Impact of adiposity on muscle function and clinical events among elders with dynapenia, presarcopenia and sarcopenia: a community-based cross-sectional study

Abstract

Introduction: Low muscle function determined unfavorable clinical outcome than low muscle mass; nevertheless, comparison of detrimental parameters among dynapenia, presarcopenia and sarcopenia was sparse. We hypothesized that adiposity is implicated in low muscle function related adverse events. Methods: We recruited community elders to measure handgrip strength and walking speed. Using bioelectronics impedance analyzer to examine body compositions. The faller is indicated of having a fall event in the past one year. Associations of different obesity parameters, metabolic syndrome (MetS) and fall among the groups were analyzed. Results: Among 765 participants, the dynapenia group had higher metabolic profiles, body fat percentage (BFP), waist circumference, and fat to muscle ratio (FMR) than the other groups, whereas the presarcopenia subjects had the lowest obesity parameters. The fallers tended to have poorer muscle function than non-fallers (p<0.001). The dynapenia individuals had the highest risk for MetS (odds ratio [OR]= 5.79; 95% confidence interval [CI]= 2.45-13.73), and the highest fall risk (OR= 3.11; 95% CI=1.41-6.87). Among obesity parameters, FMR had better diagnostic performance to estimate low muscle function, followed by BFP. Conclusion: Dynapenia individual had higher risk of obese-related adverse events. Increased adiposity irrespective of muscle mass is relevant to reduced muscle function among elders.

Higher Serum Leptin Levels are Associated with a Reduced Risk of Sarcopenia but a Higher Risk of Dynapenia Among Older Adults

“… 38 In our study, the participants with dynapenia had higher obesity parameters and higher serum leptin levels; in contrast, those with sarcopenia had lower obesity parameters and lower serum leptin levels. This specific characteristic of the body composition among elderly individuals with sarcopenia and dynapenia has been explored in our previous study, showing that elderly adults with dynapenia tend to be more obese than elderly individuals with sarcopenia, 25 which may be due to poor nutritional status among older persons who encounter a situation with a loss of both muscle mass and muscle function. Therefore, higher serum leptin is associated with a reduced risk of sarcopenia.…”

“… 9 , 17 In fact, the fat composition may interfere with muscle function, as suggested by other clinical studies. 25 , 40 …”

“… 22 However, in this research, we used FMR as the indicator of obesity because it has a better diagnostic performance than other parameters for sarcopenia and dynapenia. 25 Considering the clinical implications, it is relatively easy to measure serum leptin levels in clinical practice. Older adults with higher serum leptin levels provided information regarding relatively better nutritional status or were obese, resulting in lower muscle function.…”

“…Older adults aged 65 years and older living in communities were recruited when they attended an annual health checkup program at the Tri-Service General Hospital (TSGH) in Taipei as previously described. 25 We excluded individuals who were undergoing regular hemodialysis, had congestive heart failure or poor cognitive function, were receiving cancer treatment, or had joint pain or chest pain during exercise. Personal information such as health behaviors, physical activities, and overall health conditions was ascertained through a structured questionnaire.…”

“…Anthropometric measurements were performed as previously described. 25 Briefly, body height was measured with a stadiometer to the nearest 0.1 cm, and body weight was checked by a digital scale to the nearest 0.01 kg. Waist circumference (WC) was measured at the mid-level between the lower border of the 12th rib and the iliac crest when a participant was standing with the feet placed 25 to 30 cm apart.…”