Sarcopenia, Obesity, or Both. What is the dominant Variable of the Associated Risks of Sarcopenic Obesity?

IF 4.9 3区医学 Q1 GERIATRICS & GERONTOLOGY

Innovation in Aging Pub Date : 2025-03-28 eCollection Date: 2025-01-01 DOI:10.1093/geroni/igaf021

Alejandro Álvarez-Bustos, Jose A Carnicero, Walter Sepúlveda-Loyola, Begoña Molina-Baena, Francisco J Garcia-Garcia, Leocadio Rodríguez-Mañas

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引用次数: 0

Abstract

Background and objective: Sarcopenic obesity (SO), obesity, and sarcopenia have been related to adverse events in older adults, raising the question about the role of each component in the risk associated with SO. The objective of this manuscript is to evaluate the role of sarcopenia, obesity, and its interaction in the risks (frailty, disability, mortality) associated with sarcopenic obesity.

Research design and methods: Data from the Toledo Study of Healthy Aging (TSHA) were used. This is a cohort-based study composed of community-dwelling adults ≥65 years. Obesity (Body Mass Index-BMI ≥30) and sarcopenia (the Foundation for the National Institutes of Health-FNIH criteria, standardized to our population) were assessed at baseline. Frailty, through the Frailty Phenotype (FP) and the Frailty Trait scale-5 (FTS5), and disability (Katz Index) were evaluated at baseline. Mortality, frailty, and disability were assessed at follow-up. Logistic (odds ratio, OR) and Cox (hazard ratio, HR) regression models were computed to assess the associations.

Results: A total of 1 538 (74.73 years, 45.51% men) individuals were included. Cross-sectionally, SO, sarcopenia, and obesity were significantly associated with the risk of frailty and disability. Longitudinally, Sarcopenia was associated with all the adverse events (ORs/HRs ranged from 1.41 to 4.14, p-value < .05); whereas SO [FP, OR (95% confidence interval-CI): 4.27 (2.05, 8.93); FTS5, OR (95% CI): 6.14 (3.58, 10.51), p-value < .001] and obesity [FP, OR (95% CI): 3.10 (1.95, 4.94), p-value < 0.001; FTS5, OR (95% CI): 2.26 (1.17, 4.35), p-value 0.015] was only associated with incident frailty. Sarcopenia added risk to obesity for frailty (FP and FTS5) whereas obesity only did for frailty (FTS5) in sarcopenic individuals. The interaction between sarcopenia and obesity was not associated with any outcome.

Discussion and implications: Sarcopenia and obesity provide each other an additive risk for frailty, but not a multiplicative (ie, interaction) one, in sarcopenic obesity. Sarcopenia is the mean factor accounting for the associated risk.

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肌肉减少症、肥胖或两者兼而有之。肌肉减少性肥胖相关风险的主要变量是什么？

背景和目的：骨骼肌减少性肥胖（SO）、肥胖和骨骼肌减少症与老年人的不良事件有关，这就提出了关于每种成分在与SO相关的风险中的作用的问题。本文的目的是评估肌少症、肥胖的作用，以及它们在与肌少症肥胖相关的风险（虚弱、残疾、死亡）中的相互作用。研究设计和方法：采用托莱多健康老龄化研究（TSHA）的数据。这是一项基于队列的研究，由≥65岁的社区居住成年人组成。在基线时评估肥胖（身体质量指数- bmi≥30）和肌肉减少症（美国国立卫生研究院fnih标准，标准化到我们的人群）。在基线时，通过脆弱表型（FP）和脆弱性状量表-5 （FTS5）评估虚弱和残疾（Katz指数）。在随访中评估死亡率、虚弱和残疾。采用Logistic （odds ratio， OR）和Cox （hazard ratio， HR）回归模型评估两者的相关性。结果：共纳入1538例（74.73岁，男性45.51%）。横断面上，SO、肌肉减少症和肥胖与虚弱和残疾的风险显著相关。纵向上，肌肉减少症与所有不良事件相关（or / hr范围为1.41 ~ 4.14，p值< 0.05）；而SO [FP， OR(95%置信区间ci): 4.27 (2.05, 8.93)；FTS5, OR (95% CI): 6.14 (3.58, 10.51)， p值< 0.001]和肥胖[FP， OR (95% CI): 3.10 (1.95, 4.94)， p值< 0.001]；FTS5, OR （95% CI): 2.26 (1.17, 4.35)， p值0.015）仅与事件脆弱性相关。肌肉减少症增加了肥胖对虚弱的风险（FP和FTS5），而肥胖只对肌肉减少症个体的虚弱（FTS5）有影响。肌肉减少症和肥胖之间的相互作用与任何结果无关。讨论和意义：肌少症和肥胖在肌少症肥胖中互为虚弱的累加性风险，但不是相乘性风险（即相互作用）。肌肉减少症是导致相关风险的平均因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Innovation in Aging GERIATRICS & GERONTOLOGY-

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

15 weeks

期刊介绍： Innovation in Aging, an interdisciplinary Open Access journal of the Gerontological Society of America (GSA), is dedicated to publishing innovative, conceptually robust, and methodologically rigorous research focused on aging and the life course. The journal aims to present studies with the potential to significantly enhance the health, functionality, and overall well-being of older adults by translating scientific insights into practical applications. Research published in the journal spans a variety of settings, including community, clinical, and laboratory contexts, with a clear emphasis on issues that are directly pertinent to aging and the dynamics of life over time. The content of the journal mirrors the diverse research interests of GSA members and encompasses a range of study types. These include the validation of new conceptual or theoretical models, assessments of factors impacting the health and well-being of older adults, evaluations of interventions and policies, the implementation of groundbreaking research methodologies, interdisciplinary research that adapts concepts and methods from other fields to aging studies, and the use of modeling and simulations to understand factors and processes influencing aging outcomes. The journal welcomes contributions from scholars across various disciplines, such as technology, engineering, architecture, economics, business, law, political science, public policy, education, public health, social and psychological sciences, biomedical and health sciences, and the humanities and arts, reflecting a holistic approach to advancing knowledge in gerontology.