Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China.
Department of Radiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China.
Clin Nutr. 2024 Jan;43(1):11-17. doi: 10.1016/j.clnu.2023.11.006. Epub 2023 Nov 15.
BACKGROUND & AIMS: ESPEN/EASO advocates screening for sarcopenic obesity based on the concomitant presence of an elevated body mass index (BMI) or waist circumference. Neck circumference (NC) is another simple and reliable anthropometric measurement for estimating obesity; however, its ability to detect sarcopenic obesity has not yet been established. The aim of the present study was to explore the association between NC and sarcopenic obesity in a Shanghai community population.
The study included 1542 participants (622 men and 920 women) with a mean age of 58 years who underwent an examination for the detection of obesity at baseline in 2013-2014 and received a re-examination in 2015-2016. An automatic bioelectric impedance analyzer was used to estimate body composition, and magnetic resonance imaging was used to measure abdominal fat distribution. The definition of pre-sarcopenic obesity combined low skeletal muscle mass adjusted by weight (SMM/W) with obesity which defined according to overall adiposity or fat distribution as BMI ≥25 kg/m, fat percentage (fat%) ≥ 25% in men and 30% in women, or visceral fat area (VFA) ≥ 80 cm, respectively.
In both men and women, subjects with low SMM/W had a higher level of NC than those without (both P < 0.01). In turn, participants with elevated NC had a higher proportion of pre-sarcopenic obesity in both men and women, regardless of adiposity status assessed by BMI, fat%, or VFA (all P < 0.01). During an average follow up of 2.1 years, for each 1 cm increase in NC, multivariable-adjusted hazard ratios of pre-sarcopenic obesity in which adiposity status assessed by high BMI were 1.40 (1.11-1.76) in men and 1.32 (1.13-1.56) in women; in addition, such association remained between NC and pre-sarcopenic obesity assessed by high fat% or high VFA.
NC is closely associated with the incidence of sarcopenic obesity, suggesting that it could be helpful for screening sarcopenic obesity in a community-based population.
ESPEN/EASO 提倡根据升高的体重指数（BMI）或腰围筛查出肌少性肥胖。颈围（NC）是另一种用于估计肥胖的简单可靠的人体测量学指标；然而，其检测肌少性肥胖的能力尚未得到证实。本研究旨在探讨上海市社区人群中 NC 与肌少性肥胖之间的关系。
本研究纳入了 1542 名参与者（622 名男性和 920 名女性），平均年龄为 58 岁，他们在 2013-2014 年基线检查时接受了肥胖筛查，并在 2015-2016 年接受了复查。使用自动生物电阻抗分析仪估计身体成分，使用磁共振成像（MRI）测量腹部脂肪分布。预肌少性肥胖的定义为体重调整后的低骨骼肌质量（SMM/W）与肥胖相结合，肥胖根据总体肥胖程度或脂肪分布定义为 BMI≥25kg/m2，男性脂肪百分比（fat%）≥25%，女性≥30%，或内脏脂肪面积（VFA）≥80cm。
在男性和女性中，低 SMM/W 的受试者的 NC 水平均高于无低 SMM/W 的受试者（均 P<0.01）。相反，无论 BMI、fat%或 VFA 评估的肥胖程度如何，高 NC 的参与者中均有更高比例的预肌少性肥胖（均 P<0.01）。在平均 2.1 年的随访期间，对于 NC 每增加 1cm，通过高 BMI 评估的肥胖状态下，男性预肌少性肥胖的多变量调整后的风险比为 1.40（1.11-1.76），女性为 1.32（1.13-1.56）；此外，NC 与高 fat%或高 VFA 评估的预肌少性肥胖之间也存在这种关联。
NC 与肌少性肥胖的发生密切相关，提示其有助于在社区人群中筛查肌少性肥胖。
