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Comparison between EWGSOP1 and EWGSOP2 criteria and modelling of diagnostic algorithm for sarcopenic obesity in over 70 years old patients

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Key summary points

AbstractSection Aim

This study proposed to compare performance of sarcopenia EWGSOP2 (Cruz-Jentoft et al. in Age Ageing 48:16–31, 2019) and EWGSOP1 (Cruz-Jentoft et al. in Age Ageing 39:412–423, 2010) diagnostic criteria in identifying sarcopenia and their applicability for detecting SO; further to describe prevalence of sarcopenia and SO in Czech patient cohort screened for SPRINTT study (“Sarcopenia and Physical fRailty IN older people: multicomponenT Treatment strategies”) and develop a more precise algorithm for detecting SO.

AbstractSection Findings

Our study results suggest that EWGSOP1 (2010) criteria have higher sensitivity to identify patients with sarcopenia and SO than EWGSOP2 (2019). Using the newer criteria (EWGSOP2) may leave significant proportion of sarcopenic and sarcopenic obese patients undetected despite their physical and functional deficit.

AbstractSection Message

Our proposed diagnostic algorithm model can increase the sensitivity of SO diagnosis, is simple and easy to implement in clinical practice. Early detection of sarcopenia and SO using simple and readily available methods can help initiate optimal therapy and improve the quality of life for at-risk older adults.

Abstract

Purpose

Sarcopenic obesity (SO) as a new diagnostic entity defined by presence of obesity in combination with sarcopenia represents serious health condition negatively affecting quality of life in old age. Despite the rapidly increasing incidence of SO associated with demographic aging, clear diagnostic criteria for SO have not yet been established. We describe here the applicability of the EWGSOP2 and EWGSOP1 diagnostic criteria in identifying sarcopenia and SO and the development of a refinement algorithm for SO detection.

Methods

In total 156 subjects were pre-screened, 126 had a complete dataset and were included, 20.6% (n = 26) were men and 79.4% (n = 100) women, mean age 81 ± 6.3 years in tertiary hospital, Prague, Czech Republic. Testing of physical performance (hand-grip test, 400 m walk test, chair stand test, gait speed), anthropometric measures and SARC-F, SPPB and MNA-SF were used to determine physical, functional, and nutritional status, while muscle mass and fat mass were measured by DXA scans to confirm sarcopenia and SO diagnosis.

Results

The prevalence of sarcopenia (BMI adjusted ALM < 0.789 for men, < 0.512 for women) was 26.2% (n = 33), SO in 20.6% (n = 26). 78.8% of all sarcopenic subjects fulfilled the criteria of SO (FM > 27% for men and > 38% for women; waist circumference > 90 cm for men and > 85 cm for women). EWGSOP1 criteria for diagnosing sarcopenia showed better sensitivity of 97.0% than the EWGSOP2 66.7%, while specificity reached 100% for both criteria. According to DXA measurement, EWGSOP1 identified 3.0% cases (1 out of 33) as false negative meanwhile EWGSOP2 identified 33.3% cases as false negative and this difference was statistically significant (McNemar’s test, p < 0.001). An algorithm for SO was developed (which uses sex, BMI, height, waist circumference and SPPB) with sensitivity and specificity of 88.5 and 91.0%, respectively.

Conclusion

High prevalence of obesity among elderly people and rather low sensitivity of current diagnostic criteria for SO call for ongoing research. Broader international consensus for SO diagnostic criteria, screening and diagnosis algorithm are crucial for early detection of SO in older people in clinical practice so that optimal multi-component therapy can be initiated.

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Funding

This follow-up research was partially supported by Institutional research “PROGRESS”, Charles University, but did not receive any specific grants from funding agencies in the public or commercial sector. The original RCT study SPRINTT was funded by a grant from the Innovative Medicines Initiative-Joint Undertaking (IMI-JU 115621).

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Authors and Affiliations

  1. Department of Gerontology and Geriatrics, Charles University, 1st Faculty of Medicine, Londýnská 545/15, 128 00, Prague 2, Czech Republic

    Tereza Vágnerová, Helena Michálková & Eva Topinková

  2. Institute of Hygiene and Epidemiology, Charles University, 1st Faculty of Medicine, Londýnská 545/15, 128 00, Prague 2, Czech Republic

    Tereza Vágnerová

  3. Institute of Nursing, Midwifery and Emergency Care, University of South Bohemia, Faculty of Health and Social Sciences, J. Boreckého 1167, 370 11, České Budějovice, Czech Republic

    Helena Michálková & Eva Topinková

  4. Institute of Laboratory Diagnostics and Public Health, University of South Bohemia, Faculty of Health and Social Sciences, J. Boreckého 1167, 370 11, České Budějovice, Czech Republic

    Olga Dvořáčková

Authors
  1. Tereza Vágnerová
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  2. Helena Michálková
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  3. Olga Dvořáčková
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  4. Eva Topinková
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Contributions

TV, HM, OD and ET had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. TV is the primary author. Concept and design: TV, ET. Acquisition, analysis or interpretation of data: TV, OD, HM. Drafting of the manuscript: TV. Critical revision of the manuscript for important intellectual content: OD, ET, HM. Statistical analysis: OD. Obtained funding: ET (Institutional research “PROGRESS”). Administrative, technical or material support: HM. Supervision: OT.

Corresponding author

Correspondence to Tereza Vágnerová.

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Conflict of interest

All of the authors (except Olga Dvořáková) of the present work are partners of the SPRINTT consortium.

Ethical approval

Ethical approval was obtained from the Ethics Committee of General University Hospital in Prague.

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All patients gave full informed written consent.

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Vágnerová, T., Michálková, H., Dvořáčková, O. et al. Comparison between EWGSOP1 and EWGSOP2 criteria and modelling of diagnostic algorithm for sarcopenic obesity in over 70 years old patients. Eur Geriatr Med 13, 641–648 (2022). https://doi.org/10.1007/s41999-021-00602-4

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  • DOI: https://doi.org/10.1007/s41999-021-00602-4

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