Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
Obes Rev. 2021 May;22(5):e13187. doi: 10.1111/obr.13187. Epub 2021 Jan 24.
Sarcopenia and obesity are common conditions in older adults that may have differing effects on falls and fracture risk. This systematic review and meta-analysis aimed to determine whether older adults with sarcopenic obesity have increased risk of falls and fractures or lower bone mass compared with older adults with sarcopenia, obesity, or neither condition. Twenty-six studies (n = 37,124) were included in the systematic review and 17 (n = 31,540) were included in the meta-analysis. Older adults with sarcopenic obesity had lower femoral neck areal bone mineral density (aBMD) compared with those with obesity alone but had higher femoral neck aBMD compared with counterparts with sarcopenia alone (both P < 0.05). Older adults with sarcopenic obesity had higher nonvertebral fracture rates (incidence rate ratio: 1.88; 95% confidence intervals: 1.09, 3.23; based on two studies), compared with those with sarcopenia alone, and also had higher falls risk compared with controls (risk ratio: 1.30; 95% confidence intervals: 1.10, 1.54) and obesity alone (risk ratio: 1.17; 95% confidence intervals: 1.01, 1.36). In conclusion, this systematic review and meta-analysis has demonstrated that older adults with sarcopenic obesity are at increased risk of adverse musculoskeletal outcomes compared with individuals with obesity, sarcopenia, or neither condition. These data support the need for developing interventions to improve bone health and physical function in this population.
肌肉减少症和肥胖症是老年人常见的病症，它们可能对跌倒和骨折风险有不同的影响。本系统评价和荟萃分析旨在确定与单纯性肌肉减少症、单纯性肥胖症或两者均无的老年人相比，患有肌肉减少性肥胖症的老年人在跌倒和骨折风险或骨量方面是否有更高的风险。系统评价纳入了 26 项研究（n = 37124），荟萃分析纳入了 17 项研究（n = 31540）。与单纯肥胖症患者相比，患有肌肉减少性肥胖症的老年人股骨颈面积骨密度（aBMD）较低，但与单纯肌肉减少症患者相比，股骨颈 aBMD 较高（均 P < 0.05）。与单纯肌肉减少症患者相比，患有肌肉减少性肥胖症的老年人非椎体骨折发生率较高（发生率比：1.88；95%置信区间：1.09，3.23；基于两项研究），与对照组相比，患有肌肉减少性肥胖症的老年人跌倒风险也较高（风险比：1.30；95%置信区间：1.10，1.54）和单纯肥胖症患者（风险比：1.17；95%置信区间：1.01，1.36）。总之，本系统评价和荟萃分析表明，与肥胖症、肌肉减少症或两者均无的个体相比，患有肌肉减少性肥胖症的老年人发生不良肌肉骨骼结局的风险增加。这些数据支持在该人群中开展改善骨骼健康和身体功能的干预措施的必要性。
