Association of sarcopenic obesity with the risk of all‐cause mortality: A meta‐analysis of prospective cohort studies

Abstract

Many prospective studies have investigated the relationship between sarcopenic obesity (SO) and risk of mortality. However, the results have been controversial. The aim of the present study was to evaluate the association between SO and all-cause mortality in adults by a meta-analysis of prospective cohort studies. A systematic literature search was carried out through electronic databases up to September 2014. A total of nine articles with 12 prospective cohort studies, including 35 287 participants and 14 306 deaths, were included in the meta-analysis. Overall, compared with healthy subjects, subjects with SO had a significant increased risk of all-cause mortality (pooled HR 1.24, 95% CI 1.12-1.37, P < 0.001), with significant heterogeneity among studies (I(2) = 53.18%, P = 0.0188), but no indication for publication bias (P = 0.7373). Heterogeneity became low and no longer significant in the subgroup analyses by three SO definitions. More importantly, SO, defined by mid-arm muscle circumference and muscle strength criteria, significantly increased the risk of mortality (HR 1.46, 95% CI 1.23-1.73 and 1.23, 1.09-1.38, respectively). The risk of all-cause mortality did not appreciably change considering the geography (USA cohorts and non-USA cohorts) or the duration of follow up (≥10 years and <10 years). However, the risk estimate was only significant in men (HR 1.23, 95% CI 1.08-1.41, P = 0.0017), not in women (HR 1.16, P = 0.1332). The results of the present study show that subjects with SO are associated with a 24% increase risk of all-cause mortality, compared with those without SO, in particular in men; the significant association was found independent of geographical location and duration of follow up.

Testosterone Deficiency and Testosterone Treatment in Older Men

“…Baillargeon et al [6] reported that older men with testosterone deficiency who were treated with testosterone therapy had a reduced risk of rehospitalization. Furthermore, patients with sarcopenic obesity appear to have a significantly increased risk of all-cause mortality [4] . While the relationship between testosterone deficiency and sarcopenic obesity remains unclear, low endogenous testosterone levels are associated with a greater risk of allcause mortality [7] .…”

“…Because of their increased disability and dependence on others, frail older individuals experience reduced QoL and increased morbidity, resulting in institutionalization and increased mortality [4][5][6][7] . For these reasons, frailty is a public health threat with a serious economic impact -in light of an increasing life expectancy and the financial challenges facing health care systems worldwide.…”

Sarcopenia and sarcopenic obesity

“…In contrast, in a study using data from the NHANES III study, older women with sarcopenia had a higher risk of all-cause mortality, independent of obesity [62]. A recent meta-analysis demonstrated that sarcopenic obesity is associated with a 24% increase in the risk of all-cause mortality compared to patients without sarcopenic obesity, particularly in men [63]. …”

Adverse effects of androgen deprivation therapy in patients with prostate cancer: focus on metabolic complications

“…17 The term sarcopenic obesity is used in the literature to describe the increase of abdominal obesity accompanied by reduced muscle mass in men undergoing ADT 18 and is found to be associated with an increase in all-cause mortality. 19 The underlying mechanisms of increased abdominal fat with ADT are not well understood. Visceral adipocytes are known to have androgen receptors and it has been proposed that testosterone might be directly involved in fatty acid mobilization.…”