González Arnáiz Elena, Ariadel Cobo Diana, Estébanez Brisamar, Barajas Galindo David, Pintor de la Maza Begoña, Urioste Fondo Ana, Dameto Pons Carmen, Cuevas María J, Ballesteros Pomar María D
Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia de Salud de Castilla y León (SACYL), Alto de Nava s/n, 24071 León, Spain; Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain.
Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain.
Clin Nutr. 2024 May;43(5):1087-1093. doi: 10.1016/j.clnu.2024.03.015. Epub 2024 Apr 1.
Sarcopenic obesity (SO) is defined as a combination of low strength and muscle mass along with excess adiposity. Our study aimed to determine the prevalence of sarcopenic obesity in candidates for bariatric surgery, according to ESPEN/EASO criteria using bioimpedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA).
Retrospective study of adult patients (18-60 years) candidates for bariatric surgery (BMI ≥40 kg/m or ≥35 kg/m with associated complications). Adiposity was assessed by the percentage of fat mass by DXA, according to Gallagher's cut-off points. Muscle strength was measured by hand grip according to Sánchez-Torralvo, Dodds, and <-2SD cut-off points of healthy reference population. Muscle mass was determined by DXA (ALM/weight according to Batsis) and by BIA (SMM/weight according to Janssen and according to reference population). In addition, the agreement of the different diagnostic methods of sarcopenic obesity was analyzed.
A total of 124 subjects were included in the study, with 71.8 % being women. The overall mean age was 42.6 (SD 8.9) years. SO prevalence was found to be 13 %-22 % applying BIA with the SMM/weight equation according to Janssen, 14 %-23 % utilizing BIA with the SMM/weight equation according to the reference population, and 13 %-23 % employing DXA with the ALM/weight equation following Batsis criteria, depending on the specific hand grip strength cut-off points used. In general, we found good or very good concordances with the different diagnostic methods (with kappa values between 0.6 and 0.97).
The prevalence of SO according to ESPEN/EASO criteria in candidates for bariatric surgery was 13 %-23 % based on the diagnostic method and cut-off points used.
肌少性肥胖（SO）被定义为低强度、低肌肉量与肥胖并存的状态。我们的研究旨在根据欧洲临床营养与代谢学会（ESPEN）/欧洲肥胖症研究学会（EASO）的标准，运用生物电阻抗分析（BIA）和双能X线吸收法（DXA），确定接受减肥手术的患者中肌少性肥胖的患病率。
对成年（18 - 60岁）减肥手术候选患者（BMI≥40 kg/m²或≥35 kg/m²且伴有相关并发症）进行回顾性研究。根据加拉格尔切点，通过DXA测量脂肪量百分比来评估肥胖程度。依据桑切斯 - 托拉尔沃、多兹的方法以及健康参考人群的<-2SD切点，通过握力测量肌肉力量。通过DXA（根据巴齐斯标准的ALM/体重）和BIA（根据扬森标准以及参考人群的SMM/体重）来确定肌肉量。此外，还分析了肌少性肥胖不同诊断方法之间的一致性。
本研究共纳入124名受试者，其中71.8%为女性。总体平均年龄为42.6（标准差8.9）岁。根据扬森标准，运用BIA的SMM/体重公式，SO患病率为13% - 22%；根据参考人群，运用BIA的SMM/体重公式，患病率为14% - 23%；依据巴齐斯标准，运用DXA的ALM/体重公式，患病率为13% - 23%，具体取决于所使用的特定握力强度切点。总体而言，我们发现不同诊断方法之间具有良好或非常好的一致性（kappa值在0.6至0.97之间）。
根据所使用的诊断方法和切点，接受减肥手术的患者中，按照ESPEN/EASO标准，肌少性肥胖的患病率为13% - 23%。
