Dynapenic obesity and all-Cause mortality: A systematic review and Meta-analysis of prospective cohort studies

Background

Dynapenia and obesity have been independently shown to be associated with an increased risk of all-cause mortality. However, the association between dynapenic obesity [defined by waist circumference (WC) or body mass index (BMI)] and all-cause mortality is not yet fully elucidated.

Methods

We systematically searched databases, including PubMed, Web of Science, and Scopus, to explore the relationship between dynapenic obesity and all-cause mortality up to February 2024. Pooled hazard ratios (HRs) for all-cause mortality were calculated for individuals with dynapenic abdominal obesity (DAO) and dynapenic obesity defined by BMI relative to a healthy reference group.

Results

Six studies examining DAO and six assessing dynapenic obesity defined by BMI were included. Individuals with DAO had a significantly higher risk of all-cause mortality compared to those without dynapenia and with normal WC. The pooled HR for DAO versus non-dynapenic, non-abdominal obese individuals was 1.73 (95% CI = 1.38–2.16), with substantial heterogeneity across studies (I2 = 77%, p < 0.01). Similarly, individuals with dynapenic obesity, as defined by BMI, showed an elevated mortality risk compared to those with normal BMI, with an HR of 1.33 (95% CI = 1.16–1.53). High heterogeneity was observed across these studies (I2 = 76%, p < 0.01).

Conclusion

This meta-analysis reveals a significant association between dynapenic obesity, whether defined by WC or BMI, with an increased risk of all-cause mortality. Further studies are needed to explore the underlying mechanisms driving this relationship.

Graphical Abstract