Deguchi Naoki, Tanaka Ryo, Akita Tomoyuki
Geriatrics, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, JPN.
Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, JPN.
Cureus. 2024 Jul 15;16(7):e64612. doi: 10.7759/cureus.64612. eCollection 2024 Jul.
Background Concurrent sarcopenia and obesity in locomotive syndrome (LS) impair activities of daily living and decrease extremity muscle strength and motor function. However, the increased risk of frailty posed by sarcopenic obesity compared to either sarcopenia or obesity alone remains unclear. Objective To examine the association between sarcopenic obesity and frailty risk in community-dwelling older adult women with LS. Methods This cross-sectional study included 158 women aged ≥65 years with LS stage 1 (age, 74.0 yrs, body mass index, 22.7 kg/m) according to the Japanese Orthopaedic Association criteria. Bioelectrical impedance analysis was used to measure the skeletal muscle mass index (SMI) and percent body fat (PBF). Participants were classified into four subtypes: normal (non-obesity, non-sarcopenia), sarcopenia (SMI < 5.7 kg/m), obesity (PBF > 35%), and sarcopenic obesity (SMI < 5.7 kg/m and PBF > 35%). Logistic regression analysis was used to adjust for age, body mass index, back pain, knee pain, history of falls, and physical function. Results Among the participants, 52 individuals (32.9%) were classified as frailty risk. The percentage of body phenotypes was 30.4% normal, 32.9% were sarcopenia, 22.8% had obesity (RT1), and 13.9% had sarcopenic obesity. The odds ratios for frailty risk compared to normal were 3.97 (95% confidence interval (CI): 1.51 to 10.4), 1.71 (95% CI: 0.55 to 5.39), and 4.25 (95% CI: 1.34 to 13.5) for sarcopenia (RT2), obesity, and sarcopenic obesity subtypes, respectively, sarcopenia and sarcopenic obesity were significantly associated with frailty risk. Conclusion In older adult women with LS, the presence of sarcopenia or sarcopenic obesity may increase the risk of frailty; however, the addition of obesity does not always further increase this risk. Further investigation of the association between increased body fat and frailty in older adult women is warranted.
背景 肌肉减少症与肥胖并存于运动机能减退综合征（LS）中，会损害日常生活活动能力，并降低四肢肌肉力量和运动功能。然而，相较于单纯的肌肉减少症或肥胖症，肌肉减少性肥胖导致衰弱风险增加的情况仍不明确。目的 研究社区居住的患有LS的老年女性中肌肉减少性肥胖与衰弱风险之间的关联。方法 这项横断面研究纳入了158名年龄≥65岁、根据日本骨科协会标准处于LS 1期的女性（年龄74.0岁，体重指数22.7kg/m²）。采用生物电阻抗分析来测量骨骼肌质量指数（SMI）和体脂百分比（PBF）。参与者被分为四种亚型：正常（非肥胖、非肌肉减少症）、肌肉减少症（SMI<5.7kg/m²）、肥胖（PBF>35%）和肌肉减少性肥胖（SMI<5.7kg/m²且PBF>35%）。采用逻辑回归分析来调整年龄、体重指数、背痛、膝盖疼痛、跌倒史和身体功能。结果 在参与者中，52人（32.9%）被归类为有衰弱风险。身体表型的百分比分别为：正常30.4%、肌肉减少症32.9%、肥胖（RT1）22.8%、肌肉减少性肥胖13.9%。与正常情况相比，肌肉减少症（RT2）、肥胖和肌肉减少性肥胖亚型的衰弱风险比值比分别为3.97（95%置信区间（CI）：1.51至10.4）、1.71（95%CI：0.55至5.39）和4.25（95%CI：1.34至13.5），肌肉减少症和肌肉减少性肥胖与衰弱风险显著相关。结论 在患有LS的老年女性中，肌肉减少症或肌肉减少性肥胖的存在可能会增加衰弱风险；然而，肥胖的叠加并不总是会进一步增加这种风险。有必要进一步研究老年女性体内脂肪增加与衰弱之间的关联。
