Stefanaki Charikleia, Peppa Melpomeni, Boschiero Dario, Chrousos George P
1st Department of Pediatrics and Choremeion Research Laboratory, National and Kapodistrian University of Athens, Athens, Greece.
Endocrine and Metabolic Bone Disorders Unit, 2nd Department of Internal Propaedeutic Medicine, Research Institute and Diabetes Center, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Eur J Clin Invest. 2016 Sep;46(9):767-78. doi: 10.1111/eci.12659. Epub 2016 Aug 11.
Osteosarcopenic obesity was recently described as a variant phenotype of obesity, mainly observed in old age. This nested case-control study was performed to detect the differences in body composition between young, healthy overweight/obese and healthy lean populations of both genders. Our null hypothesis was that except for the fat mass, there would be absence of body composition differences, namely skeletal muscle and bone masses, between the groups.
We used an advanced bio-impedance device to determine the body composition and measured circulating CRP (hsCRP) and diurnal salivary cortisol concentrations, as indices of inflammation and chronic stress, respectively. Overall, 2551 subjects aged 18-21 years participated in the study.
The healthy lean group included 1072 participants [900 males (84%) and 172 females (16%)], and the healthy overweight/obese group included 1479 participants [74 males (5%) and 1405 females (95%)]. Healthy overweight/obese participants presented with an increased fat mass (P < 0·001), as expected, but lower muscle (P < 0·001) and bone (P < 0·001) masses than lean controls. These findings were accompanied by increased extracellular water compartments, circulating hsCRP levels and evening salivary cortisol concentrations in the healthy overweight/obese group.
Our study suggests that 'osteosarcopenic' elements exist even in very young populations. These may represent a 'precursor' or forme fruste of the osteosarcopenic obesity phenotype in young healthy overweight/obese subjects, who may progressively develop osteosarcopenia in its full form at an older age. Our study highlights the significance of body composition analysis in medical practice, improving prevention and alleviating later health-related economic burden.
骨少肌性肥胖最近被描述为肥胖的一种变异表型，主要见于老年人。本巢式病例对照研究旨在检测年轻、健康超重/肥胖人群与健康瘦人群在身体成分上的差异。我们的零假设是，除脂肪量外，各组之间在身体成分上不存在差异，即骨骼肌和骨量。
我们使用先进的生物阻抗设备来确定身体成分，并分别测量循环中的CRP（高敏CRP）和日间唾液皮质醇浓度，作为炎症和慢性应激的指标。共有2551名18 - 21岁的受试者参与了本研究。
健康瘦人群组包括1072名参与者[900名男性（84%）和172名女性（16%）]，健康超重/肥胖人群组包括1479名参与者[74名男性（5%）和1405名女性（95%）]。正如预期的那样，健康超重/肥胖参与者的脂肪量增加（P < 0·001），但与瘦对照组相比，肌肉量（P < 0·001）和骨量（P < 0·001）较低。这些发现伴随着健康超重/肥胖组细胞外液量增加、循环hsCRP水平和夜间唾液皮质醇浓度升高。
我们的研究表明，即使在非常年轻的人群中也存在“骨少肌性”因素。这些因素可能代表年轻健康超重/肥胖受试者骨少肌性肥胖表型的“先兆”或不完全形式，他们在老年时可能会逐渐发展为完全形式的骨少肌症。我们的研究强调了身体成分分析在医学实践中的重要性，有助于改善预防并减轻后期与健康相关的经济负担。
