Skip to main content
SpringerLink
Log in

Sarcopenic obesity and metabolic syndrome in adult Caucasian subjects

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Recently metabolic aspects linked to sarcopenic obesity (SO) were investigated. Extant studies involved especially older people from Asian or White-mixed American cohorts. The aims of our study were: to explore the prevalence of sarcopenia in Caucasian adult obese subjects using two different indices of sarcopenia, and to investigate the relationship among SO, metabolic syndrome (MS), inflammation, and serum albumin concentrations.

Design

Cross- sectional study.

Subjects/methods

The study was performed from 2011 to 2014 in a hospitalized care setting. Inclusion criteria were: age>18 and <65 years, BMI=30 Kg/m2. Fat mass (FM) and fat-free mass (FFM) were assessed by DXA. Appendicular skeletal muscle mass (ASMM) was calculated. Sarcopenia was defined as ASMM/height2 or ASMM/weight <2SD than the sex-specific mean of a young population. The cutoffs were ASMM/h2<6.54 Kg/m2 for men and 4.82 Kg/m2 for women, and ASMM/weight<0.2827 for men and 0.2347 for women. ISI-Matsuda was calculated. MS was diagnosed (NCEP-ATPIII).

Results

727 subjects (age: 45.72±13.56 years, BMI: 37.74±5.82 kg/m2) were enrolled. The prevalence of SO was 1.0% or 34.8% in men and 0.6% or 50.1% in women, using ASMM/height2 ratio or ASMM/weight. Subjects with SO based on ASMM/height2 were scarce, only data relying on ASMM/weight were considered. Subjects with SO had higher BMI, waist circumference, FM, and lower FFM and ASMM than nonsarcopenic obese individuals (all p<0.05). ISI-Matsuda was lower and hs-CRP levels were higher in subjects with SO (all p<0.05). MS was more prevalent in subjects with SO than nonsarcopenic obese subjects (47.6% vs 34.3%, p<0.001). ASMM/weight was decreased in subjects with MS (0.2522±0.0410 vs 0.2423±0.0352, p=0.001).

Conclusion

SO is associated with MS and low- grade inflammation in adult Caucasian subjects. Metabolic profile evaluation should be recommended in subjects with SO.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Waters DL, Baumgartner RN. Sarcopenia and obesity. Clin Geriatr Med 2011 27: 401–421

    Article  PubMed  Google Scholar 

  2. Stenholm S, Harris TB, Rantanen T, Visser M, Kritchevsky SB, Ferrucci L. Sarcopenic obesity: definition, cause and consequences. Curr Opin Clin Nutr Metab Care 2008;11: 693–700

    Article  PubMed  PubMed Central  Google Scholar 

  3. Poggiogalle E, Migliaccio S, Lenzi A, Donini LM. Treatment of body composition changes in obese and overweight older adults: insight into the phenotype of sarcopenic obesity Endocrine 2014;47: 699–716.

    Article  CAS  PubMed  Google Scholar 

  4. Clement FJ. Longitudinal and cross-sectional assessments of age changes in physical strength as related to sex, social class, and mental ability. J Gerontol 1974;29: 423–429

    Article  CAS  PubMed  Google Scholar 

  5. Laurentani F, Russo CR, Bandinelli S, Bartali B, Cavazzini C, Di Iorio A, et al. Ageassociated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol 2003;95: 1851–1860

    Article  Google Scholar 

  6. Fulton JE, Dai S, Steffen LM, Grunbaum JA, Shah SM, Labarthe DR. Physical activity, energy intake, sedentary behavior, and adiposity in youth. Am J Prev Med 2009;37: S40–S49

    Article  PubMed  Google Scholar 

  7. Bosy-Westphal A, Schautz B, Lagerpusch M, Pourhassan M, Braun W, Goele K, et al. Effect of weight loss and regain on adipose tissue distribution, composition of lean mass and resting energy expenditure in young overweight and obese adults. Int J Obes 2013;37: 1371–7

    Article  CAS  Google Scholar 

  8. Levine ME, Crimmins EM. The impact of insulin resistance and inflammation on the association between sarcopenic obesity and physical functioning. Obesity 2012;20: 2101–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Baumgartner RN, Wayne SJ, Waters DL, Janssen I, Gallagher D, Morley JE. Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obes Res 2004;2: 1995–2004

    Article  Google Scholar 

  10. Prado CM, Wells JC, Smith SR, Stephan BC, Siervo M. Sarcopenic obesity: A critical appraisal of the current evidence. Clin Nutr 2012;31: 583–601.

    Article  CAS  PubMed  Google Scholar 

  11. Dominguez LJ, Barbagallo M. The cardiometabolic syndrome and sarcopenic obesity in older persons. J Cardiometab Syndr 2007;2: 183–9.

    Article  PubMed  Google Scholar 

  12. Donini LM, Poggiogalle E, Migliaccio S, Aversa A, Pinto A. Body composition in sarcopenic obesity: systematic review of the literature. Mediterr J Nutr Metab 2013;6: 191–198

    Article  Google Scholar 

  13. Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998;147: 755–63.

    Article  CAS  PubMed  Google Scholar 

  14. Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 2002;50: 889–96.

    Article  PubMed  Google Scholar 

  15. Lim S, Kim JH, Yoon JW, Kang SM, Choi SH, Park YJ, et al. Sarcopenic obesity: prevalence and association with metabolic syndrome in the Korean Longitudinal Study on Health and Aging (KLoSHA). Diabetes Care 2010;33: 1652–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Kim TN, Yang SJ, Yoo HJ, Lim KI, Kang HJ, Song W, et al. Prevalence of sarcopenia and sarcopenic obesity in Korean adults: the Korean sarcopenic obesity study. Int J Obes 2009;33: 885–92.

    Article  CAS  Google Scholar 

  17. Chung JY, Kang HT, Lee DC, Lee HR, Lee YJ. Body composition and its association with cardiometabolic risk factors in the elderly: a focus on sarcopenic obesity. Arch Gerontol Geriatr 2013;56: 270–8.

    Article  PubMed  Google Scholar 

  18. Ishii S, Tanaka T, Akishita M, Ouchi Y, Tuji T, Iijima K, et al. Metabolic syndrome, sarcopenia and role of sex and age: cross-sectional analysis of kashiwa cohort study. PLoS One 2014;9: e112718.

    Article  CAS  Google Scholar 

  19. Lu CW, Yang KC, Chang HH, Lee LT, Chen CY, Huang KC. Sarcopenic obesity is closely associated with metabolic syndrome. Obes Res Clin Pract 2013;7: e301–7.

    Article  PubMed  Google Scholar 

  20. Atkins JL, Whincup PH, Morris RW, Atkins JL, Whincup PH, Morris RW. Sarcopenic obesity and risk of cardiovascular disease and mortality: a populationbased cohort study of older men. J Am Geriatr Soc 2014;62: 253–60.

    Article  PubMed  Google Scholar 

  21. Alemán-Mateo H, López Teros MT, Ramírez FA, Astiazarán-García H. Association between insulin resistance and low relative appendicular skeletal muscle mass: evidence from a cohort study in community-dwelling older men and women participants. J Gerontol A Biol Sci Med Sci 2014;69: 871–877

    Article  CAS  PubMed  Google Scholar 

  22. Frimel TN, Sinacore DR, Villareal DT. Exercise attenuates the weight-lossinduced reduction in muscle mass in frail obese older adults. Med Sci Sports Exerc. 2008;40: 1213–9.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Reference Dietary Allowances for the Italian Population-Società Italiana di Nutrizione Umana (SINU): LARN -Livelli di Assunzione di Riferimento di Nutrienti ed energia per la popolazione italiana -IV Revision-SICS, Milan (Italy) 2014, pages 620–632 (ISBN: 97888 9068224)

  24. Lohman TJ, Roache AF, Martorell R. Antropometric standardization reference manual. Med Sci Sports Exerc 2002;24:952

    Article  Google Scholar 

  25. Heymsfield SB, Smith R, Aulet M, Bensen B, Lichtman S, Wang J, et al. Appendicular skeletal muscle mass: measurement by dual-photon absorptiometry. Am J Clin Nutr 1990;52: 214–218.

    CAS  PubMed  Google Scholar 

  26. Coin A, Sarti S, Ruggiero E, Giannini S, Pedrazzoni M, Minisola S, et al. Prevalence of sarcopenia based on different diagnostic criteria using DEXA and appendicular skeletal muscle mass reference values in an Italian population aged 20 to 80. J Am Med Dir Assoc 2013;14: 507–12.

    Article  PubMed  Google Scholar 

  27. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28: 412–9.

    Article  CAS  PubMed  Google Scholar 

  28. Matsuda M, De Fronzo R. Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care 1999;22: 1462–1470

    Article  CAS  PubMed  Google Scholar 

  29. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285: 2486–2497.

  30. Park SH, Park JH, Park HY, Jang HJ, Kim HK, Park J, et al. Additional role of sarcopenia to waist circumference in predicting the odds of metabolic syndrome. Clin Nutr 2014;33: 668–72.

    Article  PubMed  Google Scholar 

  31. Martinez-Hervas S, Argente C, Garcia-Jodar J, Priego A, Real JT, Carratala A, et al. Misclassification of subjects with insulin resistance and associated cardiovascular risk factors by homeostasis model assessment index. Utility of a postprandial method based on oral glucose tolerance test. Metabolism 2011;60: 740–6.

    CAS  PubMed  Google Scholar 

  32. Levine ME, Crimmins EM. 2012 Sarcopenic obesity and cognitive functioning: the mediating roles of insulin resistance and inflammation? Curr Gerontol Geriatr Res 2012;826398.

    Google Scholar 

  33. Kim TN, Park MS, Lim KI, Choi HY, Yang SJ, Yoo HJ, et al. Relationships between sarcopenic obesity and insulin resistance, inflammation, and vitamin D status: the Korean Sarcopenic Obesity Study. Clin Endocrinol 2013;78: 525–32.

    Article  CAS  Google Scholar 

  34. Cesari M, Kritchevsky SB, Baumgartner RN, Atkinson HH, Penninx BW, Lenchik L, et al. Sarcopenia, obesity, and inflammation–results from the Trial of Angiotensin Converting Enzyme Inhibition and Novel Cardiovascular Risk Factors study. Am J Clin Nutr 2005;82:428–434

    CAS  PubMed  Google Scholar 

  35. Srikanthan P, Hevener AL, Karlamangla AS. Sarcopenia exacerbates obesityassociated insulin resistance and dysglycemia: findings from the National Health and Nutrition Examination Survey III. PloS One 2010;5: e10805

    Article  CAS  Google Scholar 

  36. Zamboni M, Mazzali G, Fantin F, Rossi A, Di Francesco V. Sarcopenic obesity: a new category of obesity in the elderly. Nutr Metab Cardiovasc Dis 2008;18: 388–95.

    Article  CAS  PubMed  Google Scholar 

  37. Pedrero-Chamizo R, Gómez-Cabello A, Meléndez A, Vila-Maldonado S, Espino L, Gusi N, Villa G, et al. Higher levels of physical fitness are associated with a reduced risk of suffering sarcopenic obesity and better perceived health among the elderly: the EXERNET multi-center study. J Nutr Health Aging. 2015;19: 211–7.

    Article  CAS  PubMed  Google Scholar 

  38. Bijlsma AY, Meskers CG, van Heemst D, Westendorp RG, De Craen AJ, Maier AB. Diagnostic criteria for sarcopenia relate differently to insulin resistance. Age (Dordr). 2013;35: 2367–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Newman AB, Kupelian V, Visser M, Simonsick E, Goodpaster B, Nevitt M, et al. Sarcopenia: alternative definitions and associations with lower extremity function. J Am Geriatr Soc 2003;51: 1602–9.

    Article  PubMed  Google Scholar 

  40. Visser M, Kritchevsky SB, Newman AB, Goodpaster BH, Tylavsky FA, Nevitt MC, et al. Lower serum albumin concentration and change in muscle mass: the Health, Aging and Body Composition Study. Am J Clin Nutr 2005;82: 531–7.

    CAS  PubMed  Google Scholar 

  41. Boirie Y, Gachon P, Cordat N, Ritz P, Beaufrère B. Differential insulin sensitivities of glucose, amino acid, and albumin metabolism in elderly men and women. J Clin Endocrinol Metab 2001;86: 638–44.

    Article  CAS  PubMed  Google Scholar 

  42. Guillet C, Boirie Y. Insulin resistance: a contributing factor to age-related muscle mass loss? Diabetes Metab 31 Spec No 2005;2:5S20–5S26.

    Google Scholar 

  43. Lustgarten MS, Price LL, Fielding RA. Analytes and Metabolites Associated With Muscle Quality in Young, Healthy Adults. Med Sci Sports Exerc, 2014 [Epub ahead of print]

    Google Scholar 

  44. Kamel HK, Maas D, Duthie EH. Role of hormones in the pathogenesis and management of sarcopenia. Drugs Aging 2002;19: 865–77.

    Article  CAS  PubMed  Google Scholar 

  45. Messier V, Rabasa-Lhoret R, Barbat-Artigas S, Elisha B, Karelis AD, Aubertin-Leheudre M. Menopause and sarcopenia: A potential role for sex hormones. Maturitas 2011;68: 331–6.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Experimental Medicine-Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Sapienza University of Rome, Piazzale Aldo Moro, 5- 00185, Rome, Italy

    Eleonora Poggiogalle, C. Lubrano, L. Gnessi, S. Mariani, A. Lenzi & L. M. Donini

  2. Department of Medicine, Geriatrics Division, University of Padova, Padova, Italy

    G. Sergi & A. Coin

Authors
  1. Eleonora Poggiogalle
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Lubrano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Sergi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Coin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. Gnessi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Mariani
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A. Lenzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. L. M. Donini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eleonora Poggiogalle.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Poggiogalle, E., Lubrano, C., Sergi, G. et al. Sarcopenic obesity and metabolic syndrome in adult Caucasian subjects. J Nutr Health Aging 20, 958–963 (2016). https://doi.org/10.1007/s12603-015-0638-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-015-0638-1

Keywords

Search

Navigation