College of Sport and Health Science, Ritsumeikan University, Shiga, Japan; Department of Geriatric Medicine, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii, USA.
Honolulu Heart Program, Kuakini Medical Center, Honolulu, Hawaii, USA.
Nutrition. 2018 Feb;46:97-102. doi: 10.1016/j.nut.2017.09.003. Epub 2017 Sep 21.
The aim of this study was to investigate the association between anthropometric measurements of sarcopenic obesity and all-cause mortality.
The study included 2309 Japanese-American men ages 71 to 93 y. Mortality data were available for up to 24 y of follow-up. Sarcopenic obesity defined by three patterns of obesity indexes (body mass index [BMI], percent body fat [%BF] and waist circumference [WC]) and skeletal muscle index estimated by anthropometric measurements.
Of the 2309 participants, 2210 deaths were reported during the mean follow-up period of 11.7 y. Risk for death was significantly increased with sarcopenia after adjusting for baseline age, lifestyle variables, hypertension, diabetes, and cognitive scores (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.15-1.38). Risk for death was significantly decreased with obesity using WC and %BF to define obesity, but not BMI. Risk for death also was significantly increased in the sarcopenia group compared with the optimal group, regardless of which pattern of obesity indexes (BMI, %BF, and WC) was used. Risk for death was significantly increased in sarcopenic obesity defined by WC (HR, 1.19; 95% CI, 1.02-1.38), borderline in the BMI-defined group, and not significant in the %BF-defined group.
All-cause mortality was increased in men with sarcopenic obesity defined by WC, but not BMI and %BF. Sarcopenia was a stronger predictor of all-cause mortality in this cohort >70 y of age. These results suggest that anthropometric definitions for sarcopenia and sarcopenic obesity are clinically useful as a predictor of all-cause mortality.
本研究旨在探讨肌少症性肥胖的人体测量学指标与全因死亡率之间的关系。
本研究纳入了 2309 名年龄在 71 至 93 岁的日裔美国男性。研究期间最长随访 24 年，随访期间可获得死亡率数据。肌少症性肥胖定义为三种肥胖指数（体重指数[BMI]、体脂肪百分比[%BF]和腰围[WC]）和通过人体测量学估计的骨骼肌指数的肥胖模式。
在 2309 名参与者中，在平均 11.7 年的随访期间报告了 2210 例死亡。在调整了基线年龄、生活方式变量、高血压、糖尿病和认知评分后，肌少症与死亡风险显著增加（风险比[HR]，1.26；95%置信区间[CI]，1.15-1.38）。使用 WC 和 %BF 定义肥胖时，死亡风险显著降低，但 BMI 则不然。与最佳组相比，无论使用哪种肥胖指数（BMI、%BF 和 WC）定义，肌少症组的死亡风险也显著增加。与 WC 定义的肌少症性肥胖相比，死亡风险在 WC 定义的组中显著增加（HR，1.19；95%CI，1.02-1.38），在 BMI 定义的组中处于边缘水平，在 %BF 定义的组中则不显著。
在使用 WC 定义的肌少症性肥胖男性中，全因死亡率增加，但 BMI 和 %BF 则不然。在这一年龄>70 岁的队列中，肌少症是全因死亡率的更强预测因子。这些结果表明，肌少症和肌少症性肥胖的人体测量定义作为全因死亡率的预测因子具有临床意义。
