Validation of a description of sarcopenic obesity defined as excess adiposity and low lean mass relative to adiposity

Baker, Joshua F.; Harris, Tamara B.; Rapoport, Allegra; Ziolkowski, Susan L.; Leonard, Mary B.; Long, Jin; Zemel, Babette S.; Weber, David R.

doi:10.1002/jcsm.12613

Cited by 23 publications

(18 citation statements)

References 30 publications

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“…Therefore, estimates using BMI rather than percentage BF may underestimate the prevalence of OLLMM, with greater disparity observed in older populations. Compared with previous prevalence estimates using NHANES data from prior survey years in those aged 20–59 years (ranged from 3.3–5.5% [ 27 , 29 ]) and ≥ 60 years (ranged from 7.0–27.3% [ 28 , 29 , 41 ]), our estimates were generally higher [ 27 – 29 ]. This may be due to an increase in the overall prevalence of disease, variability in the definition, or greater sensitivity of the methodology used in this analysis.…”

Section: Discussioncontrasting

confidence: 73%

“…Previous prevalence estimates of sarcopenic obesity in the USA, obtained from National Health and Nutrition Examination Survey (NHANES) data, are limited. Several of the prior estimates rely on data roughly 20 years old [27][28][29]. Additionally, the estimate using more recent data (NHANES 2017-2018) does not include participants aged > 59 years, thus excluding the population at the highest risk for sarcopenic obesity [30].…”

Section: Introductionmentioning

confidence: 99%

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The prevalence of low muscle mass associated with obesity in the USA

Murdock

Grimsby

et al. 2022

Skeletal Muscle

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Background Sarcopenia is defined as age-related low muscle mass and function, and can also describe the loss of muscle mass in certain medical conditions, such as sarcopenic obesity. Sarcopenic obesity describes loss of muscle and function in obese individuals; however, as sarcopenia is an age-related condition and obesity can occur in any age group, a more accurate term is obesity with low lean muscle mass (OLLMM). Given limited data on OLLMM (particularly in those aged < 65 years), the purpose of this study was to estimate the prevalence of OLLMM in adults aged ≥ 20 years in the USA. Methods Data from the National Health and Nutrition Examination Survey (NHANES) 2017–2018 and 1999–2006 were used. OLLMM was defined as an appendicular lean mass, adjusted for body mass index (BMI), cut-off point < 0.789 for males and < 0.512 for females, measured by dual-energy X-ray absorptiometry (DXA). DXA was only measured in individuals 20–59 years old in NHANES 2017–2018; we therefore utilized logistic regression models to predict OLLMM from NHANES 1999–2006 for those aged ≥ 60 years. The prevalence of OLLMM was estimated overall, and by sex, age, race/ethnicity, and clinical subgroup (high BMI, prediabetes, type 2 diabetes mellitus [T2DM], non-alcoholic fatty liver disease [NAFLD] with fibrosis, or post-bariatric surgery). Prevalence estimates were extrapolated to the USA population using NHANES sampling weights. Results We estimated that, during 2017–2018, 28.7 million or 15.9% of the USA population had OLLMM. The prevalence of OLLMM was greater in older individuals (8.1%, aged 20–59 years vs 28.3%, aged ≥ 60 years), highest (66.6%) in Mexican-American females aged ≥ 60 years, and lowest (2.6%) in non-Hispanic Black males aged 20–59 years. There was a higher prevalence of OLLMM in adults with prediabetes (19.7%), T2DM (34.5%), NAFLD with fibrosis (25.4%), or post-bariatric surgery (21.8%), compared with those without each condition. Conclusions Overall, the burden of OLLMM in the USA is substantial, affecting almost 30 million adults. The prevalence of OLLMM increased with age, and among those with prediabetes, T2DM, NAFLD with fibrosis, or post-bariatric surgery. A unified definition of OLLMM will aid diagnosis and treatment strategies.

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Section: Discussioncontrasting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

The prevalence of low muscle mass associated with obesity in the USA

Murdock

Grimsby

et al. 2022

Skeletal Muscle

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“…Five studies combined the criteria including BF% or BMI to diagnose obesity 30 . Another three studies used total fat mass, 47 high triglyceride and WC (as indicator of visceral obesity), 48 and fat mass index to diagnose obesity 44 . Among 10 studies that reported mortality data, five utilized muscle index adjusted by ht 2 with or without functional tests to diagnose sarcopenia, and six of them used BF% to identify obesity.…”

Section: Resultsmentioning

confidence: 99%

“…Among the analyzed studies, three used handgrip strength to identify sarcopenia. [38][39][40] Five used predicted muscle mass area, 41 urine creatine, 42 muscle cross-sectional area (CSA) adjusted by weight, 43 ASM adjusted by fat mass, 44 and midarm muscle circumference to diagnose sarcopenia. 45 In addition, 80 studies reported definitions of obesity.…”

Section: Definitions Of Sarcopenic Obesitymentioning

confidence: 99%

Deciphering the “obesity paradox” in the elderly: A systematic review and meta‐analysis of sarcopenic obesity

et al. 2022

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Summary Aging and obesity are two global concerns in public health. Sarcopenic obesity (SO), defined as the combination of age‐related sarcopenia and obesity, has become a pressing issue. This systematic review and meta‐analysis summarize the current clinical evidence relevant to SO. PubMed, Embase, and Web of Science were searched, and 106 clinical studies with 167,151 elderlies were included. The estimated prevalence of SO was 9% in both men and women. Obesity was associated with 34% reduced risk of sarcopenia (odds ratio [OR] 0.66, 95% CI 0.48–0.91; p < 0.001). The pooled hazard ratio (HR) of all‐cause mortality was 1.51 (95% CI 1.14–2.02; p < 0.001) for people with SO compared with healthy individuals. SO was associated with increased risk of cardiovascular disease and related mortality, metabolic disorders, cognitive impairment, arthritis, functional limitation, and lung diseases (all ORs > 1.0, p < 0.05). The attenuated risk of sarcopenia in elderlies with obesity (“obesity paradox”) was dependent on higher muscle mass and strength. Apart from unifying the diagnosis of SO, more research is needed to subphenotype people with obesity and sarcopenia for individualized treatment. Meanwhile, the maintenance of proper body composition of muscle and fat may delay or attenuate the adverse outcomes of aging.

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“…The construction of the FM/FFM ratio integrated the metabolic effect of both fat mass and fat-free mass. This indicator was regarded as a measurement of sarcopenic obesity, a body composition-defined definition using to describe individuals with both evidence of muscle loss and excess adiposity [ 17 , 32 ]. It has been reported that individuals had the highest risk when there was a concurrence of sarcopenia and obesity [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Fat mass to fat-free mass ratio and the risk of non-alcoholic fatty liver disease and fibrosis in non-obese and obese individuals

Dai¹,

Xiang²,

Hou³

et al. 2021

Nutr Metab (Lond)

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Context Body composition may explain partially why non-obese individuals still at the risk of developing non-alcoholic fatty liver disease (NAFLD). The ratio of fat mass to fat-free mass (FM/FFM) has been proposed to assess the combined effect of different body compositions. Objective We aimed to investigate the associations of FM/FFM ratio with the risk of developing NAFLD and fibrosis and to identify the potential mediators according to obesity status. Methods This cohort study comprised 3419 adults age ≥ 40 years and free of NAFLD at baseline. Body composition was measured by bioelectrical impedance analysis. NAFLD was ascertained by ultrasonography and fibrosis was assessed by non-invasive score systems. Results For each 1 standard deviation increment in FM/FFM ratio, the odds ratio for the risk of NAFLD was 1.55 (95% confidence interval [CI] 1.23–1.95) in non-obese men, 1.33 (95% CI 1.08–1.65) in obese men, 1.42 (95% CI 1.44–1.67) in non-obese women, and 1.29 (95% CI 1.12–1.50) in obese women. Similar associations were also found between FM/FFM ratio and NAFLD with fibrosis. Mediation analysis showed that insulin resistance, triglycerides, high-density lipoprotein cholesterol, white blood cells, and total cholesterol mediated the association of FM/FFM ratio with NAFLD risk in specific sex and obesity subgroups. Conclusions The FM/FFM ratio significantly associated with the NAFLD and fibrosis risk in both non-obese and obese individuals. Different factors may mediate the association between body composition and NAFLD risk according to different obesity status.

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Validation of a description of sarcopenic obesity defined as excess adiposity and low lean mass relative to adiposity

Cited by 23 publications

References 30 publications

The prevalence of low muscle mass associated with obesity in the USA

The prevalence of low muscle mass associated with obesity in the USA

Deciphering the “obesity paradox” in the elderly: A systematic review and meta‐analysis of sarcopenic obesity

Fat mass to fat-free mass ratio and the risk of non-alcoholic fatty liver disease and fibrosis in non-obese and obese individuals

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