Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.
Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.
J Am Med Dir Assoc. 2023 Aug;24(8):1179-1184.e1. doi: 10.1016/j.jamda.2023.03.008. Epub 2023 Apr 13.
Previous studies have indicated that sarcopenic obesity is a risk factor for disability onset. However, these studies had disparities in terms of criteria for sarcopenia, study design, or study population. No longitudinal study has investigated the effect of sarcopenic obesity on disability onset in an Asian population using the Asian Working Group for Sarcopenia 2019 criteria for sarcopenia definition. Herein, we aimed to investigate the longitudinal effect of sarcopenic obesity on disability onset in Japanese older adults and extend the generalizability of results to other populations.
Longitudinal cohort study.
A total of 4197 Japanese older adults (mean age 74.6 ± 5.0 years, 54.2% women) formed our study population.
Sarcopenia was identified using the Asian Working Group for Sarcopenia 2019 algorithm. Obesity was determined when body fat percentage was ≥25%, or when visceral fat content was ≥100 cm for either sex. Disability onset was defined as a new case of long-term care insurance system certification for 5 years from baseline. Missing values were managed with multi-imputation. Cox proportional hazard regression analysis was used with disability onset as dependent variable and group (nonsarcopenia/nonobesity as a reference, nonsarcopenia/obesity, sarcopenia/non-obesity, possible sarcopenia/obesity, possible sarcopenia/non-obesity, sarcopenic obesity) as explanatory variable, and was adjusted for potential confounding factors.
When the nonsarcopenia/nonobesity group was used as the reference category, other groups such as possible-sarcopenia/nonobesity [hazard ratio (HR) 1.38, 95% confidential interval (95% CI) 1.29‒1.47, P < .028], possible-sarcopenia/obesity (HR 1.54, 95% CI 1.46‒1.62 P < .001), sarcopenia/nonobesity (HR 2.09, 95% CI 1.96‒2.23, P < .001), and sarcopenic obesity (HR 2.48, 95% CI 2.24‒2.75, P < .001) showed significantly increased HRs.
The risk of disability onset because of sarcopenic obesity was exceedingly higher compared with sarcopenia alone among community-dwelling older adults in Japan The health providers should consider assessing the co-existence of sarcopenia and obesity to screen for the risk of disability onset in the community-dwelling population.
先前的研究表明，肌少症合并肥胖是残疾发生的一个危险因素。然而，这些研究在肌少症的标准、研究设计或研究人群方面存在差异。没有纵向研究使用 2019 年亚洲肌少症工作组的肌少症定义标准，以亚洲人群为对象，调查肌少症合并肥胖对残疾发生的影响。在此，我们旨在调查肌少症合并肥胖对日本老年人残疾发生的纵向影响，并将研究结果推广到其他人群。
纵向队列研究。
我们的研究人群由 4197 名日本老年人（平均年龄 74.6±5.0 岁，54.2%为女性）组成。
使用 2019 年亚洲肌少症工作组算法确定肌少症。当体脂百分比≥25%或男女内脏脂肪含量≥100cm 时，确定肥胖。残疾发生定义为从基线起 5 年内长期护理保险系统认证的新病例。缺失值通过多重插补处理。将残疾发生作为因变量，组（非肌少症/非肥胖作为参考，非肌少症/肥胖，肌少症/非肥胖，可能的肌少症/肥胖，可能的肌少症/非肥胖，肌少症合并肥胖）作为解释变量，进行 Cox 比例风险回归分析，并调整了潜在的混杂因素。
当非肌少症/非肥胖组作为参考类别时，其他组（如可能的肌少症/非肥胖组，风险比[HR]1.38，95%置信区间[95%CI]1.29-1.47，P<0.028）、可能的肌少症/肥胖组（HR 1.54，95%CI 1.46-1.62，P<0.001）、肌少症/非肥胖组（HR 2.09，95%CI 1.96-2.23，P<0.001）和肌少症合并肥胖组（HR 2.48，95%CI 2.24-2.75，P<0.001）的 HR 显著增加。
与日本社区居住的老年人中单纯肌少症相比，肌少症合并肥胖导致残疾发生的风险要高得多。医疗保健提供者应考虑评估肌少症和肥胖的共存情况，以筛查社区居民的残疾发生风险。
