Department of Experimental Medicine - Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University of Rome, Rome, Italy.
Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, United Kingdom.
Nutrition. 2020 Jul-Aug;75-76:110765. doi: 10.1016/j.nut.2020.110765. Epub 2020 Feb 13.
Sarcopenic obesity (SO) is characterized by the co-occurrence of high adiposity (HA) and low muscle mass (LM) and has been associated with an increased risk for cardiometabolic diseases. The aim of this study was to investigate the association between markers of insulin sensitivity and SO defined by three novel body composition models: body composition phenotypes; truncal fat mass to appendicular skeletal mass (TrFM/ASM) ratio load capacity; and fat mass to fat-free mass (FM/FFM) ratio load capacity.
The study included 314 participants 18 to 65 y of age. Body composition was assessed by dual-energy x-ray absorptiometry. The first model includes four phenotypes: low adiposity-high muscle mass (LA-HM), high adiposity-high muscle mass (HA-HM), low adiposity-low muscle mass (LA-LM), and high adiposity-low muscle mass (HA-LM). The second and third load-capacity models stratified participants into three centile groups: <15th, 15th to 84th and ≥85th. A 2-h oral glucose tolerance test was performed and insulin sensitivity was calculated using the Matsuda Index. Glycated hemoglobin and highly sensitive C-reactive protein also were measured.
Lower insulin sensitivity was observed in the HA-LM (P < 0.001) and in the ≥85th centile groups of the TrFM/ASM ratio (P < 0.001) and the FM/FFM ratio (P = 0.001) compared with the other body composition phenotypes. The HA-LM and ≥85th centile group of the TrFM/ASM ratio model showed significantly higher (P < 0.001) concentrations of glycated hemoglobin compared with the other phenotypes.
SO defined by both the four body composition phenotypes and TrFM/ASM definitions was associated with increased impairment of insulin sensitivity and glycemic control.
肌少症性肥胖（SO）的特征是存在高肥胖度（HA）和低肌肉量（LM），并与代谢性心血管疾病风险增加有关。本研究旨在探讨通过三种新的身体成分模型（身体成分表型；躯干脂肪量与四肢骨骼肌量（TrFM/ASM）比值负荷能力；以及脂肪量与去脂体重（FM/FFM）比值负荷能力）定义的胰岛素敏感性与 SO 之间的关联。
该研究纳入了 314 名年龄在 18 至 65 岁的参与者。通过双能 X 射线吸收法评估身体成分。第一个模型包括四种表型：低肥胖度-高肌肉量（LA-HM）、高肥胖度-高肌肉量（HA-HM）、低肥胖度-低肌肉量（LA-LM）和高肥胖度-低肌肉量（HA-LM）。第二和第三个负荷能力模型将参与者分为三个百分位组：<第 15 百分位、第 15 至 84 百分位和≥第 85 百分位。进行 2 小时口服葡萄糖耐量试验，并使用 Matsuda 指数计算胰岛素敏感性。还测量了糖化血红蛋白和高敏 C 反应蛋白。
与其他身体成分表型相比，HA-LM（P<0.001）和 TrFM/ASM 比值（P<0.001）和 FM/FFM 比值（P=0.001）≥第 85 百分位组观察到较低的胰岛素敏感性。与其他表型相比，HA-LM 和 TrFM/ASM 比值模型≥第 85 百分位组的糖化血红蛋白浓度显著更高（P<0.001）。
通过四种身体成分表型和 TrFM/ASM 定义定义的 SO 与胰岛素敏感性和血糖控制受损增加相关。
