Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan (Republic of China).
Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taiwan.
Br J Nutr. 2021 Dec 14;126(11):1749-1757. doi: 10.1017/S0007114521001288. Epub 2021 Apr 14.
The most important issue for the clinical application of sarcopenic obesity (SO) is the lack of a consensus definition. The aim of the present study was to determine the best measurement for SO by estimating the association between various definitions and the risk of falls and metabolic syndrome (MS). We studied a community of 765 adults aged 65 years and older in 2015-2017. Sarcopenia obesity was measured by sarcopenia (defined by low muscle mass with either low handgrip strength or low gait speed or both) plus obesity (defined by waist circumference, body fat percentage and BMI). The MS was defined according to the National Cholesterol Education Program ATP III. Logistic regression models were constructed to examine the relationships between sarcopenia obesity and risk of fall and MS. In the analysis of the fall risk with SO defined by waist circumference, the participants with non-sarcopenia/non-obesity were treated as the reference group. The OR to fall in participants with SO was 10·16 (95 % CI 2·71, 38·13) after adjusting for confounding covariates. In the analysis of the risk of the MS between participants with individual components of sarcopenia coupled with obesity defined by waist circumference, the risk was statistically significant for low gait speed (OR: 7·19; 95 % CI 3·61, 14·30) and low grip strength (OR: 9·19; 95 % CI 5·00, 16·91). A combination of low grip strength and abdominal obesity for identifying SO may be a more precise and practical method for predicting target populations with unfavourable health risks, such as falls risk and MS.
肌肉减少性肥胖(SO)临床应用的最重要问题是缺乏共识定义。本研究的目的是通过估计各种定义与跌倒和代谢综合征(MS)风险之间的关联,确定 SO 的最佳测量方法。我们研究了 2015-2017 年间一个由 765 名 65 岁及以上成年人组成的社区。通过肌肉减少症(定义为握力或步态速度低或两者兼有的低肌肉质量)加上肥胖症(定义为腰围、体脂百分比和 BMI)来衡量 SO。MS 根据国家胆固醇教育计划 ATP III 定义。构建逻辑回归模型来检查 SO 与跌倒和 MS 风险之间的关系。在分析以腰围定义的 SO 与跌倒风险的关系时,将非肌肉减少症/非肥胖症的参与者视为参考组。在调整混杂协变量后,SO 参与者跌倒的 OR 为 10.16(95 % CI 2.71,38.13)。在分析以腰围定义的个体肌肉减少症成分与肥胖症相结合的参与者中 MS 的风险时,低步态速度(OR:7.19;95 % CI 3.61,14.30)和低握力(OR:9.19;95 % CI 5.00,16.91)的风险具有统计学意义。以握力和腹部肥胖相结合来识别 SO 可能是一种更精确和实用的方法,可以预测具有不利健康风险的目标人群,例如跌倒风险和 MS。