.5%, respectively. The mortality rate was 6.7%. SO based on BMI (odds ratio [OR], 2.73; 95% CI, 1.12-17.9; P = 0.024) and BF% (OR, 1.43; 95% CI, 1.19-3.02; P = 0.007) were significantly associated with 3-year mortality after adjusting for the confounding variables of age, sex, and number of comorbidities. SO based on WC was not associated with mortality (OR, 0.78; 95% CI, 0.07-1.27; P = 0.104).

CONCLUSION

The use of BF% and BMI for defining SO is appropriate in outpatient older adults.

Association between sarcopenic obesity and mortality in patients on peritoneal dialysis: a prospective cohort study

Background

Whether sarcopenic obesity had unfavorable effect on survival of peritoneal dialysis (PD) patients is unknown. We aimed to investigate the association between sarcopenic obesity and survival in PD patients.

Methods

This was a prospective observational study. Eligible PD patients from November 2016 to December 2017 were enrolled and followed until August 31, 2023. Sarcopenia was defined following the recommendations of the Asian Working Group for Sarcopenia (AWGS) as low appendicular skeletal muscle mass index (ASMI) and handgrip strength (HGS). Obesity was defined using the percentage of body fat (PBF). Survival analysis was conducted using the Kaplan-Meier and log-rank test. The Cox regression and the cumulative incidence competing risk (CICR) analyzes were used to investigate the association between sarcopenic obesity and all-cause mortality.

Results

A total of 223 patients were enrolled with 133 (59.6%) males, a median age of 57.5 (44.6, 65.7) years, a median dialysis vintage of 20.3 (6.4, 57.7) months and 48 (21.5%) who had comorbid diabetes mellitus. Among them, 46 (20.6%) patients were sarcopenic, and 25 (11.2%) patients were diagnosed with sarcopenic obesity. After followed up for 51.6 (25.6, 73.9) months, the Kaplan-Meier curve showed the sarcopenic obesity (log-rank = 13.527, p < 0.001) group had significant lower survival rate compared to the nonsarcopenic non-obesity group. For multivariate analysis, the CICR method showed patients with sarcopenic obesity had significantly higher mortality rate (HR: 2.190, 95% CI: 1.011-4.743, p = 0.047) compared to those with nonsarcopenic non-obesity.

Conclusion

Sarcopenia is not uncommon in PD patients, with a considerable proportion having sarcopenic obesity. There is a significant association between sarcopenic obesity and an increased risk of mortality in PD patients.

Association of Dietary Protein Sources and Their Adequacy, Body Composition and Risk of Sarcopenic Obesity in South Korean Populations: A Cross-Sectional Study

Dietary protein sources and protein adequacy are crucial modulators of muscle quality and body composition. We investigated the association between dietary protein sources (and their adequacy) and body composition and the risk of sarcopenic obesity (SO) in South Korean populations. The participants (n = 1967) were classified into SO, obese, sarcopenia, and normal groups. A cross-sectional survey was conducted using the KS-15 questionnaire, short-form food frequency questionnaire, and anthropometric measurements. The percentage of body fat (male: 35.36 ± 0.51%; female: 44.14 ± 0.36%) was significantly high, while appendicular skeletal muscle (ASM; male: 36.39 ± 0.30%, female: 30.32 ± 0.19%) was low in the SO group. Beef and pork consumption was negatively associated with ASM (%) but positively associated with body fat (%) in the normal group and positively associated with ASM (kg/m2: beta = 0.002, p = 0.02) and BFM (kg: beta = 0.012, p = 0.03) in the SO group, respectively. The highest quintile (Q5: 173.6 g/day) showed a decreased risk of SO prevalence (AORs: 0.46, CI: 0.22-0.94) compared with that in the lowest quintile (Q1: 21.6 g/day) among the people with inadequacy protein intake. Daily poultry and egg intake was positively linked with body composition in the participants with SO, while red meat showed a negative effect on imbalanced body composition in participants in the normal and SO groups. Furthermore, a lower intake of poultry and eggs was strongly associated with SO prevalence in people who consumed inadequate amounts of daily dietary protein.

Sarcopenia, sarcopenic obesity, and arterial stiffness among older adults

Background

Aging is associated with a higher prevalence of sarcopenia, sarcopenic obesity (SO), and increased arterial stiffening, with possible detrimental effects on morbidity and mortality. The aim of this study was to assess the relationships between sarcopenia, SO, and different indexes of arterial stiffness in older adults.

Methods

A total of 77 hospitalized patients (mean age 78.68 ± 9.65 years) were evaluated, obtaining anthropometric variables, biochemical samples, handgrip test, and body composition assessment. Arterial stiffness was evaluated by measuring both carotid-femoral pulse wave velocity (cfPWV), a proxy for central stiffness, and cardio-ankle vascular index (CAVI), as well as considering peripheral arteries. The population was sorted into four subgroups: obese, sarcopenic, SO, and controls.

Results

The highest CAVI (11.31 ± 2.58) was found in sarcopenic patients. SO had the highest value of cfPWV (15.18 ± 8.44 m/s), even after adjustment for significant covariates. In multiple regressions, SO diagnosis resulted as a significant predictor of cfPWV (p = 0.03, R2 = 0.20), and sarcopenia diagnosis resulted as a predictor of CAVI (p = 0.042, R2 = 0.12).

Conclusions

In conclusion, a positive correlation is found between sarcopenia, SO, and arterial stiffness among older subjects. In particular, greater central arterial stiffness is associated with SO, outlining a remarkable effect on the cardiovascular risk profile.

Immunogenetic Aspects of Sarcopenic Obesity

Sarcopenic obesity (SO) is a combination of obesity and sarcopenia, with diagnostic criteria defined as impaired skeletal muscle function and altered body composition (e.g., increased fat mass and reduced muscle mass). The mechanism of SO is not yet perfectly understood; however, the pathogenesis includes aging and its complications, chronic inflammation, insulin resistance (IR), and hormonal changes. Genetic background is apparent in the pathogenesis of isolated obesity, which is most often polygenic and is characterized by the additive effect of various genetic factors. The genetic etiology has not been strictly established in SO. Still, many data confirm the existence of pathogenic gene variants, e.g., Fat Mass and Obesity Associated Gene (FTO), beta-2-adrenergic receptor (ADRB2) gene, melanocortin-4 receptor (MC4R) and others with obesity. The literature on the role of these genes is scarce, and their role has not yet been thoroughly established. On the other hand, the involvement of systemic inflammation due to increased adipose tissue in SO plays a significant role in its pathophysiology through the synthesis of various cytokines such as monocyte chemoattractant protein-1 (MCP-1), IL-1Ra, IL-15, adiponectin or CRP. The lack of anti-inflammatory cytokine (e.g., IL-15) can increase SO risk, but further studies are needed to evaluate the exact mechanisms of implications of various cytokines in SO individuals. This manuscript analyses various immunogenetic and non-genetic factors and summarizes the recent findings on immunogenetics potentially impacting SO development.

Effectiveness of exercise interventions on muscle mass among older adults with sarcopenic obesity: A scoping review

A disease known as sarcopenic obesity is characterized by decreased lean body mass in conjunction with excessive amounts of adipose tissue. Skeletal muscle mass, also known as SMM, is responsible for the largest share of fat-free mass in the body and plays an extremely vital role in the maintaining of metabolic health. Physical activity and exercise boosts the physiological health and overall quality of life of senior citizens. The objective of the study is to investigate the effectiveness of varied exercise interventions among the geriatric people with sarcopenic obesity. During the time period (2016-2023), a scoping review was undertaken using PubMed, orthopedic journals, and the Google Scholar database, and six literature evidences relating to the topic were discovered and subsequently analyzed. The study includes six randomized control trial publications that investigated the effectiveness and impact of exercise therapies on sarcopenic obesity. According to the pre and post-test values found in the reviewed articles, we discovered that resistance exercise is more effective than aerobic or combination exercise therapies. In conclusion, according to this scoping analysis, resistance training is more effective than other types of exercise in improving muscle mass in older people with sarcopenic obesity.

Pathophysiological-Based Nutritional Interventions in Cirrhotic Patients with Sarcopenic Obesity: A State-of-the-Art Narrative Review

In recent decades, following the spread of obesity, metabolic dysfunction has come to represent the leading cause of liver disease. The classical clinical presentation of the cirrhotic patient has, therefore, greatly changed, with a dramatic increase in subjects who appear overweight or obese. Due to an obesogenic lifestyle (lack of physical activity and overall malnutrition, with an excess of caloric intake together with a deficit of proteins and micronutrients), these patients frequently develop a complex clinical condition defined as sarcopenic obesity (SO). The interplay between cirrhosis and SO lies in the sharing of multiple pathogenetic mechanisms, including malnutrition/malabsorption, chronic inflammation, hyperammonemia and insulin resistance. The presence of SO worsens the outcome of cirrhotic patients, affecting overall morbidity and mortality. International nutrition and liver diseases societies strongly agree on recommending the use of food as an integral part of the healing process in the comprehensive management of these patients, including a reduction in caloric intake, protein and micronutrient supplementation and sodium restriction. Based on the pathophysiological paths shared by cirrhosis and SO, this narrative review aims to highlight the nutritional interventions currently advocated by international guidelines, as well as to provide hints on the possible role of micronutrients and nutraceuticals in the treatment of this multifaceted clinical condition.

The Impact of the Physical Activity Level on Sarcopenic Obesity in Community-Dwelling Older Adults

Previous studies have reported that low levels of physical activity result in sarcopenic obesity (SO). However, the effects of specific intensities of physical activity on SO and the optimal amount of physical activity for lowering the prevalence of SO have not been well studied. This study aimed to identify the effects of physical activity levels and intensity on SO and the optimal amount of physical activity related to a lower prevalence of SO. This cross-sectional study used data from the nationwide Korean Frailty and Aging Cohort Study (KFACS), which included 2071 older adults (1030 men, 1041 women). SO was defined according to the criteria of the European Society for Clinical Nutrition Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO). Multivariate logistic regression analysis was performed to investigate the association between the physical activity level and SO. The high activity group had a significantly lower prevalence of SO than the non-high activity (low and moderate activity) group. On the other hand, moderate-intensity physical activity was associated with a lower prevalence of SO. A total physical activity energy expenditure of > 3032 kcal/week (433 kcal/day) for men and 2730 kcal/week (390 kcal/day) for women was associated with a reduced prevalence of SO. The high physical activity and total physical energy expenditure described above may be beneficial for reducing the prevalence of SO.

Effect of Resistance Exercise on Body Composition and Functional Capacity in Older Women with Sarcopenic Obesity-A Systematic Review with Narrative Synthesis

BACKGROUND

Resistance exercise has shown effectiveness in reducing various risk factors related to sarcopenic obesity (SO) compared to other types of exercise, e.g., aerobic exercise.

OBJECTIVE

This systematic review evaluates the effect of resistance exercise on body composition, muscular strength, and functional capacity among older women with sarcopenic obesity aged ≥ 60 years.

METHODS

This systematic review is registered on PROSPERO (registration No. CRD42023394603) and follows the PRISMA guidelines. The following electronic databases were used to search the literature: Pedro, Cochrane Central Register of Controlled Trials, Embase, PubMed, and Web of Science. We included only RCTs that investigated the effect of resistance exercise on body composition and functional capacity. Two independent reviewers conducted the process of study selection and data extraction.

RESULTS

The search strategy retrieved 687 results. One hundred and twenty-six records were deleted as duplicates. Consequently, 534 studies were excluded after the title/abstract assessment. After further detailed evaluation of twenty-seven full texts, seven RCTs were included; all the RCTs examined the isolated effect of resistance exercise in women with sarcopenic obesity. The included studies comprised 306 participants, with an average age of 64 to 72 years. We noticed a trend of improvement in the included studies among the intervention groups compared to the control groups among the different outcomes. The study protocol was inconsistent for the intervention settings, duration, and outcomes. Including a modest number of trials made it impossible to perform data meta-analysis.

CONCLUSIONS

Heterogeneity among studies regarding training protocols and the outcome measures reported limited robust conclusions. Still, resistance exercise intervention can improve body composition and functional capacity among elderly women with sarcopenic obesity.

The Hidden Battle Within: Shedding Light on the Co-existence of Sarcopenia and Sarcopenic Obesity among Participants with Type 2 Diabetes in a Tertiary Care Hospital, Gujarat

Introduction

Type 2 diabetes (T2DM) is characterised by chronic hyperglycaemia due to abnormal insulin secretion and/or utilisation. Currently, sarcopenia has emerged as a new complication of T2DM, which increases the risk of physical disability, and even death. The study aims to estimate the prevalence of sarcopenia and sarcopenic obesity (SO) as well as their association with various other factors related to T2DM.

Methods

The study was an observational hospital-based cross-sectional study conducted among diabetic patients who came to the non-communicable diseases (NCD) clinic of a tertiary care hospital in Gujarat, India, from April 2023 to June 2023. Adult patients with T2DM attending follow-ups were included, with a diagnosis of T2DM for at least 1 year from the date of their electronic medical records, regardless of their mode of therapeutic treatment. They were on regular medical reviews with two or more visits to the study site in the past 1 year. Then a self-structured standard questionnaire was used to collect the data, containing socio-demographic characteristics, clinical profiles, anthropometric assessment (comprising weight, height and body mass index [BMI]), bio-impedance indices like body fat%, skeletal muscle% and handgrip by hand dynamometer.

Results

In the study, a total of 404 participants participated. Their mean age was 55 ± 13.5 years and their mean body fat (BF) % was 30 ± 7.4%. BF%-defined obesity was found in 260 (64.4%) participants. A total of 362 (89.6%) had possible sarcopenia, 183 (45.3%) had sarcopenia and 124 (30.7%) had SO. Age (OR: 2.6, CI: 1.7-3.9), duration of diabetes for more than 7 years (OR: 7.5, CI: 3.65-15.4) and BF%-defined obesity (OR: 2.2, CI: 3.6-15) were statistically associated with Sarcopenia, in similar pattern age (OR: 2.4, CI: 1.5-3.7), and duration of diabetes more than 7 years (OR: 18.9, CI: 5.7-62) were associated with SO (P < 0.05).

Conclusion

Older age, longer diabetes duration and BF%-defined obesity are associated with an increased likelihood of developing sarcopenia and sarcopenic obesity. Healthcare providers should prioritise regular screening for sarcopenia and SO in elderly individuals with diabetes to facilitate early detection and intervention.

Association between Sarcopenia and Reduced Bone Mass: Is Osteosarcopenic Obesity a New Phenotype to Consider in Weight Management Settings?

Sarcopenic obesity (SO) is a frequent phenotype in people with obesity; however, it is unclear whether this links with an impaired bone status. In this study, we aimed to investigate the association between SO and low bone mass, and to assess the prevalence of a new entity that combines excessive fat deposition, reduced muscle mass and strength, and low bone mass defined as osteosarcopenic obesity (OSO). Body composition was completed by a DXA scan in 2604 participants with obesity that were categorized as with or without SO, and with low or normal bone mineral content (BMC). Participants with both SO and low BMC were defined as OSO. Among the entire sample, 901 (34.6%) participants met the criteria for SO. This group showed a reduced mean BMC (2.56 ± 0.46 vs. 2.85 ± 0.57, p < 0.01) and displayed a higher prevalence of individuals with low BMC with respect to those without SO (47.3% vs. 25.9%, p < 0.01). Logistic regression analysis showed that the presence of SO increases the odds of having low BMC by 92% [OR = 1.92; 95% CI: (1.60-2.31), p < 0.05] after adjusting for age, body weight, and body fat percentage. Finally, 426 (16.4%) out of the total sample were affected by OSO. Our findings revealed a strong association between SO and reduced bone mass in adults with obesity, and this introduces a new phenotype that combines body fat, muscle, and bone (i.e., OSO) and appears to affect 16% of this population.

The Role of Exercise in Cancer-Related Sarcopenia and Sarcopenic Obesity

One of the most common adverse effects of cancer and its therapeutic strategies is sarcopenia, a condition which is characterised by excess muscle wasting and muscle strength loss due to the disrupted muscle homeostasis. Moreover, cancer-related sarcopenia may be combined with the increased deposition of fat mass, a syndrome called cancer-associated sarcopenic obesity. Both clinical conditions have significant clinical importance and can predict disease progression and survival. A growing body of evidence supports the claim that physical exercise is a safe and effective complementary therapy for oncology patients which can limit the cancer- and its treatment-related muscle catabolism and promote the maintenance of muscle mass. Moreover, even after the onset of sarcopenia, exercise interventions can counterbalance the muscle mass loss and improve the clinical appearance and quality of life of cancer patients. The aim of this narrative review was to describe the various pathophysiological mechanisms, such as protein synthesis, mitochondrial function, inflammatory response, and the hypothalamic-pituitary-adrenal axis, which are regulated by exercise and contribute to the management of sarcopenia and sarcopenic obesity. Moreover, myokines, factors produced by and released from exercising muscles, are being discussed as they appear to play an important role in mediating the beneficial effects of exercise against sarcopenia.

Clinical Significance of Nutritional Status, Inflammation, and Body Composition in Elderly Hemodialysis Patients-A Case-Control Study

Nutritional and inflammatory disorders are factors that increase the risk of adverse clinical outcomes and mortality in elderly hemodialysis (HD) patients. This study aimed to examine nutritional and inflammation status as well as body composition in older adults on HD compared to matched controls. A case-control study was conducted on 168 older participants (84 HD patients (cases) and 84 controls) age- and sex-matched. Demographic, clinical, anthropometric, and laboratory parameters were collected from medical records. The primary outcome was nutritional status assessment using a combination of nutritional and inflammatory markers along with the geriatric nutritional risk index (GNRI). Sarcopenic obesity (SO) was studied by the combined application of anthropometric measures. Body composition and hydration status were assessed by bioelectrical impedance analysis (BIA). Univariate and multivariate regression analyses were performed to identify nutritional and inflammatory independent risk indicators in elderly HD patients and controls. A significantly high prevalence of nutritional risk measured by the GNRI was found in HD patients (32.1%) compared to controls (6.0%) (p < 0.001). Elderly HD patients were overweight and had lower percent arm muscle circumference, phase angle (PA), serum albumin (s-albumin), as well as higher percent extracellular body water (ECW%) and serum C-reactive protein (s-CRP) than controls (all at least, p < 0.01). SO was higher in HD patients (15.50%) than in controls (14.30%). By multi-regression analyses, age < 75 years (OR: 0.119; 95%CI: 0.036 to 0.388), ECW% (OR: 1.162; 95%CI: 1.061 to 1.273), PA (OR: 0.099; 95%CI: 0.036 to 0.271), as well as BMI, s-albumin ≥ 3.8 g/dL, and lower s-CRP were independently related between cases and controls (all at least, p < 0.05). Elderly HD patients had increased nutritional risk, SO, inflammation, overhydration, and metabolic derangements compared to controls. This study highlights the importance of identifying nutritional risk along with inflammation profile and associated body composition disorders in the nutritional care of elderly HD patients. Further studies are needed to prevent nutritional disorders in elderly HD patients.

Sex Differences in the Association of Weight-Adjusted-Waist Index with Sarcopenic Obesity: A Cross-Sectional Study of Hemodialysis Patients

Objective: To explore the association between weight-adjusted-waist index (WWI) and sarcopenic obesity (SO) in patients with maintenance hemodialysis (MHD). Methods: A multicenter, cross-sectional study that included 3311 adult MHD patients was conducted in 20 hemodialysis (HD) centers from June 1, 2021, to August 30, 2021. Body composition was evaluated by body composition monitor based on bioimpedance spectroscopy. Hand grip strength was measured by CAMRY® dynamometer. WWI was calculated as waist circumference (cm) divided by the square root of body weight (kg). Multiple logistic regression models, spearman correlation analysis, and receiver-operating characteristic (ROC) analyses were conducted. Results: The median age of the study was 55 years, and 39.4% of patients were female. The prevalence of SO was 22.7% in the total population, and patients with SO had higher WWI. Higher WWI quartiles were independently associated with a higher risk of SO in men after adjusting for potential confounders, including age, dialysis vintage, body mass index, biochemical indicators, and various medical histories; the odds ratio (OR) of SO was highest in the fourth quartile of the WWI (OR: 4.08, 95% confidence interval: 2.65-6.27, P for trend <0.001). Age-adjusted WWI provided a better diagnostic power than WWI only for SO in men (area under the ROC curve: 0.72 vs. 0.68, P < 0.001). WWI was not associated with SO in female HD patients. Conclusion: WWI is independently associated with SO in male but not female MHD patients. This anthropometric index is simple to calculate, making it applicable in clinical practice.

Sarcopenic Obesity as a Risk Factor for Cardiovascular Disease: An Underrecognized Clinical Entity

Sarcopenic obesity (SO) is a chronic condition and an emerging health challenge, in view of the growing elderly population and the obesity epidemic. Due to a lack of awareness among treating doctors and the non-specific nauture of the associated symptoms, SO remains grossly underdiagnosed. There is no consensus yet on a standard definition or diagnostic criteria for SO, which limits the estimation of the global prevalence of this condition. It has been linked to numerous metabolic derangements, cardiovascular disease (CVD) and mortality. The treatment of SO is multimodal and requires expertise across multiple specialties. While dietary modifications and exercise regimens have shown a potential therapeutic benefit, there is currently no proven pharmacological management for SO. However, numerous drugs and the role of bariatric surgery are still under trial, and have great scope for further research. This article covers the available literature regarding the definition, diagnostic criteria, and prevalence of SO, with available evidence linking it to CVD, metabolic disease and mortality, and an overview of current directives on management.

Sarcopenic Obesity in Community-Dwelling Spanish Adults Older than 65 Years

Sarcopenic obesity (SO) is diagnosed when sarcopenia and obesity coexist in patients. The objective of this study was to determine the prevalence of SO under different diagnostic criteria in community-dwelling Spanish adults aged over 65 years residing in Valencia (Spain). The research was conducted as an observational and cross-sectional study with a sample size of 202 subjects. To diagnose sarcopenia, we used the tests proposed by the European Working Group on Sarcopenia in Older People in 2019 (EWGSOP2): SARC-F, grip strength, sit-to-stand, gait speed, Appendicular Skeletal Muscle Mass (ASMM), and Short Physical Performance Battery (SPPB). For obesity diagnosis, we used body mass index (BMI), waist circumference (WC), total body fat percentage (%TBF), and tricipital skinfold (TS). The prevalence of SO was 16.5% in women and 29% in men, according to any of the diagnostic criteria used to determine obesity. A higher proportion of SO was observed as age increased in both groups, although no significant differences were found. Most values obtained in tests related to SO diagnosis were worse in the group affected by the disease; however, there were two exceptions related to the amount of ASMM. In total, 18.8% of the participants presented SO according to any diagnostic criteria related to obesity. Our results suggest significant differences in the number of SO cases depending on diagnostic criteria used to determine the participants' obesity. BMI, WC, and TBF% were shown as principal variables to be included in obesity diagnosis within the SO construct. These findings underscore the need to unify criteria to standardize the diagnosis of SO in the global population.

The causal relationship between sarcopenic obesity factors and benign prostate hyperplasia

Background

Both benign prostatic hyperplasia (BPH) and sarcopenic obesity (SO) are common conditions among older adult/adults males. The prevalent lifestyle associated with SO is a significant risk factor for the development of BPH. Therefore, we investigated the causal relationship between SO factors and BPH.

Method

The instrumental variables for SO factors were selected using the inverse variance-weighted method, which served as the primary approach for Mendelian randomization analysis to assess the causal effect based on summary data derived from genome-wide association studies of BPH.

Result

The increase in BMR (OR = 1.248; 95% CI = (1.087, 1.432); P = 0.002) and ALM (OR = 1.126; 95% CI = (1.032, 1.228); P = 0.008) was found to be associated with an elevated risk of BPH. However, no genetic causality between fat-free mass distribution, muscle mass distribution, and BPH was observed.

Conclusion

Our findings indicate that a genetic causal association between BMR, ALM and BPH. BMR and ALM are risk factors for BPH. The decrease in BMR and ALM signified the onset and progression of SO, thus SO is a protective factor for BPH.

Publication trends in nutrition research for sarcopenic obesity: A 20-year bibliometric analysis

BACKGROUND

We used bibliometric methods to evaluate publications on the role of nutrition in sarcopenic obesity and analyzed the current situation and developmental trends over the past 2 decades.

METHODS

Publications from 2002 to 2022 related to the role of nutrition in sarcopenic obesity were extracted from the Web of Science Core Collection database. CiteSpace, VOSviewer, and the Bibliometrix R package were applied to build relevant network diagrams.

RESULTS

One thousand ninety-four articles from 64 countries were included. The annual number of publications in this field has shown an intense growth trend. The University of Alberta, Yonsei University, and Korea University are the major research institutions. Clinical Nutrition has published the most papers on the role of nutrition in sarcopenic obesity, and the American Journal of Clinical Nutrition is the most co-cited journal. A total of 5834 authors conducted the relevant studies. Yves Boirie has published the most papers in this field, and AJ Cruz-Jentoft is the most co-cited author.

CONCLUSION

This is the first bibliometric study of the role of nutrition in sarcopenic obesity. This study systematically summarizes the research hotspots and development directions in this field, and provides a reference for scholars studying the role of nutrition in sarcopenic obesity.

Sarcopenic Obesity Burden, Determinants, and Association With Risk of Frailty, Falls, and Functional Impairment in Older Adults With Diabetes: A Propensity Score Matching Analysis

BACKGROUND

Sarcopenic obesity (SO) is a medical and functional state characterized by the coexistence of excessive adipose tissue and sarcopenia inside an individual. Recent epidemiological studies suggest a rising prevalence of SO in patients with diabetes mellitus (DM) probably due to the conducive environment resulting from adipose tissue dysfunction and muscle wasting accelerated by insulin resistance, chronic inflammation, and altered protein metabolism. Individuals with SO may have higher risk of experiencing falls, frailty, and disabilities due to compromised musculoskeletal integrity, gait abnormalities, and reduced functional capacity. The primary study objective was to determine the prevalence and predictors of SO among older adults with a history of DM. The secondary objective was to assess the association of falls, frailty, and functional disability with SO in patients with DM.

METHODOLOGY

This cross-sectional study analyzed data from the nationally representative Longitudinal Aging Study in India (LASI) Wave 1, focusing on individuals aged 60 and above, with an emphasis on diabetes. SO was assessed using the Asian Working Group for Sarcopenia criteria. Propensity score matching (PSM), logistic regression, and mediation analysis were used to explore relationships between diabetes, SO, and health outcomes (falls, frailty, and disabilities).

RESULTS

Among 31,902 participants aged 60 and above, 14.26% had diabetes, and 17.67% of those with diabetes exhibited SO. Female gender (aOR = 2.63) and urban residence (aOR = 1.40) were significantly associated with higher odds of SO in individuals with diabetes. PSM analysis revealed a 9.0% higher likelihood of SO in older adults with DM than those without DM. SO was further linked to increased risk of falls, frailty, and various levels of activities of daily living (ADL) and instrumental activities of daily living (IADL) disabilities, with significant mediation effects ranging from 3.67% to 45.81%.

CONCLUSIONS

Diabetes substantially increases the risk of SO and associated functional disability with the risk of falls in older adults. Standard diabetes care should integrate health promotion especially nutrition to mitigate the risk of SO-linked functional disability and falls.

Relationship between sarcopenic obesity and cognitive function in patients with mild to moderate Alzheimer's disease

BACKGROUND

Previous research has linked sarcopenic obesity (SO) to cognitive function; however, the relationship between cognitive performance and SO Alzheimer's disease (AD) patients remains unclear. This study aimed to investigate their relationship in AD patients.

METHODS

One hundred and twenty mild to moderate AD patients and 56 normal controls were recruited. According to sarcopenia or obesity status, AD patients were classified into subgroups: normal, obesity, sarcopenia, and SO. Body composition, demographics, and sarcopenia parameters were assessed. Cognitive performance was evaluated using neuropsychological scales.

RESULTS

Among the 176 participants, the prevalence of SO in the moderate AD group was higher than in the normal control group. The moderate AD group had the lowest appendicular skeletal muscle mass index (ASMI) and the highest percentage of body fat (PBF). Hypertension and diabetes were more prevalent in the SO group than in the normal group among the subgroups. The sarcopenia and SO groups exhibited worse global cognitive function compared to the normal and obesity groups. Partial correlation analysis revealed that ASMI, PBF, and visceral fat area were associated with multiple cognitive domains scores. In logistic regression analysis, after adjusting for confounders, obesity was not found to be associated with AD. However, sarcopenia (odds ratio (OR) = 5.35, 95% CI: 1.27-22.46) and SO (OR = 5.84, 95% CI: 1.26-27.11) were identified as independent risk factors for AD.

CONCLUSIONS

SO was associated with cognitive dysfunction in AD patients. Moreover, the impact of SO on cognitive decline was greater than that of sarcopenia. Early identification and intervention for SO may have a positive effect on the occurrence and progression of AD.

Discovering the Individualized Factors Associated with Sarcopenia and Sarcopenic Obesity Phenotypes-A Machine Learning Approach

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.

Relationship between Lean Tissue Mass and Muscle Function in Women with Obesity

It is well documented that lean tissue mass (LTM) decreases with aging in patients with obesity, but there is no information available regarding muscle strength changes, a parameter that may be better associated with sarcopenic obesity (SO). The objectives of this study were to analyze the changes in LTM and fat mass (FM), muscle strength and muscle function with aging in women with obesity and to determine the prevalence of SO. LTM and FM were determined by DXA, muscle strength with the hand-grip test and muscle function with the 6 min walk test (6MWT) in 383 women with obesity. A redistribution of the LTM and FM occurred with age, characterized by a gain at the trunk to the detriment of the lower limbs, thus reducting in appendicular LTM indices. The physical performances evaluated by the muscle strength and muscle function decreased concomitantly, and the prevalence of low values for both these parameters was 22.8% and 13.4%, respectively, in the older patients. In summary, although a reduction in appendicular LTM and muscle performances occurred with age and resulted in an increase in the prevalence of SO, the number of women with obesity affected by SO remained low (n ≤ 15), even in those older than 60 years.

The role of chicken eggs in modulating sarcopenic obesity and gut microbiota in db/db mice

Background

Sarcopenia obesity, in which loss of muscle mass and fat accumulation occur simultaneously, is the pathological basis of type 2 diabetes mellitus. The usefulness of chicken eggs in sarcopenia prevention has been reported in several previous studies. The purpose of this study was to determine the beneficial effects of chicken eggs in the prevention of sarcopenic obesity in db/db mice.

Methods

We raised 8-week-old db/db male mice, a model of sarcopenia obesity, for 8 weeks and fed them a diet mixed with dried whole eggs. The fecal microbiota transplant (FMT) group was treated with antibiotics for 2 weeks, starting at 6 weeks of age, followed by FMT twice a week until 16 weeks of age.

Results

Eggs administered to db/db mice showed increased grip strength (p = 0.022) and muscle mass (p = 0.013), decreased visceral fat mass (p = 0.005), and significantly increased physical activity (p < 0.001). The FMT group of egg-fed mice showed a significant improvement in glucose intolerance and sarcopenic obesity. Sequencing of gene expression in the small intestine showed that the gene expression of amino acid transporters such as Slc6a18, Slc6a19, and Slc38a6 was increased in egg-fed mice. 16S rRNA sequencing of the gut microbiota showed an increase in the genus Vampirovibrio in both the egg-fed and FMT groups compared to that in egg-fed mice.

Conclusion

The results of this study indicate that egg consumption not only increases the intake of amino acids and other nutrients but also alters the intestinal microbiota and increases amino acid absorption from the intestinal tract, suggesting that eggs might contribute to the ameliorative mechanism of sarcopenic obesity.

Impact of sarcopenia and sarcopenic obesity on survival in patients with primary liver cancer: a systematic review and meta-analysis

Background

Sarcopenia and sarcopenic obesity are associated with an increased possibility of adverse clinical outcomes; however, the effects of sarcopenia and sarcopenic obesity on patients with primary liver cancer remain controversial. Therefore, the present study aimed to determine the impact of sarcopenia and sarcopenic obesity on survival in patients with primary liver cancer.

Methods

We searched studies published in English in PubMed, Embase, Web of Science, and Cochrane Library databases up to 13 November 2022. Cohort studies that reported the association among sarcopenia, sarcopenic obesity, and patient survival were included.

Results

A total of 64 cohort studies with data on 11,970 patients with primary liver cancer were included in the meta-analysis. Sarcopenia was associated with poor overall survival in patients with primary liver cancer [adjusted hazard ratio (HR) 2.11, 95% confidence interval (CI): 1.89-2.36, P < 0.0001], with similar findings for sarcopenic obesity (adjusted HR: 2.87, 95% CI: 2.23-3.70, P < 0.0001). Sarcopenia was also associated with poor overall survival across the subgroups analyzed by ethnicity, type of liver cancer, treatment modalities, method used to define sarcopenia, and etiology of liver cancer. We also found a negative correlation among sarcopenia, sarcopenic obesity, and recurrence-free/disease-free survival (adjusted HR: 1.73, 95% CI: 1.50-1.99, P < 0.001; adjusted HR: 2.28, 95% CI: 1.54-3.35, P < 0.001, respectively).

Conclusion

Sarcopenia and sarcopenic obesity were significantly associated with poor overall survival and recurrence-free/disease-free survival in patients with primary liver cancer.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=378433, PROSPERO [42022378433].

Skeletal muscle mass, muscle strength, and physical performance in children and adolescents with obesity

Introduction

Sarcopenic obesity (SO) is defined as obesity with low skeletal muscle function and mass. This study aimed to evaluate the presence of sarcopenic obesity according to different diagnostic criteria and assess the elements of sarcopenia in children and adolescents with obesity.

Methods

A total of 95 children and adolescents with obesity (diagnosed with the use of International Obesity Task Force (IOTF) criteria) with a mean age of 12.7( ± 3) years participated in the study. Body composition was assessed with the use of bioelectrical impedance-BIA (Tanita BC480MA) and dual-energy X-ray absorptiometry-DXA (Hologic). Fat mass (FM) and appendicular skeletal muscle mass (SMMa) were expressed as kilograms (kg) and percentage (%). Muscle-to-fat ratio (MFR) was defined as SMMa divided by FM. A dynamometer was used in order to measure grip strength. Six-minute walk test (6MWT) and a timed up-and-go test (TUG) were used to assess physical performance.

Results

The presence of SO ranged from 6.32% to 97.89%, depending on the criteria used to define sarcopenia. Children with sarcopenia, defined as a co- occurrence of low skeletal muscle mass % (SMM%) measured by DXA (≤9th centile) according to McCarthy et al. and weak handgrip strength (≤10th centile) according to Dodds et al., had significantly lower SMMa measured by both DXA and BIA, lower maximal handgrip strength, and lower physical performance. Maximal handgrip was positively correlated with SMMa (kg) and SMMa% derived from both DXA and BIA and BIA-MFR. Maximal handgrip was negatively correlated with waist-to-height ratio (WHtR). The distance of 6MWT correlated positively with BIA-measured SMMa% and BIA-MFR. 6MWT distance correlated negatively with BIA-FM% and body mass index (BMI) z-score. TUG was positively correlated with BIA-FM%, BMI z-score, WHtR, and IOTF categories and negatively correlated with BIA-SMMa% and BIA-MFR.

Discussion

The presence of sarcopenia in our study varied depending on the diagnostic criteria used. This is one of the first studies evaluating muscle mass, muscle strength, and physical performance in children and adolescents with obesity. The study highlighted the need for the implementation of a consensus statement regarding SO diagnostic criteria in children and adolescents.

Skeletal muscle-focused guideline development: hierarchical model incorporating muscle form, function, and clinical outcomes

Sarcopenia, sarcopenic obesity, malnutrition, and cachexia clinical guidelines were created by expert consensus over the past decade. These pathological states all share in common deficits in skeletal muscle mass, and in some cases muscle function, which adversely impact patient outcomes. Early identification is key as some detrimental outcomes are potentially preventable with available treatments. The four guidelines share common design features: patients suspected of having the condition are first screened with a focused clinical history; if positive, the next step is evaluation with either a measure of body "form" (e.g., mass, shape, and composition) or function (e.g., mechanical, endurance, and metabolic); combined form and functional criteria are also recognized. The form and functional "gateway" nodes establish whether or not to proceed with further evaluations and treatments. Intensive discussions among experts focus on selection of these gateway nodes and the final choice is made when consensus is reached. Form and functional measures are often treated as equivalent alternatives when framed in the context of "outcomes" for which they are intended to predict. Here we adapt a classic biological concept stating that "function follows form" to show that pathophysiological links are present between these two different muscle qualities and clinical outcomes. We argue that a hierarchy exists such that outcomes closely follow functions that, in turn, follow form…the OFF rule. The OFF rule explains why functional measures often show stronger associations with outcomes than those quantifying form, helps to frame debates on how to structure the gateway nodes used to identify patients for further evaluation and treatment, and sets out a pathophysiological structure for developing future outcome prediction models.

The serum creatinine to cystatin C to waist circumference ratios predicts risk for type 2 diabetes: A Chinese cohort study

BACKGROUND

There is a lack of research regarding the relationship between creatinine to cystatin C to waist circumference ratio (CCR/WC ratios) and the development of type 2 diabetes mellitus (T2DM). We aimed to evaluate the association between CCR/WC ratios and incident T2DM in Chinese adults.

METHODS

This prospective study was from the China Health and Retirement Longitudinal Study (2011, 2013, 2015, and 2018). The participants were divided into three groups by tertiaries of the CCR/WC ratios. Cox proportional-hazards models were used to identify the relationship between CCR/WC and T2DM.

RESULTS

Overall, 5938 participants were included for analysis, 766 of whom developed T2DM between 2011 and 2018. Risk of incident T2DM was decreased with tertiaries 2, 3 versus tertiary 1 of the CCR/WC index (adjusted hazard ratio [HR] 0.772 [95% confidence interval 0.647-0.921] and 0.724 [0.596-0.880], p for trend = .001 across tertiaries of the CCR/WC index). The results were consistent excluding participants with T2DM in the first 2 years.

CONCLUSIONS

This study demonstrated that CCR/WC was negatively correlated with the risk of T2DM in Chinese adults. Early detection is necessary to control the development of T2DM in Chinese with low CCR/WC levels.

Obesity and sarcopenic obesity characterized by low-grade inflammation are associated with increased risk for major depression in women

Background

We aimed to determine women's risk of major depressive disorder (MDD) in relation to obesity phenotypes characterized by levels of circulating high-sensitivity C-reactive protein (hsCRP).

Methods

This population-based retrospective cohort study comprised 808 women (ages 20-84 y) recruited 1994-1997 and followed for a median 16.1 y (IQR 11.9-16.8). At baseline, body fat and lean tissue mass were measured by whole body dual-energy x-ray absorptiometry (DXA). Obesity was identified as high fat mass index (>12.9 kg/m2), body fat percentage (≥35%) and body mass index (≥30 kg/m2); sarcopenic obesity referred to a high ratio fat mass/fat-free mass (≥0.80). Systemic inflammation was operationalized as serum hsCRP concentration in the upper tertile (>2.99 mg/L). Obesity phenotypes were: non-obese + lowCRP, non-obese + highCRP, obese + lowCRP, and obese + highCRP. During follow-up, the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP) was used to identify lifetime history of MDD and age of onset. Poisson regression models were used to estimate the MDD rate for each obesity phenotype during follow-up. Demographic, health and lifestyle factors were tested as potential confounders.

Results

During 11,869 p-y of follow-up, 161 (19.9%) women experienced an MDD episode. For obesity phenotypes based on fat mass index, models adjusted for baseline age and prior MDD, and non-obese + lowCRP as reference, RR for non-obese + highCRP was 1.21 (95% CI 0.80, 1.82), obese + lowCRP 1.46 (0.86, 2.47) and obese + highCRP 1.56 (1.03, 2.37). Patterns were similar for obesity by body fat percentage, body mass index and sarcopenic obesity.

Conclusion

Consistently across different obesity definitions, this longitudinal study reports that women with both obesity and systemic inflammation are at increased risk of subsequent MDD. Future research should examine whether tackling this metabolically unhealthy obesity type - through, for example, lifestyle or medication approaches - can reduce depression risk.

Prevalence of associations among sarcopenia, obesity, and metabolic syndrome in Brazilian older adults

Background

Although aging is a process associated with the development of obesity, metabolic syndrome (MetS), and sarcopenia, the prevalence of these conditions in older adults from São Paulo, Brazil, is unclear.

Methods

Therefore, the current study aimed to investigate the prevalence of obesity, sarcopenia, and MetS, both separately and together, in a community-based sample of older adults from São Paulo, Brazil. Data from the medical records of 418 older adults of both genders, aged 60  years or older (mean age 69.3 ± 6.5  years), who were not physically active, were used to conduct this retrospective cross-sectional study. Anthropometric variables were used to determine both body mass index (BMI) and Conicity index (C index). Sarcopenia and MetS were defined according to the criteria of the European Working Group on Sarcopenia in Older People and by the Brazilian Society of Endocrinology and Metabolism, respectively.

Results

Based on BMI, the group of older men (n = 91) showed a predominance of adequate weight (n = 49) and the group of older women (n = 327) showed a predominance of obesity (n = 181). In association with obesity, while only the group of older women presented with sarcopenia (n = 5), 52 older women and 9 older men presented with MetS, and two older women presented with sarcopenia + MetS [prevalence ratio = 0.0385, 95% CI (0.007;0.1924)]. Based on the C index, 58 older women and 11 older men presented with MetS, while the occurrence of sarcopenia or MetS + sarcopenia was found in 32 and 5 older women, respectively [prevalence ratio = 0.0910, 95% CI (0.037;0.2241)].

Discussion

Our results suggest that obesity, as measured by BMI or the C Index, was more closely associated with the occurrence of MetS than sarcopenia, regardless of gender, and also that sarcopenic obesity was only found in the group of older women. Additionally, the prevalence ratio of obesity, sarcopenia, and MetS evidenced using the C index was 2.3 times higher than the values found using the BMI classification.

Recent Advances in Nutraceuticals for the Treatment of Sarcopenic Obesity

Sarcopenic obesity, low muscle mass, and high body fat are growing health concerns in the aging population. This review highlights the need for standardized criteria and explores nutraceuticals as potential therapeutic agents. Sarcopenic obesity is associated with insulin resistance, inflammation, hormonal changes, and reduced physical activity. These factors lead to impaired muscle activity, intramuscular fat accumulation, and reduced protein synthesis, resulting in muscle catabolism and increased fat mass. Myostatin and irisin are myokines that regulate muscle synthesis and energy expenditure, respectively. Nutritional supplementation with vitamin D and calcium is recommended for increasing muscle mass and reducing body fat content. Testosterone therapy decreases fat mass and improves muscle strength. Vitamin K, specifically menaquinone-4 (MK-4), improves mitochondrial function and reduces muscle damage. Irisin is a hormone secreted during exercise that enhances oxidative metabolism, prevents insulin resistance and obesity, and improves bone quality. Low-glycemic-index diets and green cardamom are potential methods for managing sarcopenic obesity. In conclusion, along with exercise and dietary support, nutraceuticals, such as vitamin D, calcium, vitamin K, and natural agonists of irisin or testosterone, can serve as promising future therapeutic alternatives.

Association of socioeconomic factors and dietary intake with sarcopenic obesity in the Korean older population

BACKGROUND AND OBJECTIVES

This study investigated the relationship between socioeconomic factors, dietary intake, and sarcopenic obesity among older adults in Korea.

METHODS AND STUDY DESIGN

Data from the seventh Korean National Health and Nutrition Examination Survey (2016-2018) were analyzed. The study included 3,690 participants (1,645 men and 2,045 women) aged 65 years and older. Sarcopenic obesity was defined as the coexistence of low muscle strength (handgrip strength <28 kg in men and <18 kg in women) and abdominal obesity (waist circumference >90 cm in men and >85 cm in women). Socioeconomic factors assessed included age, living status, residential area, employment, education, and family income level. Dietary intake was evaluated using the nutrient adequacy ratio and mean adequacy ratio derived from 24-h dietary recall data. Multiple logistic regression was used to identify factors associated with sarcopenic obesity.

RESULTS

The prevalence rates of sarcopenic obesity were 6.5% in men and 17.4% in women. Low education levels were significantly associated with a higher prevalence of sarcopenic obesity in women, whereas lower family income levels were associated with an increased risk of sarcopenic obesity in men. In women, a lower mean adequacy ratio was significantly associated with a higher risk of sarcopenic obesity.

CONCLUSIONS

Lower family income and education level are associated with a higher prevalence of sarcopenic obesity. Ad-ditionally, overall nutritional adequacy is inversely related to the prevalence of sarcopenic obesity, particularly in women.

The trajectory of sarcopenia following diagnosis of prostate cancer: A systematic review and meta-analysis

INTRODUCTION

Sarcopenia is a common skeletal muscle disorder in older people. Here we explore the prevalence of sarcopenia and its impact on men with prostate cancer.

MATERIALS AND METHODS

We searched PubMed, Embase, and Web of Science databases for relevant studies with an explicit definition of sarcopenia in men with prostate cancer which were published between years 2000 and 2022. Prevalence of sarcopenia and its association with time to biochemical recurrence (BCR), progression-free survival (PFS), non-cancer mortality, overall survival (OS), and treatment-related complications in men with prostate cancer were explored. The summary prevalence, hazard ratios (HRs), and 95% confidence intervals (CIs) were calculated.

RESULTS

A total of 24 studies comprising 3,616 patients with early and advanced prostate cancer were included. The prevalence of sarcopenia and sarcopenic obesity was 43.8% (95% CI 19.2%-68.5%) and 24.0% (95% CI 5.0%-43.1%), respectively. Sarcopenia was not associated with a shorter time to BCR (HR 0.89, 95% CI 0.64-1.23, p = 0.48), a shorter PFS (HR 1.20, 95% CI 0.73-1.97, p = 0.48), or a shorter OS (HR 1.29, 95% CI 0.90-1.85, p = 0.16). In contrast, sarcopenia was significantly associated with a higher non-cancer mortality (HR 1.85, 95% CI 1.23-2.80, p = 0.003). In four out of five studies eligible for assessment, sarcopenia was not associated with an increased risk of treatment-related complications.

DISCUSSION

Sarcopenia increases the risk of death from other causes in men with prostate cancer. Patients with prostate cancer should be assessed and managed for sarcopenia in everyday clinical practice.

Nutritional Management of a Liver Transplant Candidate

Nearly two-thirds of patients with cirrhosis suffer from malnutrition resulting from multiple contributory factors such as poor intake, accelerated starvation, catabolic milieu, and anabolic resistance. Nutritional assessment and optimization are integral to adequate management of a liver transplant (LT) candidate. A detailed nutritional assessment should be done at baseline in all potential transplant candidates with periodic reassessments. Sarcopenia is defined as a reduction in muscle mass, function, and/or performance. Skeletal muscle index at 3rd lumbar vertebra determined by computed tomography is the most objective tool to assess muscle mass. Hand-grip strength and gait speed are simple tools to gauge muscle strength and performance, respectively. Sarcopenia, sarcopenic obesity, and myosteatosis portend poor outcomes. Sarcopenia contributes greatly to frailty, which is a syndrome of reduced physiological reserve and impaired response to stressors. Dietary interventions must ensure adequate calorie (35-40 kcal/kg/day) and protein (1.2-1.5 gm/kg/day) intake via multiple frequent meals and late-evening calorie-dense snack. Micronutrient supplementation is essential, keeping in mind the etiology of cirrhosis. Individualized, gradually up-titrated exercise prescription consisting of both aerobic and resistance training of 150 min/week is advisable after appropriate risk assessment. Early initiation of enteral nutrition within 12-24 h of LT is recommended. Data with respect to immune-nutrition, monomeric formulas, and hormone replacement remain conflicting at present. A multidisciplinary team comprising of hepatologists, transplant surgeons, intensivists, dieticians, and physiotherapists is vital to improve overall nutrition and outcomes in this vulnerable group.

GABA Prevents Age-Related Sarcopenic Obesity in Mice with High-Fat-Diet-Induced Obesity

Sarcopenic obesity is characterized by concurrent obesity and muscle wasting (sarcopenia) and is common in the elderly. Sarcopenic obesity has steadily increased as the aging population has grown and is an increasing public health burden. Both obesity and sarcopenia independently increase health risks of the elderly, but sarcopenic obesity has a greater effect on metabolic disease than either obesity or sarcopenia alone. The metabolic mechanisms of obesity and sarcopenia are strongly interconnected, and obesity and sarcopenia form a vicious cycle, with each pathology exacerbating the other. The pathogenesis of sarcopenic obesity is more complex than either disease alone and remains incompletely understood, underscoring the significant unmet clinical need for effective sarcopenic obesity treatments. We aimed to determine the efficacy and underlying regulatory mechanisms of Gamma-aminobutyric acid (GABA) in sarcopenic obesity in high-fat-diet-fed obese aged mice and alterations in related mechanisms to determine the potential of GABA as a therapeutic modality for sarcopenic obesity. In this study, we used young (3 months) and aged (20 months) mice to evaluate age-related sarcopenic obesity. The daily administration of GABA for 8 weeks resulted in decreased fat mass and increased muscle mass and strength in aged mice. GABA also enhanced energy expenditure in both adipose tissue and skeletal muscle. In addition, GABA promoted muscle synthesis and decreased muscle degradation by activating the phosphatidylinositol-3-kinase (PI3K)/Akt pathway. These findings demonstrate that GABA has potential uses in preventing age-related sarcopenic obesity and related metabolic diseases.

Nutritional and exercise interventions in individuals with sarcopenic obesity around retirement age: a systematic review and meta-analysis

CONTEXT

Retirement is an opportune time for people to establish new healthy routines. Exercise and nutritional interventions are promising in the prevention and treatment of sarcopenic obesity.

OBJECTIVE

This systematic review aimed.

to assess the effectiveness of nutritional and exercise interventions for the treatment of sarcopenic obesity in persons of retirement age.

DATA SOURCES

PubMed, Embase, CINAHL, and CENTRAL databases were searched in September 2021 for randomized controlled trials; a manual search was also conducted. The search yielded 261 studies, of which 11 were eligible for inclusion.

DATA EXTRACTION

Studies of community-dwelling individuals with sarcopenic obesity receiving any nutritional or exercise intervention ≥ 8 weeks with the mean age  ±  standard deviation between 50 and 70 years were included. Primary endpoint was body composition, and secondary endpoints were body mass index, muscle strength, and physical function. The literature review, study selection, data extraction, and risk-of-bias assessment were performed by two reviewers independently. Data were pooled for meta-analysis when possible.

RESULTS

Meta-analysis was only possible for the exposure "resistance training" and the exposure "training (resistance or aerobic)" in combination with the exposure "added protein" as compared with "no intervention" or "training alone." Resistance training led to a significant body fat reduction of -1.53% (95%CI, -2.91 to -0.15), an increase in muscle mass of 2.72% (95%CI, 1.23-4.22), an increase in muscle strength of 4.42 kg (95%CI, 2.44-6.04), and a slight improvement in gait speed of 0.17 m/s (95%CI, 0.01-0.34). Protein combined with an exercise intervention significantly reduces fat mass (-0.80 kg; 95%CI, -1.32 to -0.28). Some individual studies of dietary or food supplement interventions for which data could not be pooled showed positive effects on body composition.

CONCLUSION

Resistance training is an effective treatment for persons of retirement age with sarcopenic obesity. Increased protein intake combined with exercise may increase reductions in fat mass.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42021276461.

Phase Angle, Inflammation, and Sarcopenia in Late Postoperative Roux-En-Y Gastric Bypass

Sarcopenic obesity is characterized by a disproportion between the amount of muscle to fat. Contrary to most studies evaluating parameters related to sarcopenic obesity in the elderly, this study aims to evaluate the phase angle (PhA) and sarcopenia in young individuals pre- and post-Roux-en-Y gastric bypass. A total of 69 volunteers (46 women and 23 men; 38.5 ± 8.1 years) participated in this study. Body composition and PhA were assessed using BIA. Sarcopenia was assessed using a handgrip strength test (HGS) and gait speed (GS), and appendicular lean mass (ALM) was assessed using Dual Energy X-ray Absorptiometry (DXA). The PhA was significantly lower (p < 0.0007) and the resistance (R) significantly higher (p = 0.0026) in the postoperative group. HGS was negatively correlated with R (r = -0.63669; p < 0.0001), hs-CRP (r = -0.45436; p = 0.0197), and leptin (r = -0.46505; p = 0.0043). GS was negatively correlated with R (r = -0.36220; p = 0.0254), and ALM was negatively correlated with reactance (r = -0.49485; p = 0.0034) and R (r = -0.65797; p ≤ 0.0001). PhA and other components of BIA provide a good correlation with sarcopenia, especially regarding the reduction in muscle function, in an early form, in individuals in the pre- and postoperative period of gastric bypass.

Association between Dietary Habits and Sarcopenia in Patients with Liver Cirrhosis

Sarcopenia and sarcopenic obesity are frequent complications of cirrhosis, and the dietary patterns of patients with these diseases significantly impact the development of both conditions. This study aims to evaluate the adequacy of the dietary intake of patients with liver cirrhosis. A total of 201 patients with liver cirrhosis were included in this analysis. We evaluated the nutritional status of the patients as stated by EWGSOP2 criteria. Subjects were divided into three groups: non-sarcopenic, sarcopenic, and with sarcopenic obesity. We conducted a dietary assessment three times over nonconsecutive 24 h periods within a month. According to EWGSOP2 criteria, combining low handgrip strength with low skeletal muscle index, the prevalence of sarcopenia was 57.2%. Sarcopenic obesity was found in 25.3% of patients. In the sarcopenic group of patients, the energy intake was lower than the current recommendations. Regarding protein intake, the consumption was relatively low in both sarcopenia and sarcopenic obesity samples of patients (0.85 g/kg body weight and 0.77 g/kg BW, p < 0.0001). Patients had a median of 2-3 eating episodes daily, and they often missed late-evening snacks. In conclusion, diet quality in cirrhotic patients was relatively poor, and energy and protein intakes were lower than suggested.

Personalized Nutritional Strategies to Reduce Knee Osteoarthritis Severity and Ameliorate Sarcopenic Obesity Indices: A Practical Guide in an Orthopedic Setting

Knee osteoarthritis (KOA) is one of the most common joint diseases, especially in individuals with obesity. Another condition within this population, and which presents frequently, is sarcopenic obesity (SO), defined as an increase in body fat and a decrease in muscle mass and strength. The current paper aims to describe recent nutritional strategies which can generally improve KOA clinical severity and, at the same time, ameliorate SO indices. Searches were carried out in the PubMed and Science Direct databases and data were summarized using a narrative approach. Certain key findings have been revealed. Firstly, the screening and identification of SO in patients with KOA is important, and to this end, simple physical performance tests and anthropometric measures are available in the literature. Secondly, adherence to a Mediterranean diet and the achievement of significant body weight loss by means of low-calorie diets (LCDs) remain the cornerstone nutritional treatment in this population. Thirdly, supplementation with certain micronutrients such as vitamin D, essential and non-essential amino acids, as well as whey protein, also appear to be beneficial. In conclusion, in the current review, we presented a detailed flowchart of three different nutritional tracks that can be adopted to improve both KOA and SO based on joint disease clinical severity.

A scientometric analysis of sarcopenic obesity: Future trends and new perspectives

Sarcopenic obesity is a complex condition characterized by the combination of age-related loss of muscle mass and high levels of adiposity, or body fat. Up to 30% of older adults may be affected by this condition, and its prevalence varies by gender, race, and ethnicity. It can lead to postural instability and reduced physical activity, increasing the risk of falls, fractures, and functional limitations. The purpose of this study was to evaluate scientific articles on sarcopenic obesity using statistical methods and to assess the topic from a novel perspective. The Web of Science database publications on sarcopenic obesity published between 1980 and 2023 were analyzed using statistical and bibliometric methods. Spearman correlation coefficient was used in correlation analyses. A nonlinear cubic model regression analysis was performed to forecast the number of publications in the following years. Using keyword network visualization maps, recurrent topics, and relationships were identified. Between 1980 and 2023, the search criteria yielded 1013 publications on geriatric malnutrition. Nine hundred of these (articles, reviews, and meeting abstracts) were included in the analysis. Since 2005, the volume of published materials on the topic has increased dramatically and is continuing to rise. The USA and South Korea were the most active nations, Scott D and Prado CMM were the most active authors, and Osteoporosis International was the most active journal on the subject. This research has shown that countries with higher economic development tend to produce more research on the issue, and the number of publications on the topic will rise in the upcoming years. It is an important research topic in an aging society and needs to be further researched. We believe this article may aid clinicians and scientists in comprehending global efforts to combat sarcopenic obesity.

Sarcopenia prevalence and association with nutritional status in cohort of elderly patients affected by musculoskeletal concerns: a real-life analysis

Introduction

The progressive loss of skeletal muscle mass, strength, and function that frequently occurs as people get older is referred to as sarcopenia. Elderly musculoskeletal aging, sarcopenia, and obesity are all intimately connected. Our study's aim is to investigate the prevalence of sarcopenia in a real cohort of patients over 65 with musculoskeletal conditions referring to a Rehabilitation Unit. The secondary aim of our study is to investigate associations between sarcopenia and alterations in nutritional status and Body Mass Index (BMI). Finally, quality of life and global health has been investigated in our population.

Materials and methods

From January 2019 to January 2021, 247 patients over 65 years old with musculoskeletal concerns were enrolled and participated in an observational study. As outcome measures, the Mini Nutritional Assessment (MNA), the 12-Item Short Form Health Survey (SF-12), and the Cumulative Illness Rating Scale Severity Index (CIRS-SI) were used. Additionally, measurements of total skeletal muscle mass (SMM) and appendicular muscle mass (ASMM) using bioelectrical impedance analysis, as well as a hand grip strength test of the non-dominant hand were taken. The Mid Upper Arm Circumference (MUAC) and the Calf Circumference (CC) were measured and recorded as further indications of possible sarcopenia.

Results

A percentage of 46.1% of subjects with overt sarcopenia was found and 10.1% showed a severe sarcopenia. Patients with severe sarcopenia showed significantly lower values of BMI and MNA. Additionally, sarcopenic patients showed significantly lower values in MNA when compared to non-sarcopenic patients. Considering SF-12, only the physical score revealed slight significant differences. In particular, patients affected by probable or severe sarcopenia presented a lower value than non-sarcopenic patients. Concerning MUAC and CC, severe sarcopenic patients showed significant lower values for both the body parts.

Conclusion

Our study considers a cohort of real-life elderly subjects with musculoskeletal concerns and shows that these subjects are highly susceptible to sarcopenia. Therefore, rehabilitation for elderly patients with musculoskeletal concerns requires to be customized and multidisciplinary. Future research should further investigate these aspects in order to enable the early identification of sarcopenia and the formulation of customized rehabilitative programs. .

Sarcopenia and sarcopenic obesity among community-dwelling Peruvian adults: A cross-sectional study

Background

Sarcopenia and sarcopenic obesity (SO) have emerged as significant contributors to negative health outcomes in the past decade. However, there remains a lack of consensus on the criteria and cut-off thresholds for assessing sarcopenia and SO. Moreover, limited data are available on the prevalence of these conditions in Latin American countries. To address this evidence gap, we aimed to estimate the prevalence of probable sarcopenia, sarcopenia, and SO in a community-dwelling population of 1151 adults aged ≥ 55 years in Lima, Peru.

Methods

Data collection for this cross-sectional study was conducted between 2018 and 2020 in two urban low-resource settings in Lima, Peru. Sarcopenia was defined as the presence of low muscle strength (LMS) and low muscle mass (LMM) according to European (EWGSOP2), US (FNIH) and Asian (AWGS) guidelines. We measured muscle strength by maximum handgrip strength; muscle mass using a whole-body single-frequency bioelectrical impedance analyzer, and physical performance using the Short Physical Performance Battery and 4-meter gait speed. SO was defined as a body mass index ≥ 30 kg/m2 and sarcopenia.

Results

The study participants had a mean age of 66.2 years (SD 7.1), of which 621 (53.9%) were men, and 41.7% were classified as obese (BMI ≥ 30.0 kg/m2). The prevalence of probable sarcopenia was estimated to be 22.7% (95%CI: 20.3-25.1) using the EWGSOP2 criteria and 27.8% (95%CI:25.2-30.4) using the AWGS criteria. Sarcopenia prevalence, assessed using skeletal muscle index (SMI), was 5.7% (95%CI: 4.4-7.1) according to EWGSOP2 and 8.3% (95%CI: 6.7-9.9) using AWGS criteria. The prevalence of sarcopenia based on the FNIH criteria was 18.1% (95%CI: 15.8-20.3). The prevalence of SO, considering different sarcopenia definitions, ranged from 0.8% (95%CI: 0.3-1.3) to 5.0% (95%CI: 3.8-6.3).

Conclusions

Our findings reveal substantial variation in the prevalence of sarcopenia and SO when using different guidelines, underscoring the necessity for context-specific cut-off values. Nevertheless, regardless of the chosen guideline, the prevalence of probable sarcopenia and sarcopenia among community-dwelling older adults in Peru remains noteworthy.

Sarcopenic Obesity in People with Alcoholic Use Disorder: Relation with Inflammation, Vascular Risk Factors and Serum Vitamin D Levels

In recent years, the terms sarcopenia, sarcopenic obesity, and osteosarcopenic obesity (OSO) were coined to define a situation in elderly people strongly associated with frailty and increased mortality. Possibly, a complex interplay of several hormones and cytokines are involved in its development. Ongoing research detected that OSO may occur at any age and in several conditions. The prevalence of OSO in alcoholism was poorly analyzed. The aim of this study was to analyze the prevalence of OSO in alcoholism and its relationship with proinflammatory cytokines and/or common complications of alcoholism, such as cirrhosis, cancer, or vascular disease. We included 115 patients with alcoholic use disorder. Body composition analysis was performed by double X-ray absorptiometry. Handgrip strength was recorded using a dynamometer. We assessed liver function according to Child's classification, and determined serum levels of proinflammatory cytokines (TNF-α, IL-6, IL-8), routine laboratory variables, and vitamin D. People with alcoholic use disorder showed a high prevalence of OSO, especially regarding OSO obesity (60%), OSO osteopenia (55.65%), and OSO lean mass (60.17%). OSO handgrip was closely, independently, related to the presence of vascular calcification (χ² = 17.00; p < 0.001). OSO handgrip was related to several proinflammatory cytokines and vitamin D. Vitamin D deficiency kept a close correlation with OSO handgrip (rho = -0.54, p < 0.001). Therefore, among people with alcohol use disorder, OSO prevalence was high. OSO handgrip is related to serum proinflammatory cytokine levels supporting the possible pathogenetic role of these cytokines on OSO development. Vitamin D deficiency is related to OSO handgrip suggesting its pathogenetic involvement in sarcopenia in patients with alcohol use disorder. The close association between OSO handgrip and vascular calcification is clinically relevant and suggests that OSO handgrip may constitute a prognostic tool in these patients.