Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
Health Management Center, West China Hospital, Sichuan University, Chengdu, China.
BMC Geriatr. 2024 May 21;24(1):446. doi: 10.1186/s12877-024-04955-w.
Sarcopenic obesity (SO) in nursing home residents is rarely studied. We aimed to evaluate and compare the prevalence and consistency of different SO diagnostic methods and to investigate which criterion demonstrated a stronger association with instrumental activities of daily living (IADL) disability.
We consecutively recruited older adults aged ≥ 60 years, residing in 15 nursing homes in Zigong City, China. Sarcopenia obesity was defined according to the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity criteria (SO), recommending skeletal muscle mass (SMM) adjusted by body weight (SMM/W) to identify low muscle mass. Further, we adapted ESPEN criteria (SO) by employing SMM adjusted by body mass index (SMM/BMI).
We included 832 participants (median age 73.0 years, 296 women). The prevalence of SO and SO was 43.5% and 45.3%, respectively. SO showed good consistency with SO (Cohen's kappa = 0.759). More than one-third of participants in the normal weight group were diagnosed with SO or SO. Even within the underweight group, the prevalence of SO and SO was 8.9% and 22.2%, respectively. Participants with IADL disability had significantly lower SMM/W and SMM/BMI, but higher fat mass percentage of body weight (FM%) than participants without IADL disability. After full adjustment for potential confounders, SO (OR 1.68, 95% CI 1.21 to 2.32), but not SO (OR 1.28, 95% CI 0.93 to 1.75), remained significantly associated with IADL disability.
Both SO and SO showed a high prevalence among nursing home residents, even among individuals with underweight or normal weight. While SO had a good consistency with SO, only SO was independently associated with IADL disability. Screening and diagnosis of SO should be conducted in nursing home residents irrespective of BMI.
养老院居民的肌肉减少性肥胖（SO）很少被研究。我们旨在评估和比较不同 SO 诊断方法的患病率和一致性，并研究哪种标准与日常生活活动（IADL）残疾的关联更强。
我们连续招募了年龄≥60 岁的老年人，他们居住在中国自贡市的 15 家养老院。根据欧洲临床营养与代谢学会（ESPEN）和欧洲肥胖研究协会（SO）标准，将肌肉减少症肥胖定义为通过体重调整的骨骼肌质量（SMM/W）来识别低肌肉质量。此外，我们通过采用身体质量指数（SMM/BMI）调整的 SMM 来适应 ESPEN 标准（SO）。
我们纳入了 832 名参与者（中位年龄 73.0 岁，296 名女性）。SO 和 SO 的患病率分别为 43.5%和 45.3%。SO 与 SO 具有良好的一致性（Cohen's kappa=0.759）。超过三分之一的正常体重组参与者被诊断为 SO 或 SO。即使在体重不足组中，SO 和 SO 的患病率也分别为 8.9%和 22.2%。有 IADL 残疾的参与者的 SMM/W 和 SMM/BMI 明显较低，但体重脂肪百分比（FM%）较高，而没有 IADL 残疾的参与者则较低。在充分调整潜在混杂因素后，SO（OR 1.68，95%CI 1.21 至 2.32），而不是 SO（OR 1.28，95%CI 0.93 至 1.75），与 IADL 残疾显著相关。
SO 和 SO 在养老院居民中均具有较高的患病率，甚至在体重不足或正常体重的人群中也是如此。虽然 SO 与 SO 具有良好的一致性，但只有 SO 与 IADL 残疾独立相关。应在养老院居民中进行 SO 的筛查和诊断，而不论 BMI 如何。
