肥胖青少年的骨骼肌量、肌肉力量和身体机能。
Skeletal muscle mass, muscle strength, and physical performance in children and adolescents with obesity.
机构信息
Department of Pediatrics, Pediatric Obesity and Metabolic Bone Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Department of Medical Biophysics, Medical University of Silesia, Katowice, Poland.
出版信息
Front Endocrinol (Lausanne). 2023 Oct 4;14:1252853. doi: 10.3389/fendo.2023.1252853. eCollection 2023.
INTRODUCTION
Sarcopenic obesity (SO) is defined as obesity with low skeletal muscle function and mass. This study aimed to evaluate the presence of sarcopenic obesity according to different diagnostic criteria and assess the elements of sarcopenia in children and adolescents with obesity.
METHODS
A total of 95 children and adolescents with obesity (diagnosed with the use of International Obesity Task Force (IOTF) criteria) with a mean age of 12.7( ± 3) years participated in the study. Body composition was assessed with the use of bioelectrical impedance-BIA (Tanita BC480MA) and dual-energy X-ray absorptiometry-DXA (Hologic). Fat mass (FM) and appendicular skeletal muscle mass (SMMa) were expressed as kilograms (kg) and percentage (%). Muscle-to-fat ratio (MFR) was defined as SMMa divided by FM. A dynamometer was used in order to measure grip strength. Six-minute walk test (6MWT) and a timed up-and-go test (TUG) were used to assess physical performance.
RESULTS
The presence of SO ranged from 6.32% to 97.89%, depending on the criteria used to define sarcopenia. Children with sarcopenia, defined as a co- occurrence of low skeletal muscle mass % (SMM%) measured by DXA (≤9th centile) according to McCarthy et al. and weak handgrip strength (≤10th centile) according to Dodds et al., had significantly lower SMMa measured by both DXA and BIA, lower maximal handgrip strength, and lower physical performance. Maximal handgrip was positively correlated with SMMa (kg) and SMMa% derived from both DXA and BIA and BIA-MFR. Maximal handgrip was negatively correlated with waist-to-height ratio (WHtR). The distance of 6MWT correlated positively with BIA-measured SMMa% and BIA-MFR. 6MWT distance correlated negatively with BIA-FM% and body mass index (BMI) z-score. TUG was positively correlated with BIA-FM%, BMI z-score, WHtR, and IOTF categories and negatively correlated with BIA-SMMa% and BIA-MFR.
DISCUSSION
The presence of sarcopenia in our study varied depending on the diagnostic criteria used. This is one of the first studies evaluating muscle mass, muscle strength, and physical performance in children and adolescents with obesity. The study highlighted the need for the implementation of a consensus statement regarding SO diagnostic criteria in children and adolescents.
简介
肌少症性肥胖（SO）定义为肌肉功能和质量低的肥胖症。本研究旨在根据不同的诊断标准评估肌少症性肥胖的存在，并评估肥胖儿童和青少年的肌少症元素。
方法
本研究共纳入 95 名肥胖儿童和青少年（使用国际肥胖工作组（IOTF）标准诊断），平均年龄为 12.7( ± 3)岁。使用生物电阻抗-BIA（Tanita BC480MA）和双能 X 射线吸收法-DXA（Hologic）评估身体成分。脂肪量（FM）和四肢骨骼肌量（SMMa）以千克（kg）和百分比（%）表示。肌肉与脂肪比（MFR）定义为 SMMa 除以 FM。使用测力计测量握力。使用 6 分钟步行试验（6MWT）和计时起立行走试验（TUG）评估身体机能。
结果
根据定义肌少症的标准，SO 的存在范围为 6.32%至 97.89%。根据 McCarthy 等人定义的 DXA 测量的低骨骼肌量%（SMM%）（≤第 9 百分位数）和 Dodds 等人定义的弱握力（≤第 10 百分位数）同时存在的肌少症儿童，其 DXA 和 BIA 测量的 SMMa 显著较低，最大握力较低，身体机能较差。最大握力与 DXA 和 BIA 测量的 SMMa（kg）和 SMMa%以及 BIA-MFR 呈正相关。最大握力与腰高比（WHtR）呈负相关。6MWT 距离与 BIA 测量的 SMMa%和 BIA-MFR 呈正相关。6MWT 距离与 BIA-FM%和体重指数（BMI）z 评分呈负相关。TUG 与 BIA-FM%、BMI z 评分、WHtR 和 IOTF 类别呈正相关，与 BIA-SMMa%和 BIA-MFR 呈负相关。
讨论
根据使用的诊断标准，本研究中肌少症的存在存在差异。这是评估肥胖儿童和青少年肌肉量、肌肉力量和身体机能的首批研究之一。该研究强调需要制定一份关于儿童和青少年肌少症性肥胖症诊断标准的共识声明。
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