SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
BMC Geriatr. 2021 Apr 14;21(1):247. doi: 10.1186/s12877-021-02132-x.
High rates of food insecurity, obesity and obesity-related comorbidities in ageing South African (SA) women may amplify the risk of developing sarcopenic obesity. This study aimed to investigate the prevalence and correlates of sarcopenic obesity and its diagnostic components [grip strength, appendicular skeletal muscle mass (ASM) and body mass index (BMI)] in older SA women from a low-income setting.
This cross-sectional study recruited black SA women between the ages of 60-85 years (n = 122) from a low-income community. Testing included a fasting blood sample (markers of cardiometabolic risk, HIV), whole body and regional muscle and fat mass (dual-energy absorptiometry x-ray), anthropometry, blood pressure, functional movement tests, current medication use, demographic and health questionnaires, physical activity (PA; accelerometery), household food insecurity access scale, and a one-week quantified food frequency questionnaire. Foundation for the National Institutes of Health (FNIH) criteria (grip strength and ASM, adjusted for BMI) were used to classify sarcopenia. Participants with sarcopenia alongside a BMI of > 30.0 kg/m were classified as having sarcopenic obesity. Prevalence using other criteria (European Working Group on Sarcopenia in Older People, Asian Working Group for Sarcopenia and the International Working Group for Sarcopenia) were also explored.
The prevalence of sarcopenia was 27.9%, which comprised of sarcopenia without obesity (3.3%) and sarcopenic obesity (24.6%). Other classification criteria showed that sarcopenia ranged from 0.8-14.7%, including 0.8-9.8% without obesity and 0-4.9% with sarcopenic obesity. Using multivariate-discriminant analysis (OPLS-DA) those with sarcopenic obesity presented with a descriptive profile of higher C-reactive protein, waist circumference, food security and sedentary time than women without sarcopenic obesity (p = 0.046). A similar profile described women with low BMI-adjusted grip strength (p < 0.001).
The majority of women with sarcopenia were also obese (88%). We show a large discrepancy in the diagnostic criteria and the potential for significantly underestimating the prevalence of sarcopenia if BMI is not adjusted for. The main variables common to women with sarcopenic obesity were higher food security, lower PA and chronic inflammation. Our data highlights the importance of addressing obesity within these low-income communities to ensure the prevention of sarcopenic obesity and that quality of life is maintained with ageing.
在南非（SA）老年女性中，食物不安全、肥胖和肥胖相关合并症的发生率较高，这可能会增加发生肌少症性肥胖的风险。本研究旨在调查低收入环境中南非老年女性肌少症性肥胖及其诊断成分（握力、四肢骨骼肌质量（ASM）和体重指数（BMI））的患病率和相关因素。
本横断面研究招募了年龄在 60-85 岁之间的来自低收入社区的黑人南非女性（n=122）。检测包括空腹血样（心血管代谢风险标志物、HIV）、全身和局部肌肉和脂肪质量（双能吸收 X 射线）、人体测量、血压、功能运动测试、当前用药情况、人口统计学和健康问卷、体力活动（加速度计）、家庭食物不安全获取量表和一周量化食物频率问卷。采用美国国立卫生研究院基金会（FNIH）标准（握力和 ASM，根据 BMI 调整）对肌少症进行分类。将同时 BMI>30.0kg/m2 的肌少症患者归类为肌少症性肥胖。还探讨了其他分类标准（欧洲老年人肌少症工作组、亚洲肌少症工作组和国际肌少症工作组）的患病率。
肌少症的患病率为 27.9%，其中包括无肥胖的肌少症（3.3%）和肌少症性肥胖（24.6%）。其他分类标准显示，肌少症的范围为 0.8-14.7%，包括无肥胖的 0.8-9.8%和肌少症性肥胖的 0-4.9%。使用多元判别分析（OPLS-DA），与无肌少症性肥胖的女性相比，肌少症性肥胖的女性具有更高的 C 反应蛋白、腰围、食物保障和久坐时间的描述性特征（p=0.046）。与低 BMI 调整握力的女性（p<0.001）相比，具有相似特征的女性也表现出较低的 BMI 调整握力。
大多数肌少症患者也肥胖（88%）。如果不调整 BMI，我们发现诊断标准存在较大差异，肌少症的患病率可能会被显著低估。肌少症性肥胖女性的主要共同变量是更高的食物保障、更低的体力活动和慢性炎症。我们的数据强调了在这些低收入社区解决肥胖问题的重要性，以确保肌少症性肥胖的预防，并随着年龄的增长保持生活质量。
