The prevalence of sarcopenic obesity in community-dwelling healthy Indian adults - The Sarcopenic Obesity-Chandigarh Urban Bone Epidemiological Study (SO-CUBES)

Abstract

Objectives To determine the prevalence of sarcopenia obesity (SO) in healthy Indian adults and delineate the relative impact of the 3 indices of obesity [body mass index (BMI), waist circumference (WC), fat mass percent (FM%)] with regards to inter-definitional agreement and their relationship with usual gait speed (GS). Methods Apparently healthy adults (aged ≥ 20 years) with no background history of comorbidities were enrolled from the community by door-to-door survey. Following blood investigations, individuals with biochemical abnormalities were excluded. Enrolled participants underwent dual-energy X-ray absorptiometry (DXA). Sarcopenia was defined according to EWGSOP2 consensus based on indigenous cut-offs obtained from the Sarcopenia-Chandigarh Urban Bone Epidemiological Study (Sarco-CUBES). Obesity was defined based on BMI (≥ 25.0 kg/m 2 ) or WC (> 90 cm in men, > 80 cm in women) or DXA-derived FM% (> 32% in men, > 40% in women). Results Data of 804 participants were analyzed after exclusion. The mean ± SD for BMI, WC, and FM% were 26.5 ± 2.7 kg/m 2 , 86.8 ± 9.6, and 34.7 ± 7.3%, respectively. Prevalence of sarcopenia was 3.2%. Based on BMI, WC, and FM%, the prevalence of SO in elderly subjects (≥65 years) was 5.4%, 5.4%, and 6.3%, respectively. Using Cohen’s kappa, inter-definitional agreement between the 3 groups was ‘almost perfect’. FM%, and not BMI/WC, emerged as a significant predictor of GS on multiple linear regression analysis. Conclusions The prevalence of SO in healthy elderly Indian adults is 5.4%–6.3%. Either BMI/WC/FM% can be used to correctly identify individuals with SO.

Sex Differences in Bone Health Among Indian Older Adults with Obesity, Sarcopenia, and Sarcopenic Obesity

“…Those with high BMI may therefore be less likely to have concomitant sarcopenia as opposed to when obesity is defined by body fat percentage [ 28 , 29 ]. In a study of 804 community-dwelling healthy Indian adults, body fat percentage was reported to be a better diagnostic criterion for sarcopenic obesity as it assesses body fat distribution unlike other methods such as by BMI or waist circumference [ 10 ]. Although consensus definitions of sarcopenic obesity are not currently available, it would appear that the obesity component should be defined where possible using direct estimates of adiposity such as by DXA.…”

“…Sarcopenia is another age-associated condition and is defined as the loss of skeletal muscle mass and function which increases the risk of adverse musculoskeletal outcomes [ 7 – 10 ]. The prevalence of sarcopenia for those aged > 45 years is between 5 and 39%, depending on the definition of sarcopenia [ 11 ].…”

“…However, studies have reported that older adults with combined sarcopenia and obesity, known as “sarcopenic obesity”, have poorer bone health and physical function [ 8 , 9 ]. As a result, older adults with sarcopenic obesity have increased risk for morbidity, falls, and fractures [ 8 – 10 , 13 – 15 ]. Most of the studies exploring these relationships have been conducted in Caucasian populations [ 8 , 9 , 15 ].…”

Sarcopenic osteoporosis, sarcopenic obesity, and sarcopenic osteoporotic obesity in the Camargo cohort (Cantabria, Spain)

“…A German study [ 36 ] in women over 70 years using the EWGSOP-1 definition of sarcopenia found a prevalence of sarcopenic obesity of 0% when obesity was diagnosed by BMI and of 2.3% with the percentage of fat criterion. A recent Indian study [ 37 ] applying the EWGSOP-2 definition of sarcopenia has reported a prevalence of sarcopenic obesity in the over-65 population of 3.8% in women and 6.7% in men when obesity was diagnosed by BMI, and 5.7% in women and 6.7% in men when diagnosed by fat percentage. The data reported in both studies are fairly similar to ours.…”

South Asian Working Action Group on SARCOpenia (SWAG-SARCO) – A consensus document

“…A global study reported sarcopenia prevalence of 17.5% in Indian elderly (≥ 65 years) [ 1 ]. Indian studies have reported a prevalence of 14.2% (≥ 60 years) from South India [ 6 ] and 3.2% in community dwelling North Indians (≥ 20 years; younger population in SO-CUBES study) [ 7 ]. According to the SARIR Study from Iran the prevalence of presarcopenia (52.7% vs 25.3%), sarcopenia (20.7% vs 15.3%), and severe sarcopenia (6% vs 5.3%), were higher in men than women (> 55 years) [ 8 ].…”