Skip to main content

Advertisement

SpringerLink
Log in

A comprehensive meta-analysis of risk factors associated with osteosarcopenic obesity: a closer look at gender, lifestyle and comorbidities

  • Review
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

This study reviewed the risk factors of Osteosarcopenic obesity (OSO), a condition linking weak bones, muscle loss, and obesity. Notable associations were found with female gender, physical inactivity, hypertension, and frailty. Recognizing these early can aid targeted prevention, emphasizing further research for improved understanding and strategies.

Purpose

Osteosarcopenic obesity (OSO) represents a confluence of osteopenia/osteoporosis, sarcopenia, and obesity, contributing to increased morbidity and mortality risks. Despite escalating prevalence, its risk factors remain under-explored, necessitating this comprehensive systematic review and meta-analysis.

Methods

A diligent search of PubMed, Scopus, and Cochrane databases was conducted for pertinent studies until June 2023. The random-effects model was employed to compute pooled odds ratios (ORs) and 95% confidence intervals (CIs), scrutinizing various risk factors like age, gender, lifestyle factors, and common comorbidities.

Results

Our meta-analysis incorporated 21 studies comprising 178,546 participants. We identified significant associations between OSO and factors such as female gender (OR 1.756, 95% CI 1.081 to 2.858), physical inactivity (OR 1.562, 95% CI 1.127–2.165), and hypertension (OR 1.482, 95% CI 1.207–1.821). Conversely, smoking (OR 0.854, 95% CI 0.672–1.084), alcohol consumption (OR 0.703, 95% CI 0.372–1.328), and dyslipidemia (OR 1.345, 95% CI 0.982–1.841) showed no significant associations. Remarkable heterogeneity was observed across studies, indicating considerable variation in effect sizes. Notably, OSO was strongly associated with frailty (OR 6.091; 95% CI 3.576–10.375).

Conclusions

Our study underscored the substantial role of female gender, physical inactivity, and hypertension in the development of OSO, whilst suggesting a strong link between OSO and frailty. These findings emphasize the importance of early risk factor identification and targeted interventions in these groups. Further research is warranted to decode the complex pathophysiological interplay and devise effective prevention and management strategies.

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

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. JafariNasabian P, Inglis JE, Kelly OJ, Ilich JZ (2017) Osteosarcopenic obesity in women: impact, prevalence, and management challenges. Int J Womens Health 9:33–42. https://doi.org/10.2147/IJWH.S106107

    Article  PubMed  PubMed Central  Google Scholar 

  2. Liu Y, Song Y, Hao Q, Wu J (2023) Global prevalence of osteosarcopenic obesity amongst middle aged and older adults: a systematic review and meta-analysis. Arch Osteoporos 18(1):60. https://doi.org/10.1007/s11657-023-01247-5

    Article  CAS  PubMed  Google Scholar 

  3. Ormsbee MJ, Prado CM, Ilich JZ et al (2014) Osteosarcopenic obesity: the role of bone, muscle, and fat on health. J Cachexia Sarcopenia Muscle 5(3):183–192. https://doi.org/10.1007/s13539-014-0146-x

    Article  PubMed  PubMed Central  Google Scholar 

  4. Reginster JY, Beaudart C, Buckinx F, Bruyère O (2016) Osteoporosis and sarcopenia: two diseases or one? Curr Opin Clin Nutr Metab Care 19(1):31–36. https://doi.org/10.1097/MCO.0000000000000230

    Article  PubMed  Google Scholar 

  5. Fuster JJ, Ouchi N, Gokce N, Walsh K (2016) Obesity-induced changes in adipose tissue microenvironment and their impact on cardiovascular disease. Circ Res 118(11):1786–1807. https://doi.org/10.1161/CIRCRESAHA.115.306885

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Bauer JM, Cruz-Jentoft AJ, Fielding RA et al (2019) Is There enough evidence for osteosarcopenic obesity as a distinct entity? A critical literature review. Calcif Tissue Int 105:109–124. https://doi.org/10.1007/s00223-019-00561-w

    Article  CAS  PubMed  Google Scholar 

  7. Ilich JZ, Kelly OJ, Inglis JE, Panton LB, Duque G, Ormsbee MJ (2014) Interrelationship among muscle, fat, and bone: connecting the dots on cellular, hormonal, and whole body levels. Ageing Res Rev 15:51–60

    Article  CAS  PubMed  Google Scholar 

  8. Daskalopoulou C, Wu YT, Pan W et al (2020) Factors related with sarcopenia and sarcopenic obesity among low- and middle-income settings: the 10/66 DRG study. Sci Rep 10:20453. https://doi.org/10.1038/s41598-020-76575-4

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Fini M, Salamanna F, Veronesi F et al (2012) Role of obesity, alcohol and smoking on bone health. Front Biosci (Elite Ed) 4(7):2586–2606. https://doi.org/10.2741/e575

    Article  PubMed  Google Scholar 

  10. Tarantino U, Cariati I, Greggi C, Gasbarra E, Belluati A, Ciolli L, Maccauro G, Momoli A, Ripanti S, Falez F, Brandi ML (2021) Skeletal system biology and smoke damage: from basic science to medical clinic. Int J Mol Sci 22(12):6629. https://doi.org/10.3390/ijms22126629

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Traversy G, Chaput JP (2015) Alcohol consumption and obesity: an update. Curr Obes Rep 4(1):122–130. https://doi.org/10.1007/s13679-014-0129-4

    Article  PubMed  PubMed Central  Google Scholar 

  12. Park JH, Moon JH, Kim HJ, Kong MH, Oh YH (2020) Sedentary lifestyle: overview of updated evidence of potential health risks. Korean J Fam Med 41(6):365–373. https://doi.org/10.4082/kjfm.20.0165

    Article  PubMed  PubMed Central  Google Scholar 

  13. Klop B, Elte JW, Cabezas MC (2013) Dyslipidemia in obesity: mechanisms and potential targets. Nutrients 5(4):1218–1240. https://doi.org/10.3390/nu5041218

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Díaz ME (2002) Hypertension and obesity. J Hum Hypertens 16(Suppl 1):S18–S22. https://doi.org/10.1038/sj.jhh.1001335

    Article  PubMed  Google Scholar 

  15. Kobylińska M, Antosik K, Decyk A, Kurowska K (2022) Malnutrition in obesity: Is it possible? Obes Facts 15(1):19–25. https://doi.org/10.1159/000519503

    Article  CAS  PubMed  Google Scholar 

  16. Szlejf C, Parra-Rodríguez L, Rosas-Carrasco O (2017) Osteosarcopenic obesity: prevalence and relation with frailty and physical performance in middle-aged and older women. J Am Med Dir Assoc 18(8):733.e1-733.e5. https://doi.org/10.1016/j.jamda.2017.02.023

    Article  PubMed  Google Scholar 

  17. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int J Surg 1(88):105906

    Article  Google Scholar 

  18. Lo CK, Mertz D, Loeb M (2014) Newcastle-Ottawa Scale: comparing reviewers’ to authors’ assessments. BMC Med Res Methodol 14:1–5

    Article  Google Scholar 

  19. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (eds) (2019) Cochrane handbook for systematic reviews of interventions. Wiley

    Google Scholar 

  20. Kashiwagi K, Takayama M, Ichikawa H, Takaishi H, Iwao Y, Kanai T (2021) A significant association of non-obese non-alcoholic fatty liver disease with osteosarcopenic obesity in females 50 years and older. Clin Nutr ESPEN 42:166–172

    Article  PubMed  Google Scholar 

  21. Su YH, Chang YM, Kung CY, Sung CK, Foo WS, Wu MH et al (2021) A study of correlations between metabolic syndrome factors and osteosarcopenic adiposity. BMC Endocr Disord 21(1):216

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Chen X, Kong C, Yu H, Gong J, Lan L, Zhou L et al (2019) Association between osteosarcopenic obesity and hypertension among four minority populations in China: a cross-sectional study. BMJ Open 9(7):e026818

    Article  PubMed  PubMed Central  Google Scholar 

  23. Chung JH, Hwang HJ, Shin HY, Han CH (2016) Association between sarcopenic obesity and bone mineral density in middle-aged and elderly Korean. Ann Nutr Metab 68(2):77–84

    Article  CAS  PubMed  Google Scholar 

  24. Lim HS, Kim DK, Gil HI, Lee MY, Lee HS, Lee YT et al (2023) Association of pulmonary function with osteosarcopenic obesity in older adults aged over 50 years. Nutrients 15(13):2933

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Kim YM, Kim S, Won YJ, Kim SH (2019) Clinical manifestations and factors associated with osteosarcopenic obesity syndrome: a cross-sectional study in Koreans with obesity. Calcif Tissue Int 105(1):77–88

    Article  CAS  PubMed  Google Scholar 

  26. Pang BWJ, Wee SL, Chen KK, Lau LK, Jabbar KA, Seah WT et al (2021) Coexistence of osteoporosis, sarcopenia and obesity in community-dwelling adults – The Yishun Study. Osteoporos Sarcopenia 7(1):17–23

    Article  PubMed  PubMed Central  Google Scholar 

  27. Abidin NZ, Mitra SR (2021) Comparison of anthropometric profile, bone-related parameters, biochemical parameters, functional capacity, and vitamin D status–a study on postmenopausal Malaysian women. Mal J Nutr 27(2):233–246

    Google Scholar 

  28. Abidin NZ, Mitra SR (2021) Determination of cutoff values for the screening of osteosarcopenia in obese postmenopausal women. Kuo YF, editor. Current Gerontology and Geriatrics Research. 1–15

  29. Bae YJ (2020) Fruit intake and osteosarcopenic obesity in Korean postmenopausal women aged 50–64 years. Maturitas 134:41–46

    Article  CAS  PubMed  Google Scholar 

  30. Cvijetić S, Keser I, Boschiero D, Ilich JZ (2023) Osteosarcopenic adiposity and nutritional status in older nursing home residents during the COVID-19 pandemic. Nutrients 15(1):227

    Article  PubMed  PubMed Central  Google Scholar 

  31. Nie Y-z, Yan Z-q, Yin H, Shan L-h, Wang J-h, Wu Q-h (2022) Osteosarcopenic obesity and its components—osteoporosis, sarcopenia, and obesity—are associated with blood cell count-derived inflammation indices in older Chinese people. BMC Geriatr 22(1):532

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Mo D, Hsieh P, Yu H, Zhou L, Gong J, Xu L et al (2018) Osteosarcopenic obesity and its relationship with dyslipidemia in women from different ethnic groups of China. Arch Osteoporos 13(1):65

    Article  PubMed  Google Scholar 

  33. Ma Y, Zhang W, Han P, Kohzuki M, Guo Q (2020) Osteosarcopenic obesity associated with poor physical performance in the elderly Chinese community. CIA 15:1343–1352

    Article  Google Scholar 

  34. Keramidaki K, Tsagari A, Hiona M, Risvas G (2019) Osteosarcopenic obesity, the coexistence of osteoporosis, sarcopenia and obesity and consequences in the quality of life in older adults ≥365 years-old in Greece. JFSF 1:91–101

    Article  Google Scholar 

  35. Szlejf C, Parra-Rodríguez L, Rosas-Carrasco O (2017) Osteosarcopenic obesity: prevalence and relation with frailty and physical performance in middle-aged and older women. J Am Med Dir Assoc 18(8):733.e1-733.e5

    Article  PubMed  Google Scholar 

  36. Choi MK, Bae YJ (2020) Protein intake and osteosarcopenic adiposity in Korean adults aged 50 years and older. Osteoporos Int 31(12):2363–2372

    Article  CAS  PubMed  Google Scholar 

  37. Chung SJ, Lim HS, Lee MY, Lee YT, Yoon KJ, Park CH (2022) Sex-specific associations between serum ferritin and osteosarcopenic obesity in adults aged over 50 years. Nutrients 14(19):4023

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Sasaki K-i, Kakuma T, Sasaki M, Ishizaki Y, Fukami A, Enomoto M et al (2020) The prevalence of sarcopenia and subtypes in cardiovascular diseases, and a new diagnostic approach. J Cardiol 76(3):266–72

    Article  PubMed  Google Scholar 

  39. Okyar Baş A, Güner Oytun M, Deniz O, Öztürk Y, Kahyaoğlu Z, Ceylan S et al (2022) Ultrasonografically assessed osteosarcopenic obesity is associated with frailty in community-dwelling older adults. Nutrition 103–104:111827

    Article  PubMed  Google Scholar 

  40. Kolbaşı EN, Demirdağ F (2020) Prevalence of osteosarcopenic obesity in community-dwelling older adults: a cross-sectional retrospective study. Arch Osteoporos 15:1–9

    Article  Google Scholar 

  41. Yang CY, Cheng-Yen Lai J, Huang WL, Hsu CL, Chen SJ (2021) Effects of sex, tobacco smoking, and alcohol consumption osteoporosis development: Evidence from Taiwan biobank participants. Tob Induc Dis 17(19):52. https://doi.org/10.18332/tid/136419

    Article  CAS  Google Scholar 

  42. Zhai J, Ma B, Qin J, Lyu Q, Khatun P, Liang R, Cong M, Guo L, Kong Y (2022) Alcohol consumption patterns and the risk of sarcopenia: a population-based cross-sectional study among chinese women and men from Henan province. BMC Public Health 22(1):1894. https://doi.org/10.1186/s12889-022-14275-6

    Article  PubMed  PubMed Central  Google Scholar 

  43. Manrique C, Lastra G, Gardner M, Sowers JR (2009) The renin angiotensin aldosterone system in hypertension: roles of insulin resistance and oxidative stress. Med Clin North Am 93(3):569–582. https://doi.org/10.1016/j.mcna.2009.02.014

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Griendling KK, Camargo LL, Rios FJ, Alves-Lopes R, Montezano AC, Touyz RM (2021) Oxidative stress and hypertension. Circ Res 128(7):993–1020. https://doi.org/10.1161/CIRCRESAHA.121.318063

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Marino FR, Lessard DM, Saczynski JS, McManus DD, Silverman-Lloyd LG, Benson CM, Blaha MJ, Waring ME (2019) Gait speed and mood, cognition, and quality of life in older adults with atrial fibrillation. J Am Heart Assoc 8(22):e013212. https://doi.org/10.1161/JAHA.119.013212

    Article  PubMed  PubMed Central  Google Scholar 

  46. Adam CE, Fitzpatrick AL, Leary CS, Hajat A, Phelan EA, Park C, Semmens EO (2021) The association between gait speed and falls in community dwelling older adults with and without mild cognitive impairment. Int J Environ Res Public Health 18(7):3712. https://doi.org/10.3390/ijerph18073712

    Article  PubMed  PubMed Central  Google Scholar 

  47. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), the Extended Group for EWGSOP2 et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48(1):16–31. https://doi.org/10.1093/ageing/afy169

    Article  PubMed  Google Scholar 

Download references

Funding

National Key Research and Development Program of China, Grant/Award Number: 2018YFC2002100 and 2018YFC2002103.

Author information

Authors and Affiliations

  1. Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, China

    Ying Liu, Qinjian Hao, Jinqiu Zhou & Jinhui Wu

Authors
  1. Ying Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Qinjian Hao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jinqiu Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jinhui Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jinhui Wu.

Ethics declarations

Conflict of interest

Ying Liu, Qinjian Hao, Jinqiu Zhou, Jinhui Wu declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liu, Y., Hao, Q., Zhou, J. et al. A comprehensive meta-analysis of risk factors associated with osteosarcopenic obesity: a closer look at gender, lifestyle and comorbidities. Osteoporos Int 35, 759–773 (2024). https://doi.org/10.1007/s00198-023-07007-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-023-07007-y

Keywords

Search

Navigation