Prevalence and risk factors of sarcopenia without obesity and sarcopenic obesity among Chinese community older people in suburban area of Shanghai: A cross-sectional study

Abstract

ObjectivesThe aim of the present study was to explore the prevalence and risk factors of sarcopenia without obesity (S) and sarcopenic obesity (SO) among community-dwelling older people in the Chongming District of Shanghai, China, according to the Asian Working Group for Sarcopenia (AWGS) 2019 Consensus as the diagnostic criteria of sarcopenia.MethodsIn this cross-sectional study, a total of 1,407 subjects aged ≥65 years were included, where the mean age of the subjects was 71.91 ± 5.59 years and their mean body mass index (BMI) was 24.65 ± 3.32 kg/m2. According to the Asian Working Group for Sarcopenia (AWGS) 2019 Consensus, sarcopenia was defined as a low appendicular skeletal muscle mass index (≤7.0 kg/m2 in males and ≤5.7 kg/m2 in females), decreased handgrip strength (<28.0 kg in males and <18.0 kg in females), and/or low gait speed (<1.0 m/s) or poor 5-time chair stand test (5CST) (≥12s). The SO met both the diagnostic criteria for sarcopenia and obesity, meanwhile obesity was defined as an increased percentage of body fat (PBF) (≥25% in males and ≥35% in females). Univariate and multiple logistic regression analyses were performed to explore the risk factors of both S and SO.ResultsThe prevalence of S and SO was 9.74% (M: 9.29%, F: 10.05%) and 9.95% (M: 13.94%, F: 7.14%). Lower BMI (OR = 0.136, 95% CI: 0.054–0.340, p < 0.001), lower hip circumference (OR = 0.858, 95% CI: 0.816–0.903, p < 0.001), farming (OR = 1.632, 95% CI: 1.053–2.530, p = 0.028), higher high-density lipoprotein cholesterol (HDL-C) level (OR = 2.235, 95% CI: 1.484–3.367, p < 0.001), and a sleep duration <7 h (OR = 0.561, 95% CI: 0.346–0.909, p = 0.019) were risk factors for S. While aging (70–74 y, OR = 1.923, 95% CI: 1.122–3.295, p = 0.017; 75–79 y, OR = 3.185, 95% CI: 1.816–5.585, p < 0.001; ≥80 y, OR = 7.192, 95% CI: 4.133–12.513, p < 0.001), male (OR = 1.981, 95% CI: 1.351–2.904, p < 0.001), higher BMI (OR = 4.865, 95% CI: 1.089–21.736, p = 0.038), higher monocyte level (OR = 4.203, 95% CI: 1.340–13.181, p = 0.014), and a sleep duration >9 h (OR = 1.881, 95% CI: 1.117–3.166, p = 0.017) were risk factors for SO.ConclusionOur study showed the high prevalence of S and SO among community-dwelling older people in the Chongming District. The SO was more prevalent in males. Behavioral factors and lifestyle (such as farming and sleep duration) were associated more with the development of S, while age and male gender were associated more with the development of SO.

Prevalence of sarcopenic obesity in the older non-hospitalized population: a systematic review and meta-analysis

“…Among them, 17 [ 6 , 9 , 13 , 15 , 20 – 32 ] were cohort studies, and 29 [ 7 – 8 , 10 , 14 , 17 , 33 – 56 ] were cross-sectional studies. Articles published in the last 3 years (post-2020) accounted for 28 [ 6 – 7 , 9 – 10 , 15 , 20 – 21 , 23 , 26 – 31 , 36 , 39 , 41 , 44 – 47 , 49 – 50 , 52 – 56 ] studies. The total number of participants included in this review was 71,757 from studies with sample sizes ranging from 64 [ 34 ] to 7,852 [ 6 ].…”

“…The included studies used varying diagnostic criteria for sarcopenia (low muscle mass, low muscle strength, or low muscle strength and mass) combined with different obesity criteria (percentage of body fat [PBF], BMI, or waist circumference [WC]) to diagnose SO. Among them, 14 [ 6 – 8 , 10 , 13 , 17 , 20 , 22 , 28 , 34 , 45 , 47 , 51 , 54 ] studies used low muscle mass as the diagnostic criterion for sarcopenia, 10 [ 9 , 20 , 26 , 29 , 40 – 41 , 49 – 50 , 55 – 56 ] studies used low muscle strength as the diagnostic criterion for sarcopenia, and 20 [ 14 – 15 , 21 – 25 , 27 , 30 – 31 , 35 – 36 , 39 , 42 – 44 , 46 , 48 , 52 – 53 ] studies used low muscle mass plus low muscle strength as the diagnostic criterion for sarcopenia. In addition, one [ 6 ] study, a multicenter population study, did not provide a specific cutoff for their obesity diagnostic criteria (PBF).…”

“…Most studies were of fair [ 6 , 8 , 10 , 2 – 13 , 16 , 19 , 25 – 26 , 29 , 31 , 32 , 35 – 37 , 42 , 48 , 51 – 53 ] or high [ 7 , 9 , 15 , 21 – 25 , 28 – 29 , 31 , 33 , 35 , 36 , 40 – 43 , 45 , 49 , 51 , 52 – 56 ] quality because they scored “yes” for at least five items in the quality assessment checklist. Specifically, 26 [ 7 , 9 , 15 , 21 – 25 , 28 – 29 , 31 , 33 , 35 – 36 , 40 – 43 , 45 – 49 , 51 – 52 , 56 ] studies scored “yes” for 8–9 items, 18 [ 6 , 8 , 13 – 14 , 17 , 20 , 26 – 27 , 30 , 32 , 34 , 37 , 39 , 44 , ...…”

“…The pooled prevalence of SO diagnosed using low muscle mass + low muscle strength combined with different diagnostic criteria for obesity was 10% (95% CI: 6–14%, I 2 = 98%, P < 0.01, 20 studies [ 14 – 15 , 21 – 25 , 27 , 30 – 31 , 35 – 36 , 39 , 42 – 44 , 46 , 48 , 52 – 53 ]). Among them, the pooled prevalence of SO diagnosed using low muscle mass + low muscle + PBF, low muscle mass + low muscle + BMI, and low muscle mass + low muscle + BMI + WC + PBF was 10% (95% CI: 6–14%, I 2 = 98%, P < 0.01, 9 studies [ 14 – 15 , 22 , 24 , 35 , 42 – 43 , 46 , 52 ]), 18% (95% CI: 15–20%, I 2 = 57%, P = 0.07, 4 studies [ 15 , 31 , 44 , 48 ]), and 9% (95% CI: 9–17%, I 2 = 94%, P < 0.01, 3 studies [ 27 , 36 , 53 ]), respectively (Table 1 ).…”

Longitudinal association of sleep duration with possible sarcopenia: evidence from CHARLS

“…Current evidence on the association between sleep duration and the incidence of sarcopenia is inconsistent. For example, several studies have exhibited a U-shaped association between sleep duration and sarcopenia and indicated that both short and long sleep durations were potential risk factors for sarcopenia,6 11 12 while other studies suggested that only short or long sleep duration had a positive association with sarcopenia 13–15. In contrast, studies from China showed that no significant associations were observed between sleep duration and sarcopenia 16 17.…”