Value of appendicular skeletal muscle mass to total body fat ratio in predicting obesity in elderly people: a 2.2-year longitudinal study

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Abstract

Background

Obesity is a disease characterized by much fat accumulation and abnormal distribution, which was related to cardiovascular diseases, diabetes mellitus (DM) and muscular skeletal diseases. The aim of this study was to evaluate the usefulness of appendicular skeletal muscle mass to total body fat ratio (ASM/TBF) in screening for the risk of obesity in elderly people.

Methods

A prospective study was carried out with 446 participants (non-obese elderly people with body mass index (BMI) < 28 kg/m ²) who underwent baseline and an average around 2.2-year follow-up health check-up examinations.

Results

The mean age at baseline was 63.6 years. The incidence of new obesity was 5.4% during follow-up. Linear regression demonstrated that baseline ASM/TBFs were negatively correlated with follow-up BMIs in both men and women ( β = − 1.147 (− 1.463—-0.831) for men and − 4.727 (− 5.761—-3.692) for women). The cut-off points of baseline ASM/TBF in elderly people for obesity were 1.24 in men and 0.90 in women which were identified by Classification and Regression Tree (CART). Logistic regression showed that both men and women with decreased ASM/TBF had higher risks of obesity over the follow-up period ( Relative Risk ( RRs) = 5.664 (1.879–17.074) for men and 34.856 (3.930–309.153) for women).

Conclusions

Elderly people with a low ASM/TBF had a higher risk of new obesity, which suggested that ASM/TBF should be considered in obesity management in the elderly.

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Most cited references 20

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Sarcopenic obesity: A Critical appraisal of the current evidence.

C.M.M. Prado, J.C.K. Wells, S.R. Smith … (2012)

Sarcopenic obesity (SO) is assuming a prominent role as a risk factor because of the double metabolic burden derived from low muscle mass (sarcopenia) and excess adiposity (obesity). The increase in obesity prevalence rates in older subjects is of concern given the associated disease risks and more limited therapeutic options available in this age group. This review has two main objectives. The primary objective is to collate results from studies investigating the effects of SO on physical and cardio-metabolic functions. The secondary objective is to evaluate published studies for consistency in methodology, diagnostic criteria, exposure and outcome selection. Large between-study heterogeneity was observed in the application of diagnostic criteria and choice of body composition components for the assessment of SO, which contributes to the inconsistent associations of SO with cardio-metabolic outcomes. We propose a metabolic load:capacity model of SO given by the ratio between fat mass and fat free mass, and discuss how this could be operationalised. The concept of regional fat distribution could be incorporated into the model and tested in future studies to advance our understanding of SO as a predictor of risk for cardio-metabolic diseases and physical disability. Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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Longitudinal associations between body composition, sarcopenic obesity and outcomes of frailty, disability, institutionalisation and mortality in community-dwelling older men: The Concord Health and Ageing in Men Project

Robert G Cumming, Vasant Hirani, Vasi Naganathan … (2017)

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Is Open Access

The impact of confounding on the associations of different adiposity measures with the incidence of cardiovascular disease: a cohort study of 296 535 adults of white European descent

Stamatina Iliodromiti, Carlos A Celis-Morales, Donald Lyall … (2018)

Abstract Aims The data regarding the associations of body mass index (BMI) with cardiovascular (CVD) risk, especially for those at the low categories of BMI, are conflicting. The aim of our study was to examine the associations of body composition (assessed by five different measures) with incident CVD outcomes in healthy individuals. Methods and results A total of 296 535 participants (57.8% women) of white European descent without CVD at baseline from the UK biobank were included. Exposures were five different measures of adiposity. Fatal and non-fatal CVD events were the primary outcome. Low BMI (≤18.5 kg m−2) was associated with higher incidence of CVD and the lowest CVD risk was exhibited at BMI of 22–23 kg m−2 beyond, which the risk of CVD increased. This J-shaped association attenuated substantially in subgroup analyses, when we excluded participants with comorbidities. In contrast, the associations for the remaining adiposity measures were more linear; 1 SD increase in waist circumference was associated with a hazard ratio of 1.16 [95% confidence interval (CI) 1.13–1.19] for women and 1.10 (95% CI 1.08–1.13) for men with similar magnitude of associations for 1 SD increase in waist-to-hip ratio, waist-to-height ratio, and percentage body fat mass. Conclusion Increasing adiposity has a detrimental association with CVD health in middle-aged men and women. The association of BMI with CVD appears more susceptible to confounding due to pre-existing comorbidities when compared with other adiposity measures. Any public misconception of a potential ‘protective’ effect of fat on CVD risk should be challenged. Take home figure The obesity paradox is mainly due to the effect of confounding on BMI and disappears on other adiposity measures.

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Author and article information

Contributors

Xiao-Ying Li: xyli3012@163.com

Journal

Journal ID (nlm-ta): BMC Geriatr

Journal ID (iso-abbrev): BMC Geriatr

Title: BMC Geriatrics

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2318

Publication date (Electronic): 19 April 2020

Publication date PMC-release: 19 April 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 143

Affiliations

[1 ]GRID grid.284723.8, ISNI 0000 0000 8877 7471, Department of Epidemiology, School of Public Health, , Southern Medical University, ; Guangzhou, Guangdong China

[2 ]GRID grid.414252.4, ISNI 0000 0004 1761 8894, Department of Geriatric Cardiology, , Chinese PLA General Hospital, ; Beijing, China

[3 ]GRID grid.460080.a, Department of Rehabilitation, , Zhengzhou Central Hospital Affiliated to Zhengzhou University, ; Zhengzhou, China

[4 ]GRID grid.414252.4, ISNI 0000 0004 1761 8894, Department of Rehabilitation, , Chinese PLA General Hospital, ; Beijing, China

[5 ]GRID grid.414252.4, ISNI 0000 0004 1761 8894, International Medical Center, Chinese PLA General Hospital, ; Beijing, China

[6 ]GRID grid.11135.37, ISNI 0000 0001 2256 9319, Center for Healthy Aging and Development Studies, National School of Development, , Peking University, ; Beijing, China

[7 ]GRID grid.414252.4, ISNI 0000 0004 1761 8894, Institute of Geriatrics, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, ; Beijing, China

Article

Publisher ID: 1540

DOI: 10.1186/s12877-020-01540-9

PMC ID: 7168820

PubMed ID: 32306902

SO-VID: 2337e103-1409-4ce2-b6a8-cc7ad3a492fe

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 22 September 2019

Date accepted : 29 March 2020

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ScienceOpen disciplines: Geriatric medicine

Keywords: appendicular skeletal muscle mass,elderly,obesity,total body fat

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ScienceOpen disciplines: Geriatric medicine

Keywords: appendicular skeletal muscle mass, elderly, obesity, total body fat

Value of appendicular skeletal muscle mass to total body fat ratio in predicting obesity in elderly people: a 2.2-year longitudinal study

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Most cited references 20

Sarcopenic obesity: A Critical appraisal of the current evidence.

Longitudinal associations between body composition, sarcopenic obesity and outcomes of frailty, disability, institutionalisation and mortality in community-dwelling older men: The Concord Health and Ageing in Men Project

The impact of confounding on the associations of different adiposity measures with the incidence of cardiovascular disease: a cohort study of 296 535 adults of white European descent

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