Prevalence of Sarcopenic Obesity in Adults with Class II/III Obesity Using Different Diagnostic Criteria

Abstract

Background/Objective. Sarcopenic obesity (SO) is a hidden condition of reduced lean soft tissue (LST) in context of excess adiposity. SO is most commonly reported in older adults and both its risk and prevalence increase with age. A variety of body composition indices and cut points have been used to define this condition, leading to conflicting prevalence and risk prediction. Here, we investigate variability in the prevalence of SO in an adult sample of individuals with class II/III obesity (BMI ≥ 35 kg/m2) using different diagnostic criteria. Methods. SO definitions were identified from a literature review of studies using dual-energy X-ray absorptiometry (DXA) to assess LST. Demographics, anthropometrics, and body composition (by DXA) were measured in n = 120, 86% female (46.9 ± 11.1 years). Results. LST was extremely variable in individuals, even with similar body sizes, and observed across the age spectrum. The prevalence of SO ranged from 0 to 84.5% in females and 0 to 100% in males, depending upon the definition applied, with higher prevalence among definitions accounting for measures of body size or fat mass. Conclusion. SO is present, yet variable, in adults with class II/III obesity. Accounting for body mass or fat mass may identify a higher number of individuals with SO, although risk prediction remains to be studied.

Association Between Reduced Daily Steps and Sarcopenic Obesity in Treatment-Seeking Adults With Obesity

“…Firstly, our assessment of the prevalence of sarcopenia among patients with obesity seeking treatment, using criteria accounting for body weight, revealed an SO prevalence of 49.5% across the entire sample (53.1% in males and 48.1% in females). This falls within the large prevalence range of 0-100% reported for males and 0-85% reported for females, a range that may depend on the SO definition applied (24), in which a greater prevalence may be likely to be reported in studies accounting for body weight or BMI, whereas a smaller prevalence will be reported in those that do not (16). However, specifically, the prevalence of sarcopenia in our sample (53.1% in males and 48.1% in females) highly exceeded that found by Oh and colleagues in their original sample (19.6% in males and 31.3% in females) (18).…”

“…Firstly, patients with obesity tend to have a relatively large lean mass (15). Hence, sarcopenia criteria may not be met in these individuals, and the prevalence of sarcopenia may be underestimated (16). Second, low physical fitness is more closely associated with obesity than sarcopenia (17).…”

Sarcopenic Obesity: Definition, Health Consequences and Clinical Management

“…Firstly, patients with obesity tend to have a relatively large lean mass. Hence, sarcopenia criteria based on this parameter may not be met in these individuals and the prevalence of sarcopenia may, therefore, be greatly underestimated [8]. Secondly, low physical fitness is more strongly associated with obesity than with sarcopenia [9], with the result that the prevalence of sarcopenia may be overestimated.…”

“…To address this problem, recent reports have recommended accounting for body mass or body fat mass when identifying individuals with sarcopenic obesity [8]. In light of this recommendation, a new definition of sarcopenic obesity has been established, which in addition to the Appendicular Lean Mass (ALM) also includes the Body Mass Index (BMI) [10].…”

Sarcopenic obesity negatively affects muscle strength, physical function and quality of life in obese elderly women

“…Different approaches such as the ratio of appendicular skeletal muscle mass and height squared (aLM/ht²) has been widely used 2 . In addition, based on the literature review, ten studies used the aLM to define sarcopenia 3 . However, this approach requires further refinement as it was based in a small and unknown representative population of the Rosetta Study 2 .…”