Clinical Section: Research Article

Sääksjärvi K.a· Härkänen T.a· Stenholm S.b,c· Schaap L.d· Lundqvist A.a· Koskinen S.a· Borodulin K.e· Visser M.d

Author affiliations

aDepartment of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
bDepartment of Public Health, University of Turku and Turku University Hospital, Turku, Finland
cCentre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
dDepartment of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
eAge Institute, Helsinki, Finland

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Article / Publication Details

First-Page Preview

Received: November 17, 2021
Accepted: October 19, 2022
Published online: January 30, 2023

Number of Print Pages: 10
Number of Figures: 0
Number of Tables: 4

ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)

For additional information: https://www.karger.com/GER

Abstract

Introduction: Conflicting evidence exists concerning whether having sarcopenic obesity has additive mortality risk over having only sarcopenia or obesity. We examined the independent and combined associations of obesity and probable sarcopenia with all-cause mortality. Methods: The pooled analysis included three large, harmonized datasets (Health 2000 Survey; Health, Aging and Body Composition Study; Longitudinal Aging Study Amsterdam) with mortality follow-up data on individuals aged 70 years and over at baseline (n = 4,612). Obesity indicators included body mass index and waist circumference, and probable sarcopenia was defined based on grip strength. The mixed effects Cox model was used for statistical analyses, adjusting for age, sex, marital status, education, race, physical activity, alcohol consumption, smoking, and baseline diseases. Results: Risk of death increased for those having probable sarcopenia only (hazard ratio [HR]: 1.61, 95% confidence interval [CI]: 1.39–1.85) or probable sarcopenia with obesity (HR: 1.36, 95% CI: 1.13–1.64) but not for the obese-only group (HR: 0.92, 95% CI: 0.85–1.01), when compared to non-obese non-sarcopenic individuals. The results were similar regardless of adjustments for covariates or different obesity criteria applied. Conclusion: Probable sarcopenia, whether combined with obesity or not, is associated with increased mortality. Obesity did not increase mortality among older adults. Maintaining muscle strength and identifying older adults at risk of sarcopenia is important for the prevention of premature mortality.

© 2023 S. Karger AG, Basel

References Roubenoff R. Sarcopenic obesity: the confluence of two epidemics. Obes Res. 2004;12(6):887–8. Stenholm S, Harris TB, Rantanen T, Visser M, Kritchevsky SB, Ferrucci L. Sarcopenic obesity: definition, cause and consequences. Curr Opin Clin Nutr Metab Care. 2008;11(6):693–700. Visser M, Goodpaster BH, Kritchevsky SB, Newman AB, Nevitt M, Rubin SM, et al. Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol A Biol Sci Med Sci. 2005;60(3):324–33. Chang VW, Alley DE, Dowd JB. Trends in the relationship between obesity and disability, 1988–2012. Am J Epidemiol. 2017;186(6):688–95. Rantanen T, Harris T, Leveille SG, Visser M, Foley D, Masaki K, et al. Muscle strength and body mass index as long-term predictors of mortality in initially healthy men. J Gerontol A Biol Sci Med Sci. 2000;55(3):168–M173. Gao Q, Mei F, Shang Y, Hu K, Chen F, Zhao L, et al. Global prevalence of sarcopenic obesity in older adults: a systematic review and meta-analysis. Clin Nutr. 2021;40(7):4633–41. Dominguez LJ, Barbagallo M. The cardiometabolic syndrome and sarcopenic obesity in older persons. J Cardiometab Syndr. 2007;2(3):183–9. Prado CM, Wells JC, Smith SR, Stephan BC, Siervo M. Sarcopenic obesity: a Critical appraisal of the current evidence. Clin Nutr. 2012;31(5):583–601. Hamer M, O'Donovan G. Sarcopenic obesity, weight loss, and mortality: the English Longitudinal Study of Ageing. Am J Clin Nutr. 2017;106(1):125–9. Batsis JA, Mackenzie TA, Barre LK, Lopez-Jimenez F, Bartels SJ. Sarcopenia, sarcopenic obesity and mortality in older adults: results from the National Health and Nutrition Examination Survey III. Eur J Clin Nutr. 2014;68(9):1001–7. Rossi AP, Bianchi L, Volpato S, Bandinelli S, Guralnik J, Zamboni M, et al. Dynapenic abdominal obesity as a predictor of worsening disability, hospitalization, and mortality in older adults: results from the InCHIANTI study. J Gerontol A Biol Sci Med Sci. 2017;72(8):1098–104. Rossi AP, Fantin F, Caliari C, Zoico E, Mazzali G, Zanardo M, et al. Dynapenic abdominal obesity as predictor of mortality and disability worsening in older adults: a 10-year prospective study. Clin Nutr. 2016;35(1):199–204. Atkins JL, Whincup PH, Morris RW, Lennon LT, Papacosta O, Wannamethee SG. Sarcopenic obesity and risk of cardiovascular disease and mortality: a population-based cohort study of older men. J Am Geriatr Soc. 2014;62(2):253–60. Zhang X, Xie X, Dou Q, Liu C, Zhang W, Yang Y, et al. Association of sarcopenic obesity with the risk of all-cause mortality among adults over a broad range of different settings: a updated meta-analysis. BMC Geriatr. 2019;19(1):183. Baumgartner RN, Wayne SJ, Waters DL, Janssen I, Gallagher D, Morley JE. Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obes Res. 2004;12(12):1995–2004. Donini LM, Busetto L, Bauer JM, Bischoff S, Boirie Y, Cederholm T, et al. Critical appraisal of definitions and diagnostic criteria for sarcopenic obesity based on a systematic review. Clin Nutr. 2020;39(8):2368–88. Newman AB, Kupelian V, Visser M, Simonsick EM, Goodpaster BH, Kritchevsky SB, et al. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol A Biol Sci Med Sci. 2006;61(1):72–7. Schaap LA, Koster A, Visser M. Adiposity, muscle mass, and muscle strength in relation to functional decline in older persons. Epidemiol Rev. 2013;35:51–65. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(4):601–31. Heistaro S. Methodology report: health 2000 survey. ed. Helsinki: National Public Health Institute; 2008. National Institute on Aging (Internet). The health, aging and body composition study. (cited 2021 Jun). Available from: https://healthabc.nia.nih.gov/. Huisman M, Poppelaars JL, van der Horst MHL, Beekman ATF, Brug J, van Tilburg TG, et al. Cohort profile: the longitudinal aging study Amsterdam. Int J Epidemiol. 2011;40(4):868–76. Cederholm T, Compher C, Correia MITD, Gonzalez MC, Fukushima R, Higashiguchi T, et al. Response to the letter: comment on ‘GLIM criteria for the diagnosis of malnutrition–a consensus report from the global clinical nutrition community’. Some considerations about the GLIM criteria: a consensus report for the diagnosis of malnutrition by Drs. LB da Silva Passos and DA De-Souza. Clin Nutr. 2019;38(3):1480–1. Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005;293(15):1861–7. WHO. Obesity: preventing and managing the global epidemic: report of a WHO consultation. Geneva: World Health Organization; 2000. Heim N, Snijder MB, Heymans MW, Deeg DJH, Seidell JC, Visser M. Optimal cutoff values for high-risk waist circumference in older adults based on related health outcomes. Am J Epidemiol. 2011;174(4):479–89. Ripatti S, Palmgren J. Estimation of multivariate frailty models using penalized partial likelihood. Biometrics. 2000;56(4):1016–22. Grambsch PM, Therneau TM. Proportional hazards tests and diagnostics based on weighted residuals. Biometrika. 1994;81(3):515–26. Therneau TM. Coxme: mixed effects Cox models. R package version 2.2-16 (Internet). (cited 2021 Aug). Available from: https://CRAN.R-project.org/package=coxme. Stenholm S, Mehta NK, Elo IT, Heliövaara M, Koskinen S, Aromaa A. Obesity and muscle strength as long-term determinants of all-cause mortality: a 33-year follow-up of the Mini-Finland Health Examination Survey. Int J Obes. 2014;38(8):1126–32. Van Aller C, Lara J, Stephan BCM, Donini LM, Heymsfield S, Katzmarzyk PT, et al. Sarcopenic obesity and overall mortality: results from the application of novel models of body composition phenotypes to the National Health and Nutrition Examination Survey 1999-2004. Clin Nutr. 2019;38(1):264–70. Hirani V, Naganathan V, Blyth F, Le Couteur DG, Seibel MJ, Waite LM, et al. Longitudinal associations between body composition, sarcopenic obesity and outcomes of frailty, disability, institutionalisation and mortality in community-dwelling older men: the Concord Health and Ageing in Men Project. Age Ageing. 2017;46(3):413–20. Veronese N, Cereda E, Solmi M, Fowler SA, Manzato E, Maggi S, et al. Inverse relationship between body mass index and mortality in older nursing home residents: a meta-analysis of 19, 538 elderly subjects. Obes Rev. 2015;16(11):1001–15. Visser M. Obesity, sarcopenia and their functional consequences in old age. Proc Nutr Soc. 2011;70(1):114–8. Ross R, Neeland IJ, Yamashita S, Shai I, Seidell J, Magni P, et al. Waist circumference as a vital sign in clinical practice: a consensus statement from the IAS and ICCR working group on visceral obesity. Nat Rev Endocrinol. 2020;16(3):177–89. Rantanen T, Era P, Kauppinen M, Heikkinen E. Maximal isometric muscle strength and socioeconomic status, health and physical activity in 75-year-old persons. J Aging Phys activity. 1994;2(3):206–20. Cawthon PM, Travison TG, Manini TM, Patel S, Pencina KM, Fielding RA, et al. Establishing the link between lean mass and grip strength cut points with mobility disability and other health outcomes: proceedings of the sarcopenia definition and outcomes consortium conference. J Gerontol A Biol Sci Med Sci. 2020;75(7):1317–23. Schaap LA, van Schoor NM, Lips P, Visser M. Associations of sarcopenia definitions, and their components, with the incidence of recurrent falling and fractures: the longitudinal aging study Amsterdam. J Gerontol A Biol Sci Med Sci. 2018;73(9):1199–204. Kalinkovich A, Livshits G. Sarcopenic obesity or obese sarcopenia: a cross talk between age-associated adipose tissue and skeletal muscle inflammation as a main mechanism of the pathogenesis. Ageing Res Rev. 2017;35:200–21. Article / Publication Details

First-Page Preview

Received: November 17, 2021
Accepted: October 19, 2022
Published online: January 30, 2023

Number of Print Pages: 10
Number of Figures: 0
Number of Tables: 4

ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)

For additional information: https://www.karger.com/GER

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