Abstract
Background and Aim: Research interests in a new phenotype termed as sarcopenic obesity (SO), which refers to a decrease in lean body mass and muscle strength associated with an increase in body fat deposition, have grown. However, neither SO definition nor its impact on health outcomes is clear. In the current paper, we aim to summarize the available literature on the dilemma surrounding the definition of SO, and the potential health consequences of this phenomenon on individuals with overweight and obesity.
Methods: A literature review using the PubMed/Medline database was conducted and data were summarized by applying a narrative approach, based on clinical expertise in the interpretation of the available evidence base in the literature.
Results: Some definitions that account for body mass (i.e., body weight, body mass index) seem to be more suitable for screening of SO and revealed as clinically useful. The association between SO and certain health outcomes has also been investigated, especially those related to obesity; however, little is known about the association of SO with psychosocial distress and health-related quality of life impairment, as well as harsh outcomes such as mortality.
Conclusion: International consensus regarding SO definition is needed, which would allow for a better understanding of its prevalence. Moreover, future investigations should be conducted in order to determine whether SO has an adverse effect (i.e., cause-effect relationship, in addition to association) on health. Once these issues are achieved, confirmed and clarified, evidenced-based protocols of treatment may become necessary to address the increase in the prevalence of obesity and sarcopenia worldwide.
Keywords: Obesity, body composition, sarcopenic obesity, lean body mass, muscle strength, diabetes.
[1]
El Ghoch M, Fakhoury R. Challenges and new directions in obesity management: Lifestyle modification programmes, pharmacotherapy and bariatric surgery. J Popul Ther Clin Pharmacol 2019; 26(2): e1-4.
[PMID: 31577079]
[PMID: 31577079]
[2]
Kreidieh D, Itani L, El Kassas G, et al. Long-term lifestyle-modification programs for overweight and obesity management in the arab states: systematic review and meta-analysis. Curr Diabetes Rev 2018; 14(6): 550-8.
[http://dx.doi.org/10.2174/1573399813666170619085756] [PMID: 28625131]
[http://dx.doi.org/10.2174/1573399813666170619085756] [PMID: 28625131]
[3]
Segula D. Complications of obesity in adults: a short review of the literature. Malawi Med J 2014; 26(1): 20-4.
[PMID: 24959321]
[PMID: 24959321]
[4]
El Ghoch M, Calugi S, Dalle Grave R. The effects of low-carbohydrate diets on psychosocial outcomes in obesity/overweight: a systematic review of randomized, controlled studies. Nutrients 2016; 8(7): 8.
[http://dx.doi.org/10.3390/nu8070402] [PMID: 27367726]
[http://dx.doi.org/10.3390/nu8070402] [PMID: 27367726]
[5]
Itani L, Calugi S, Dalle Grave R, et al. The association between body mass index and health-related quality of life in treatment-seeking arab adults with obesity. Med Sci (Basel) 2018; 6(1): 6.
[http://dx.doi.org/10.3390/medsci6010025] [PMID: 29534025]
[http://dx.doi.org/10.3390/medsci6010025] [PMID: 29534025]
[6]
Abdelaal M, le Roux CW, Docherty NG. Morbidity and mortality associated with obesity. Ann Transl Med 2017; 5(7): 161.
[http://dx.doi.org/10.21037/atm.2017.03.107] [PMID: 28480197]
[http://dx.doi.org/10.21037/atm.2017.03.107] [PMID: 28480197]
[7]
Malafarina V, Uriz-Otano F, Iniesta R, Gil-Guerrero L. Sarcopenia in the elderly: diagnosis, physiopathology and treatment. Maturitas 2012; 71(2): 109-14.
[http://dx.doi.org/10.1016/j.maturitas.2011.11.012] [PMID: 22153348]
[http://dx.doi.org/10.1016/j.maturitas.2011.11.012] [PMID: 22153348]
[8]
Afshin A, Forouzanfar MH, Reitsma MB, et al. GBD 2015 obesity collaborators. health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 2017; 377(1): 13-27.
[http://dx.doi.org/10.1056/NEJMoa1614362] [PMID: 28604169]
[http://dx.doi.org/10.1056/NEJMoa1614362] [PMID: 28604169]
[9]
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(5): 388-95.
[http://dx.doi.org/10.1016/j.numecd.2007.10.002] [PMID: 18395429]
[http://dx.doi.org/10.1016/j.numecd.2007.10.002] [PMID: 18395429]
[10]
El Ghoch M, Calugi S, Dalle Grave R. Sarcopenic obesity: definition, health consequences and clinical management. Open Nutr J 2018; 12: 70-3.
[http://dx.doi.org/10.2174/1874288201812010070]
[http://dx.doi.org/10.2174/1874288201812010070]
[11]
Batsis JA, Cook SB. Is the whole not greater than the sum of its parts? The case of sarcopenic obesity. Am J Clin Nutr 2017; 106(1): 14-5.
[http://dx.doi.org/10.3945/ajcn.117.159871] [PMID: 28615264]
[http://dx.doi.org/10.3945/ajcn.117.159871] [PMID: 28615264]
[12]
Perna S, Spadaccini D, Rondanelli M. Sarcopenic obesity: time to target the phenotypes. J Cachexia Sarcopenia Muscle 2019; 10(3): 710-1.
[http://dx.doi.org/10.1002/jcsm.12425] [PMID: 30941929]
[http://dx.doi.org/10.1002/jcsm.12425] [PMID: 30941929]
[13]
Barazzoni R, Bischoff SC, Boirie Y, et al. Sarcopenic obesity: Time to meet the challenge. Clin Nutr 2018; 37(6 Pt A): 1787-93.
[http://dx.doi.org/10.1016/j.clnu.2018.04.018] [PMID: 29857921]
[http://dx.doi.org/10.1016/j.clnu.2018.04.018] [PMID: 29857921]
[14]
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(6): 693-700.
[http://dx.doi.org/10.1097/MCO.0b013e328312c37d] [PMID: 18827572]
[http://dx.doi.org/10.1097/MCO.0b013e328312c37d] [PMID: 18827572]
[15]
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. European working group on sarcopenia in older people. sarcopenia: european consensus on definition and diagnosis: report of the european working group on sarcopenia in older people. Age Ageing 2010; 39(4): 412-23.
[http://dx.doi.org/10.1093/ageing/afq034] [PMID: 20392703]
[http://dx.doi.org/10.1093/ageing/afq034] [PMID: 20392703]
[16]
Fielding RA, Vellas B, Evans WJ, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc 2011; 12(4): 249-56.
[http://dx.doi.org/10.1016/j.jamda.2011.01.003] [PMID: 21527165]
[http://dx.doi.org/10.1016/j.jamda.2011.01.003] [PMID: 21527165]
[17]
Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 2014; 15(2): 95-101.
[http://dx.doi.org/10.1016/j.jamda.2013.11.025] [PMID: 24461239]
[http://dx.doi.org/10.1016/j.jamda.2013.11.025] [PMID: 24461239]
[18]
Johnson Stoklossa CA, Sharma AM, Forhan M, Siervo M, Padwal RS, Prado CM. Prevalence of Sarcopenic Obesity in Adults with Class II/III Obesity Using Different Diagnostic Criteria. J Nutr Metab 2017.20177307618
[http://dx.doi.org/10.1155/2017/7307618] [PMID: 28421144]
[http://dx.doi.org/10.1155/2017/7307618] [PMID: 28421144]
[19]
Bouchard DR, Dionne IJ, Brochu M. Sarcopenic/obesity and physical capacity in older men and women: data from the Nutrition as a Determinant of Successful Aging (NuAge)-the Quebec longitudinal Study. Obesity (Silver Spring) 2009; 17(11): 2082-8.
[http://dx.doi.org/10.1038/oby.2009.109] [PMID: 19373219]
[http://dx.doi.org/10.1038/oby.2009.109] [PMID: 19373219]
[20]
Zoico E, Di Francesco V, Guralnik JM, et al. Physical disability and muscular strength in relation to obesity and different body composition indexes in a sample of healthy elderly women. Int J Obes Relat Metab Disord 2004; 28(2): 234-41.
[http://dx.doi.org/10.1038/sj.ijo.0802552] [PMID: 14708033]
[http://dx.doi.org/10.1038/sj.ijo.0802552] [PMID: 14708033]
[21]
Levine ME, Crimmins EM. The impact of insulin resistance and inflammation on the association between sarcopenic obesity and physical functioning. Obesity (Silver Spring) 2012; 20(10): 2101-6.
[http://dx.doi.org/10.1038/oby.2012.20] [PMID: 22310233]
[http://dx.doi.org/10.1038/oby.2012.20] [PMID: 22310233]
[22]
Oh C, Jho S, No JK, Kim HS. Body composition changes were related to nutrient intakes in elderly men but elderly women had a higher prevalence of sarcopenic obesity in a population of Korean adults. Nutr Res 2015; 35(1): 1-6.
[http://dx.doi.org/10.1016/j.nutres.2014.07.018] [PMID: 25524331]
[http://dx.doi.org/10.1016/j.nutres.2014.07.018] [PMID: 25524331]
[23]
Kim TN, Yang SJ, Yoo HJ, et al. Prevalence of sarcopenia and sarcopenic obesity in Korean adults: the Korean sarcopenic obesity study. Int J Obes 2009; 33(8): 885-92.
[http://dx.doi.org/10.1038/ijo.2009.130] [PMID: 19564878]
[http://dx.doi.org/10.1038/ijo.2009.130] [PMID: 19564878]
[24]
Batsis J, Mackenzie TA, Lopez-Jimenez FSJ. B Prevalence of sarcopenic obesity using FNIH criteria in the US population: NHANES 1999-2004. The Gerontological Society of America 2015; p. 1.
[25]
Khazem S, Itani L, Kreidieh D, et al. Reduced lean body mass and cardiometabolic diseases in adult males with overweight and obesity: a pilot study. Int J Environ Res Public Health 2018; 15(12): 15.
[http://dx.doi.org/10.3390/ijerph15122754] [PMID: 30563167]
[http://dx.doi.org/10.3390/ijerph15122754] [PMID: 30563167]
[26]
Kreidieh D, Itani L, El Masri D, Tannir H, Citarella R, El Ghoch M. Association between sarcopenic obesity, type 2 diabetes, and hypertension in overweight and obese treatment-seeking adult women. J Cardiovasc Dev Dis 2018; 5(4): 5.
[http://dx.doi.org/10.3390/jcdd5040051] [PMID: 30347794]
[http://dx.doi.org/10.3390/jcdd5040051] [PMID: 30347794]
[27]
Bouchonville MF, Villareal DT. Sarcopenic obesity: how do we treat it? Curr Opin Endocrinol Diabetes Obes 2013; 20(5): 412-9.
[http://dx.doi.org/10.1097/01.med.0000433071.11466.7f] [PMID: 23974769]
[http://dx.doi.org/10.1097/01.med.0000433071.11466.7f] [PMID: 23974769]
[28]
Farmer RE, Mathur R, Schmidt AF, et al. Associations between measures of sarcopenic obesity and risk of cardiovascular disease and mortality: a cohort study and mendelian randomization analysis using the uk biobank. J Am Heart Assoc 2019; 8(13)e011638
[http://dx.doi.org/10.1161/JAHA.118.011638] [PMID: 31221000]
[http://dx.doi.org/10.1161/JAHA.118.011638] [PMID: 31221000]
[29]
Khadra D, Itani L, Tannir H, Kreidieh D, El Masri D, El Ghoch M. Association between sarcopenic obesity and higher risk of type 2 diabetes in adults: A systematic review and meta-analysis. World J Diabetes 2019; 10(5): 311-23.
[http://dx.doi.org/10.4239/wjd.v10.i5.311] [PMID: 31139318]
[http://dx.doi.org/10.4239/wjd.v10.i5.311] [PMID: 31139318]
[30]
Atkins JL, Wannamethee SG. The effect of sarcopenic obesity on cardiovascular disease and all-cause mortality in older people. Rev Clin Gerontol 2015; 25: 86-97.
[http://dx.doi.org/10.1017/S0959259815000076]
[http://dx.doi.org/10.1017/S0959259815000076]
[31]
Srikanthan P, Hevener AL, Karlamangla AS. Sarcopenia exacerbates obesity-associated insulin resistance and dysglycemia: findings from the National Health and Nutrition Examination Survey III. PLoS One 2010; 5(5)e10805
[http://dx.doi.org/10.1371/journal.pone.0010805] [PMID: 22421977]
[http://dx.doi.org/10.1371/journal.pone.0010805] [PMID: 22421977]
[32]
Park CH, Do JG, Lee YT, Yoon KJ. Sarcopenic obesity associated with high-sensitivity C-reactive protein in age and sex comparison: A two-center study in South Korea. BMJ Open 2018; 8(9)e021232
[http://dx.doi.org/10.1136/bmjopen-2017-021232] [PMID: 30232104]
[http://dx.doi.org/10.1136/bmjopen-2017-021232] [PMID: 30232104]
[33]
Katsiari CG, Bogdanos DP, Sakkas LI. Inflammation and cardiovascular disease. World J Transl Med 2019; 8: 1-8.
[http://dx.doi.org/10.5528/wjtm.v8.i1.1]
[http://dx.doi.org/10.5528/wjtm.v8.i1.1]
[34]
Solem RC. Limitation of a cross-sectional study. Am J Orthod Dentofacial Orthop 2015; 148(2): 205.
[http://dx.doi.org/10.1016/j.ajodo.2015.05.006] [PMID: 26232823]
[http://dx.doi.org/10.1016/j.ajodo.2015.05.006] [PMID: 26232823]
[35]
Hamer M, Batty GD, Kivimaki M. Sarcopenic obesity and risk of new onset depressive symptoms in older adults: English Longitudinal Study of Ageing. Int J Obes 2015; 39(12): 1717-20.
[http://dx.doi.org/10.1038/ijo.2015.124] [PMID: 26122029]
[http://dx.doi.org/10.1038/ijo.2015.124] [PMID: 26122029]
[36]
Ishii S, Chang C, Tanaka T, et al. The association between sarcopenic obesity and depressive symptoms in older Japanese adults. PLoS One 2016; 11(9)e0162898
[http://dx.doi.org/10.1371/journal.pone.0162898] [PMID: 27627756]
[http://dx.doi.org/10.1371/journal.pone.0162898] [PMID: 27627756]
[37]
Tolea MI, Chrisphonte S, Galvin JE. Sarcopenic obesity and cognitive performance. Clin Interv Aging 2018; 13: 1111-9.
[http://dx.doi.org/10.2147/CIA.S164113] [PMID: 29922049]
[http://dx.doi.org/10.2147/CIA.S164113] [PMID: 29922049]
[38]
Garratt A, Schmidt L, Mackintosh A, Fitzpatrick R. Quality of life measurement: bibliographic study of patient assessed health outcome measures. BMJ 2002; 324(7351): 1417.
[http://dx.doi.org/10.1136/bmj.324.7351.1417] [PMID: 12065262]
[http://dx.doi.org/10.1136/bmj.324.7351.1417] [PMID: 12065262]
[39]
Testa MA, Simonson DC. Assessment of quality-of-life outcomes. N Engl J Med 1996; 334(13): 835-40.
[http://dx.doi.org/10.1056/NEJM199603283341306] [PMID: 8596551]
[http://dx.doi.org/10.1056/NEJM199603283341306] [PMID: 8596551]
[40]
Itani L, Calugi S, Kreidieh D, et al. Validation of an Arabic Version of the Obesity-Related Wellbeing (ORWELL 97) questionnaire in adults with obesity. Curr Diabetes Rev 2019; 15(2): 127-32.
[http://dx.doi.org/10.2174/1573399814666180111111934] [PMID: 29332589]
[http://dx.doi.org/10.2174/1573399814666180111111934] [PMID: 29332589]
[41]
Kroes M, Osei-Assibey G, Baker-Searle R, Huang J. Impact of weight change on quality of life in adults with overweight/obesity in the United States: A systematic review. Curr Med Res Opin 2016; 32(3): 485-508.
[http://dx.doi.org/10.1185/03007995.2015.1128403] [PMID: 26652030]
[http://dx.doi.org/10.1185/03007995.2015.1128403] [PMID: 26652030]
[42]
Messier V, Karelis AD, Lavoie ME, et al. Metabolic profile and quality of life in class I sarcopenic overweight and obese postmenopausal women: a MONET study. Appl Physiol Nutr Metab 2009; 34(1): 18-24.
[http://dx.doi.org/10.1139/H08-135] [PMID: 19234581]
[http://dx.doi.org/10.1139/H08-135] [PMID: 19234581]
[43]
Silva Neto LS, Karnikowiski MG, Tavares AB, Lima RM. Association between sarcopenia, sarcopenic obesity, muscle strength and quality of life variables in elderly women. Rev Bras Fisioter 2012; 16(5): 360-7.
[http://dx.doi.org/10.1590/S1413-35552012005000044] [PMID: 22983215]
[http://dx.doi.org/10.1590/S1413-35552012005000044] [PMID: 22983215]
[44]
Müller MJ, Enderle J, Bosy-Westphal A. Changes in energy expenditure with weight gain and weight loss in humans. Curr Obes Rep 2016; 5(4): 413-23.
[http://dx.doi.org/10.1007/s13679-016-0237-4] [PMID: 27739007]
[http://dx.doi.org/10.1007/s13679-016-0237-4] [PMID: 27739007]
[45]
Zamboni M, Rubele S, Rossi AP. Sarcopenia and obesity. Curr Opin Clin Nutr Metab Care 2019; 22(1): 13-9.
[PMID: 30461451]
[PMID: 30461451]
[46]
Tannir H, Kreidieh D, Itani L, El Masri D, El Ghoch M. Reduction of resting energy expenditure and sarcopenic obesity in adults with overweight and obesity: A brief report. Curr Diabetes Rev 2020; 16(4): 376-80.
[http://dx.doi.org/10.2174/1573399815666191030092138] [PMID: 31663844]
[http://dx.doi.org/10.2174/1573399815666191030092138] [PMID: 31663844]
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