Associations of sarcopenic obesity versus sarcopenia alone with functionality

Bahat, Gülistan; Kılıç, Cihan; Özkök, Serdar; Öztürk, Savaş; Karan, Mehmet Akif

doi:10.1016/j.clnu.2021.04.002

Cited by 37 publications

(39 citation statements)

References 44 publications

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“…Regarding the prevalence of sarcopenia, there was a variation depending on the cut-off point and the consensus used, thus reinforcing the hypothesis that the classification of sarcopenia is dependent on the method used, the chosen cut-off point, as well as the population studied (Bijlsma et al, 2013;Bahat et al, 2018Bahat et al, , 2021.…”

Section: Discussionmentioning

confidence: 59%

Cut-off points to screening for sarcopenia in community-dwelling older people residents in Brazil

Fernandes

Andrade

Gonçalves

et al. 2021

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Background At a time when the world’s population is aging, one of the most important challenges for the healthcare field is to control the decline of the musculoskeletal system. This decline consists of a reduction in muscle mass and function, which is called sarcopenia and is associated with adverse health outcomes. Although there has been an increase in the number of publications on sarcopenia and its consequences, the reported prevalence varies widely, since these depend on the characteristics of the population studied, the definitions found in the literature and the cut-off points adopted. In this perspective, the heterogeneity in the classification and the different reference values has a critical impact on the epidemiology of sarcopenia, since neither the procedures, the components and the cut-off points are consistent. Objectives To develop cut-off points for the screening of sarcopenia in community-dwelling older people residents in the northeast of Brazil and compare the prevalences between the values defined by the consensus and the values of the population studied. Methods Community-dwelling older men and women living in three cities in the countryside of Rio Grande do Norte were evaluated. Cutoff points were defined for the variables used to screen for sarcopenia (handgrip strength, SMI, gait speed and SPPB) using the 20th percentile of their population distributions. Results The sample was composed of 1,290 older people (62.5% female and 37.5% male), with an average of 69.5 (± 6.05) years of age. Regarding the cutoff points, the handgrip values were defined as 25.3 kg and 16 kg for men and women, respectively. Considering the SMM adjusted according to their height, the values of 7.88 kg/m2 were adopted for men and 5.52 kg/m2 for women. When adjusting by BMI we obtained 0.73 kg/BMI for men and 0.41 kg/BMI for women. For gait speed it was defined 0.71 m/s for men and 0.63 m/s for women. In the case of SPPB, the result was the same for both genders (≤8). When applying the values found in the studied population, a variation in prevalence was observed for both men and women, depending on the cut-off points and consensus used. Conclusion The cutoff values found in our population were lower than those adopted by international consensus (EWGSOP2, IWGS and FNIH), except for HGS in woman and SMI/m2 for men. Therefore, using specific cutoff points for different populations can provide an accurate assessment of the presence of sarcopenia and better target health prevention strategies for the older people living in the community.

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Section: Discussionmentioning

confidence: 59%

Cut-off points to screening for sarcopenia in community-dwelling older people residents in Brazil

Fernandes

Andrade

Gonçalves

et al. 2021

PeerJ

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“…A previous study involving 2303 community-dwelling residents aged 70–84 years reported lower SPPB scores in residents with sarcopenic obesity than in those with sarcopenia or obesity [ 30 ]. Contrariwise, a clinical study including 1468 community-dwelling older Turks showed that the occurrence of sarcopenia alone was significantly associated with impaired activities of daily living compared to the occurrence of sarcopenic obesity [ 31 ]. The reason why this result [ 31 ] was different from ours was unclear; however, there was a greater proportion of younger (median age, 75 years) and male (68.8%) participants in the previous study [ 31 ] than in our study, and different criteria were used for sarcopenia diagnosis (the European Working Group on Sarcopenia in Older People 2).…”

Section: Discussionmentioning

confidence: 99%

Sarcopenic obesity is associated with impaired physical function and mortality in older patients with heart failure: insight from FRAGILE-HF

et al. 2022

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Background The purpose of this study was to clarify the prevalence, association with frailty and exercise capacity, and prognostic implication of sarcopenic obesity in patients with heart failure. Methods The present study included 779 older adults hospitalized with heart failure (median age: 81 years; 57.4% men). Sarcopenia was diagnosed based on the guidelines by the Asian Working Group for Sarcopenia. Obesity was defined as the percentage of body fat mass (FM) obtained by bioelectrical impedance analysis. The FM cut-off points for obesity were 38% for women and 27% for men. The primary endpoint was 1-year all-cause death. We assessed the associations of sarcopenic obesity occurrence with the short physical performance battery (SPPB) score and 6-minute walk distance (6MWD). Results The rates of sarcopenia and obesity were 19.3 and 26.2%, respectively. The patients were classified into the following groups: non-sarcopenia/non-obesity (58.5%), non-sarcopenia/obesity (22.2%), sarcopenia/non-obesity (15.3%), and sarcopenia/obesity (4.0%). The sarcopenia/obesity group had a lower SPPB score and shorter 6MWD, which was independent of age and sex (coefficient, − 0.120; t-value, − 3.74; P < 0.001 and coefficient, − 77.42; t-value, − 3.61; P < 0.001; respectively). Ninety-six patients died during the 1-year follow-up period. In a Cox proportional hazard analysis, sarcopenia and obesity together were an independent prognostic factor even after adjusting for a coexisting prognostic factor (non-sarcopenia/non-obesity vs. sarcopenia/obesity: hazard ratio, 2.48; 95% confidence interval, 1.22–5.04; P = 0.012). Conclusion Sarcopenic obesity is a risk factor for all-cause death and low physical function in older adults with heart failure. Trial registration University Hospital Information Network (UMIN-CTR: UMIN000023929).

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“…Among the macronutrients, protein intake is of paramount importance, as inadequate protein intake has been shown to cause sarcopenia, defined as the loss of skeletal muscle mass and function. Sarcopenia has been reported in 10-40% of community-dwelling older adults [36] and in 15-70% of the residents of nursing homes [37,38]. There is a well-established connection between bone and muscle, osteosarcopenia, defined as the simultaneous presence of OP and sarcopenia, and it is prevalent particularly in older OP patients.…”

Section: Non-pharmacological Approachesmentioning

confidence: 99%

The current situation in the approach to osteoporosis in older adults in Turkey: areas in need of improvement with a model for other populations

et al. 2021

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Purpose The total number of older adults in Turkey is striking, amounting to around 8 million, and this translates into considerably higher numbers of cases of osteoporosis (OP) and fractures in older adults. In this article, we outlined the current situation of OP in older adults in Turkey and investigated the differences between Turkey and a representative developed European country (Belgium), in terms of the screening, diagnosis, and treatment of OP. Our intention in this regard was to identify areas in need of improvement and subsequently to make a clear call for action to address these issues. Methods Herein, considering the steps related to the OP approach, we made a complete review of the studies conducted in Turkey and compared with the literature recommendations. Results There is a need for a national osteoporotic fracture registry; measures should be taken to improve the screening and treatment of OP in older males, such as educational activities; technicians involved in dual-energy X-ray absorptiometry (DXA) scanning should undergo routine periodic training; all DXA centers should identify center-specific least significant change values; all older adults should be considered for routine lateral dorsolumbar X-ray imaging for the screening of vertebral fractures while ordering DXA scans; the inclusion of vertebral fracture assessment (VFA) software in DXA assessments should be considered; screening using a fracture risk assessment tool (FRAX) algorithm that is specific to Turkey should be integrated; the fortification of foods with vitamin D is required; the high fracture risk by country-specific FRAX algorithm and the presence of falls/high fall risk should be integrated in reimbursement terms; and finally, more "fracture liaison services" should be established. ConclusionWe suggest that the practical consideration of our suggestions will provide considerable support to the efforts for combating with the adverse consequences of OP in society. This approach can be subsequently modeled for other populations to improve the management of OP globally. KeywordsOsteoporosis • Current situation • Turkey • Older • Improvement Abbreviations BMD Bone mineral density DXA Dual-energy X-ray absorptiometry eGFR Estimated glomerular filtration rate ESCEO Economic evaluation of osteoporosis and osteoarthritis * Gulistan Bahat

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Associations of sarcopenic obesity versus sarcopenia alone with functionality

Cited by 37 publications

References 44 publications

Cut-off points to screening for sarcopenia in community-dwelling older people residents in Brazil

Cut-off points to screening for sarcopenia in community-dwelling older people residents in Brazil

Sarcopenic obesity is associated with impaired physical function and mortality in older patients with heart failure: insight from FRAGILE-HF

The current situation in the approach to osteoporosis in older adults in Turkey: areas in need of improvement with a model for other populations

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