The association between sarcopenic obesity, sarcopenia and functional dependence, malnutrition, and mortality: the phenomenon of obesity paradox in sarcopenic obesity.

Abstract

The aim of this study is to investigate the association between four phenotypes of sarcopenia/obesity in older individuals and functional disability, malnutrition, and all-cause mortality. This study is a cross-sectional study, survival is 3 years. A total of 487 Chinese older adults were included with 283 (58.1%) females, a median age of 77 (69, 99) years. Sarcopenia was diagnosed according to skeletal muscle mass index, grip strength (GS), 5-time chair stand test, and gait speed test; obesity was diagnosed according to waist circumference, body mass index (BMI), and the percentage of body fat (PBF). Nutritional status was estimated with the Mini Nutritional Assessment short-form (MNA-SF) and functional health status was assessed using the Barthel Index (BI). The binary logistic regression analysis and the multivariate Cox regression analysis were utilized to investigate the association between sarcopenic/obesity phenotype and functional impairment, nutritional deficiency, and all-cause mortality. In the final-adjusted model, compared to patients with non-sarcopenic non-obesity phenotype, sarcopenic obesity is significantly associated with functional dependence (odds ratio [OR]: 3.83, 95% CI 1.47-9.97; P = 0.006), malnutrition (OR: 0.48, 95% CI 0.24-0.99; P = 0.047), and all-cause mortality (hazard ratio[HR]: 2.78, 95% CI 1.57-4.94; P = 0.001); sarcopenia is significantly associated with malnutrition (OR: 2.48, 95% CI 1.09-5.65; P = 0.030), and all-cause mortality (HR:3.06, 95% CI 1.69-5.56; P < 0.001); obesity is significantly associated with malnutrition (OR:0.11, 95% CI 0.05-0.22; P < 0.001). Consequently, it is advisable to incorporate sarcopenia and sarcopenic obesity into the screening and treatment protocols for older adults in the community to effectively mitigate the adverse health consequences.