The Role of Sarcopenic Obesity in Cancer and Cardiovascular Disease: A Synthesis of the Evidence on Pathophysiological Aspects and Clinical Implications

Abstract

Obesity is globally a serious public health concern and is associated with a high risk of cardiovascular disease (CVD) and various types of cancers. It is important to evaluate various types of obesity, such as visceral and sarcopenic obesity. The evidence on the associated risk of CVD, cancer and sarcopenic obesity, including pathophysiological aspects, occurrence, clinical implications and survival, needs further investigation. Sarcopenic obesity is a relatively new term. It is a clinical condition that primarily affects older adults. There are several endocrine-hormonal, metabolic and lifestyle aspects involved in the occurrence of sarcopenic obesity that affect pathophysiological aspects that, in turn, contribute to CVD and neoplasms. However, there is no available evidence on the role of sarcopenic obesity in the occurrence of CVD and cancer and its pathophysiological interplay. Therefore, this review aims to describe the pathophysiological aspects and the clinical and epidemiological evidence on the role of sarcopenic obesity related to the occurrence and mortality risk of various types of cancer and cardiovascular disease. This literature review highlights the need for further research on sarcopenic obesity to demonstrate the interrelation of these various associations.

Association of Dietary Factors With Grip Strength, Body Fat, and Prevalence of Sarcopenic Obesity in Rural Korean Elderly With Cardiometabolic Multimorbidity

“…Sarcopenic obesity (SO) is related to not only aging but also cardiovascular diseases (CVDs) and metabolic diseases such as insulin resistance (IR), type 2 diabetes (T2DM), and obesity ( 1 ). A recent review reported that more than one in 10 older adults face a health crisis due to SO ( 2 ).…”

Impact of Sarcopenia on the Severity of the Liver Damage in Patients With Non-alcoholic Fatty Liver Disease

“…The British Regional Heart Study, conducted in older men of 60–79 years of age, although found a significant association between SO and cardiovascular mortality, failed to demonstrate an association between SO and coronary heart disease events. Ultimately, the association between SO and individual cardiovascular risk factors—atherogenic lipids profile with low high-density lipoprotein cholesterol (HDL-C) and high triglyceride levels, increased hs-CRP and IR acts together and increases the overall cardiovascular risk and mortality ( 196 ).…”

Sarcopenic Obesity: An Emerging Public Health Problem

“…At the same time, adipose tissue enhances the secretion of pro-inflammatory actin in muscle tissue. On the other hand, myocytokines (↓IL-15, ↓irisin, ↓IGF-1, ↑myostatin, impaired IL-6 secretion) may lead to muscle atrophy and dysfunction, they may play an endocrine role to aggravate fatty tissue inflammation and propagate a pro-inflammatory state between myocytes and adipocytes [ 5 , 49 - 52 ]. A summary of the possible mechanisms is shown in Figure 1 .…”

“…Further, the dietary pattern of elderly people, which is often characterized by insufficient protein intake combined with excess dietary calorie intake that is rich in saturated fatty acids, coupled with a sedentary lifestyle promotes the occurrence of sarcopenic obesity [ 11 ]. SO shares a common pathogenic mechanism with a variety of chronic diseases such as diabetes, cardiovascular disease, and cancer, among others [ 7 , 8 , 49 ]. SO can lead to a variety of pathophysiological changes, such as excessive secretion of pro-inflammatory cytokines by adipose tissue, changes in the expression of adipocytokines by adipocytes, and fat accumulation in muscle [ 6 , 12 ].…”

“…The pro-inflammatory state and lipid accumulation in muscle fibers induce phosphorylation and deactivate insulin receptors and their substrates [ 19 ], resulting in insulin resistance and AR. Insulin resistance is the core mechanism of SO associated with cardiovascular metabolic diseases and cancer [ 49 , 50 ].…”