Sarcopenic Obesity in Children and Adolescents: A Systematic Review

Zembura, Marcela; Matusik, Paweł

doi:10.3389/fendo.2022.914740

Cited by 41 publications

(49 citation statements)

References 58 publications

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“…Interestingly, the body composition of our NCCAH subjects was characterized by a low MFR z-score due to higher fat mass, indicating that their muscle mass was relatively low compared to their fat mass, thus placing them at risk for sarcopenic obesity ( 53 ). Sex differences in body composition are primarily attributable to the level and action of sex steroid hormones that drive the dimorphisms during pubertal development.…”

Section: Discussionmentioning

confidence: 99%

Body composition in children and adolescents with non-classic congenital adrenal hyperplasia and the risk for components of metabolic syndrome: An observational study

Simon

Brener²,

Segev-Becker³

et al. 2022

Front. Endocrinol.

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BackgroundTreated or untreated non-classic congenital adrenal hyperplasia (NCCAH) diagnosed in childhood could pose an increased risk of obesity and metabolic derangements in adolescence and early adulthood. We aimed to explore the interaction between muscle-to-fat ratio (MFR) and components of metabolic syndrome in pediatric subjects with NCCAH.MethodsThis retrospective observational study was conducted in the Tel Aviv Medical Center from January 2018 to January 2022. The study group comprised 75 subjects (26 males) with NCCAH (61 hydrocortisone-treated [21 males] and 14 untreated [5 males]) and 134 healthy sex- and age-matched subjects (41 males) with normal puberty served as controls. Body composition was measured by bioelectrical impedance analysis (BIA) and muscle-to-fat ratio (MFR) z-scores were calculated. Stepwise linear regression models were applied to evaluate explanatory variables for MFR z-scores, blood pressure percentiles, lipid profiles, and glucose metabolism.ResultsThe median age [interquartile range] was 7.5 years [5.3, 8.8] at NCCAH diagnosis and 12.3 years [8.9, 15.4] at BIA. The median cumulative hydrocortisone dose was 7620 mg/m2 [2547, 12903]. Subjects with NCCAH had higher mean BMI z-scores and lower median MFR z-scores compared to controls [(0.47 ± 0.97 vs. -0.19 ± 1.04, p<0.001) and (-0.74 [-1.06, -0.14] vs.-0.37 [-0.99, 0.15], p=0.045), respectively]. The linear regression models dependent variables and their explanatory variables were: MFR z-score (R2= 0.253, p<0.001) - socioeconomic position index (β=0.348, p=0.003), birthweight z-score (β=-0.258, p=0.013), and duration of hydrocortisone treatment in years (β=0.048, p=0.023); systolic blood pressure percentile (R2 = 0.166, p<0.001) - MFR z-score (β=-9.75, p<0.001); TG/HDL ratio (R2 = 0.116, p=0.024) - MFR z-score (β=-0.300, p=0.024). No significant variables were found for glucose.ConclusionsChildren and adolescents with NCCAH have a body composition characterized by an imbalance between muscle and fat tissues, which may place them at increased risk for early-onset cardiometabolic derangements. It is reassuring that glucocorticoid therapy aimed to alleviate androgen overproduction does not appear to adversely affect their body composition.

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Section: Discussionmentioning

confidence: 99%

Body composition in children and adolescents with non-classic congenital adrenal hyperplasia and the risk for components of metabolic syndrome: An observational study

Simon

Brener²,

Segev-Becker³

et al. 2022

Front. Endocrinol.

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“…According to a review, the prevalence is 5.7 % to 69.7 % in girls and 7.2 % to 81.3 % in boys. A connection with cardiometabolic events, severity of non-alcoholic fatty liver disease, inflammation, and mental health has also already been described [14].…”

Section: Definitionmentioning

confidence: 91%

Sarcopenia – Definition, Radiological Diagnosis, Clinical Significance

Vogele

Otto

Sollmann

et al. 2023

Rofo

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Background Sarcopenia is an age-related syndrome characterized by a loss of muscle mass and strength. As a result, the independence of the elderly is reduced and the hospitalization rate and mortality increase. The onset of sarcopenia often begins in middle age due to an unbalanced diet or malnutrition in association with a lack of physical activity. This effect is intensified by concomitant diseases such as obesity or metabolic diseases including diabetes mellitus. Method With effective preventative diagnostic procedures and specific therapeutic treatment of sarcopenia, the negative effects on the individual can be reduced and the negative impact on health as well as socioeconomic effects can be prevented. Various diagnostic options are available for this purpose. In addition to basic clinical methods such as measuring muscle strength, sarcopenia can also be detected using imaging techniques like dual X-ray absorptiometry (DXA), computed tomography (CT), magnetic resonance imaging (MRI), and sonography. DXA, as a simple and cost-effective method, offers a low-dose option for assessing body composition. With cross-sectional imaging techniques such as CT and MRI, further diagnostic possibilities are available, including MR spectroscopy (MRS) for noninvasive molecular analysis of muscle tissue. CT can also be used in the context of examinations performed for other indications to acquire additional parameters of the skeletal muscles (opportunistic secondary use of CT data), such as abdominal muscle mass (total abdominal muscle area – TAMA) or the psoas as well as the pectoralis muscle index. The importance of sarcopenia is already well studied for patients with various tumor entities and also infections such as SARS-COV2. Results and Conclusion Sarcopenia will become increasingly important, not least due to demographic changes in the population. In this review, the possibilities for the diagnosis of sarcopenia, the clinical significance, and therapeutic options are described. In particular, CT examinations, which are repeatedly performed on tumor patients, can be used for diagnostics. This opportunistic use can be supported by the use of artificial intelligence. Key Points: Citation Format

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“…NWO is identified as a risk factor for adverse metabolic and cardiovascular outcomes in pediatric patients and was associated with impaired physical fitness, including reduced hand grip strength, exercise deficit disorder and decreased motor performance, ultimately leading to sarcopenic obesity [ 76 , 77 , 78 , 79 ]. Sarcopenic obesity in turn was also linked with impaired cardiometabolic and mental health [ 3 ].…”

Section: Obesity and Muscle Wastingmentioning

confidence: 99%

“…Moreover, daily physical activity level remains insufficient in the European adolescent population, mainly due to the increased time spent on screen activities and mobile devices. High adiposity levels coupled with sedentary behaviors, ultimately result to sarcopenic obesity, which varies from 5.66% to 69.7% in girls and from 7.2% to 81.3% in boys among different pediatric studies and is highly linked to the occurrence of non-communicable diseases, including cardiovascular disease and diabetes in early adulthood [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Malnutrition Patterns in Children with Chronic Kidney Disease

Karava

Dotis

Kondou

et al. 2023

Life

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Malnutrition is frequent in children with chronic kidney disease (CKD). Apart from undernutrition and protein energy wasting (PEW), overnutrition prevalence is rising, resulting in fat mass accumulation. Sedentary behavior and unbalanced diet are the most important causal factors. Both underweight and obesity are linked to adverse outcomes regarding renal function, cardiometabolic risk and mortality rate. Muscle wasting is the cornerstone finding of PEW, preceding fat loss and may lead to fatigue, musculoskeletal decline and frailty. In addition, clinical data emphasize the growing occurrence of muscle mass and strength deficits in patients with fat mass accumulation, attributed to CKD-related wasting processes, reduced physical activity and possibly to obesity-induced inflammatory diseases, leading to sarcopenic obesity. Moreover, children with CKD are susceptible to abdominal obesity, resulting from high body fat distribution into the visceral abdomen compartment. Both sarcopenic and abdominal obesity are associated with increased cardiometabolic risk. This review analyzes the pathogenetic mechanisms, current trends and outcomes of malnutrition patterns in pediatric CKD. Moreover, it underlines the importance of body composition assessment for the nutritional evaluation and summarizes the advantages and limitations of the currently available techniques. Furthermore, it highlights the benefits of growth hormone therapy and physical activity on malnutrition management.

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Sarcopenic Obesity in Children and Adolescents: A Systematic Review

Cited by 41 publications

References 58 publications

Body composition in children and adolescents with non-classic congenital adrenal hyperplasia and the risk for components of metabolic syndrome: An observational study

Body composition in children and adolescents with non-classic congenital adrenal hyperplasia and the risk for components of metabolic syndrome: An observational study

Sarcopenia – Definition, Radiological Diagnosis, Clinical Significance

Malnutrition Patterns in Children with Chronic Kidney Disease

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