Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
Gerontology. 2023;69(6):706-715. doi: 10.1159/000527804. Epub 2023 Jan 30.
Conflicting evidence exists concerning whether having sarcopenic obesity has additive mortality risk over having only sarcopenia or obesity. We examined the independent and combined associations of obesity and probable sarcopenia with all-cause mortality.
The pooled analysis included three large, harmonized datasets (Health 2000 Survey; Health, Aging and Body Composition Study; Longitudinal Aging Study Amsterdam) with mortality follow-up data on individuals aged 70 years and over at baseline (n = 4,612). Obesity indicators included body mass index and waist circumference, and probable sarcopenia was defined based on grip strength. The mixed effects Cox model was used for statistical analyses, adjusting for age, sex, marital status, education, race, physical activity, alcohol consumption, smoking, and baseline diseases.
Risk of death increased for those having probable sarcopenia only (hazard ratio [HR]: 1.61, 95% confidence interval [CI]: 1.39-1.85) or probable sarcopenia with obesity (HR: 1.36, 95% CI: 1.13-1.64) but not for the obese-only group (HR: 0.92, 95% CI: 0.85-1.01), when compared to non-obese non-sarcopenic individuals. The results were similar regardless of adjustments for covariates or different obesity criteria applied.
Probable sarcopenia, whether combined with obesity or not, is associated with increased mortality. Obesity did not increase mortality among older adults. Maintaining muscle strength and identifying older adults at risk of sarcopenia is important for the prevention of premature mortality.
关于肥胖合并肌肉减少症是否比单独存在肌肉减少症或肥胖具有更高的死亡风险，目前存在相互矛盾的证据。我们研究了肥胖和可能的肌肉减少症与全因死亡率的独立和联合关联。
这项汇总分析纳入了三个大型、协调一致的数据集（健康 2000 调查；健康、衰老和身体成分研究；阿姆斯特丹纵向老龄化研究），这些数据均具有在基线时年龄在 70 岁及以上的个体的死亡率随访数据（n=4612）。肥胖指标包括体重指数和腰围，而可能的肌肉减少症则根据握力来定义。采用混合效应 Cox 模型进行统计分析，调整了年龄、性别、婚姻状况、教育程度、种族、身体活动、酒精摄入量、吸烟情况和基线疾病。
与非肥胖非肌肉减少症个体相比，仅存在可能的肌肉减少症（危险比 [HR]：1.61，95%置信区间 [CI]：1.39-1.85）或可能的肌肉减少症合并肥胖（HR：1.36，95% CI：1.13-1.64）的个体死亡风险增加，但肥胖个体（HR：0.92，95% CI：0.85-1.01）的死亡风险并未增加。无论调整协变量还是应用不同的肥胖标准，结果均相似。
无论是否合并肥胖，可能的肌肉减少症均与死亡率增加相关。肥胖并未增加老年人的死亡率。保持肌肉力量和识别有肌肉减少症风险的老年人对于预防过早死亡至关重要。
