Department of Family Medicine, Busan Paik Hospital, College of Medicine, Inje University, 75, Bokji-ro, Busanjin-gu, Busan, 47392, Republic of Korea.
J Bone Miner Metab. 2020 Sep;38(5):695-701. doi: 10.1007/s00774-020-01104-2. Epub 2020 Apr 25.
To evaluate the differences in the associations of combinations of co-existent osteopenia, obesity, and/or sarcopenia with insulin resistance (IR) according to different criteria of obesity.
Among 4500 Korean men and postmenopausal women who were aged ≥ 50 years and did not have diabetes mellitus, osteopenia, sarcopenia, and obesity were defined using bone mineral density, skeletal mass index, and body fat % (or BMI). Body composition groups were generated based on the combinations of these components. IR was defined using the HOMA-IR ≥ 2.5.
When obesity was defined by body fat % and the relationships were adjusted for age, sex, education, and health behaviors, the odds ratios (ORs) for IR was highest in the groups with obesity and osteopenic obesity, followed by sarcopenic obesity and osteosarcopenic obesity, followed by osteopenia and sarcopenia, and followed by osteosarcopenia. When BMI was additionally adjusted, the ORs for IR were not significantly different between body composition groups except for osteopenia: those groups had higher ORs for IR compared to osteopenia. When obesity was defined by BMI, obesity co-existent groups had higher ORs for IR than the obesity non-coexistent groups. The ORs for IR were not significantly different within obesity co-existent groups or obesity non-coexistent groups.
Combinations of co-existent osteopenia, obesity, and/or sarcopenia had different associations with IR according to obesity classification methods and consideration of BMI adjustment. Osteosarcopenic obesity may not have a stronger association with IR compared to obesity only and obesity co-existent other conditions.
本研究旨在评估根据不同肥胖标准，并存的骨质疏松症、肥胖症和/或肌肉减少症与胰岛素抵抗（IR）的关联差异。
本研究纳入了 4500 名年龄≥50 岁、无糖尿病、骨质疏松症、肌肉减少症的韩国男性和绝经后女性，使用骨密度、骨骼肌指数和体脂肪百分比（或 BMI）定义了骨质疏松症、肌肉减少症和肥胖症。根据这些成分的组合生成了身体成分组。使用 HOMA-IR≥2.5 定义 IR。
当使用体脂肪百分比定义肥胖症，并且将年龄、性别、教育程度和健康行为等因素进行调整时，肥胖症和骨质疏松性肥胖症的 IR 比值比（OR）最高，其次是肌肉减少性肥胖症和骨质疏松性肌肉减少症，然后是骨质疏松症和肌肉减少症，最后是骨质疏松性肌肉减少症。当进一步调整 BMI 时，除了骨质疏松症之外，各组之间的 IR 比值比没有显著差异：与骨质疏松症相比，这些组的 IR 比值比更高。当使用 BMI 定义肥胖症时，肥胖症共存组的 IR 比值比高于肥胖症非共存组。在肥胖症共存组或肥胖症非共存组内，IR 比值比没有显著差异。
根据肥胖症分类方法和 BMI 调整的考虑，并存的骨质疏松症、肥胖症和/或肌肉减少症与 IR 的关联存在差异。与单纯肥胖症相比，骨质疏松性肌肉减少症与 IR 的关联可能并不更强。
