Falls, fractures, and areal bone mineral density in older adults with sarcopenic obesity: A systematic review and meta‐analysis

Gandham, Anoohya; Mesinovic, Jakub; Jansons, Paul; Zengin, Ayse; Bonham, Maxine P.; Ebeling, Peter R.; Scott, David

doi:10.1111/obr.13187

Cited by 71 publications

(52 citation statements)

References 62 publications

(340 reference statements)

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“…Lean mass (LM) protects bone density and skeletal muscle mass and strength 1 and contributes to energy expenditure via basal metabolic rate, as well as facilitating whole‐body metabolism by partitioning nutrients into several tissues 2 . Age‐related declines in LM (or low muscle mass) are linked to mobility impairments, falls, fragility fractures, disability and reduced quality of life, 1,3 and several acute and chronic conditions such as cachexia, sarcopenia, sarcopenic obesity, and type 2 diabetes 1,4–6 …”

Section: Introductionmentioning

confidence: 99%

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Body composition reference ranges in community‐dwelling adults using dual‐energy X‐ray absorptiometry: the Australian Body Composition (ABC) Study

Kirk

Hassan

Brennan-Olsen

et al. 2021

J cachexia sarcopenia muscle

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Background Reference ranges for lean mass (LM) and fat mass (FM) are essential in identifying soft tissue disorders; however, no such reference ranges exist for the most commonly used Hologic dual‐energy X‐ray absorptiometry (DXA) machine in Australia. Methods Cross‐sectional study of community‐dwelling adults (aged 18–88 years) who underwent a Hologic DXA scan at one of three commercialized densitometry centres in Australia. Age‐specific and sex‐specific percentile curves were generated for LM [LM, appendicular lean mass (ALM), ALM adjusted for height squared (ALM/h2), and ALM adjusted for body mass index (ALM/BMI)] and FM [FM, FM adjusted for height squared (FM/h2), appendicular fat mass, and android and gynoid fat] parameters using the LMS statistical method. Cutpoints equivalent to T‐scores of −1, −2, and −2.5 standard deviations below the young mean reference group (20–29 years) were also generated for LM parameters. Results A total of 15 479 community‐dwelling adults (54% men) with a median age of 33 years (interquartile range: 28, 42) were included. LM, ALM, and ALM/h2 remained stable until age 50, after which these parameters started to decline in both sexes. Compared with age 50, median percentiles of LM, ALM, and ALM/h2 declined by −5.9 kg, −3.7 kg, and −0.86 kg/m2 in men and by −2.5 kg, −1.8 kg, and −0.10 kg/m2 in women at age 70, respectively. Adjusting ALM for BMI (rather than height squared) resulted in different trends, with ALM/BMI decreasing from as early as age 20. Compared with age 20, median percentiles of ALM/BMI at age 40 declined by −0.10 kg/kg/m2 in men and by −0.06 kg/kg/m2 in women; and at age 70, ALM/BMI declined by −0.25 kg/kg/m2 in men and by −0.20 kg/kg/m2 in women. Cutpoints equivalent to T‐scores of −1, −2, and −2.5 standard deviations for ALM/BMI were 1.01, 0.86, and 0.77 kg/kg/m2 in men and 0.70, 0.59, and 0.53 kg/kg/m2 in women, respectively. All FM parameters progressively increased from age 20 and continued up until age 70. Conclusions We developed reference ranges for LM and FM parameters from Hologic DXA machines in a large cohort of Australian adults, which will assist researchers and clinicians in identifying soft tissue disorders such as obesity, sarcopenia, and cachexia.

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Section: Introductionmentioning

confidence: 99%

“… 2 Age‐related declines in LM (or low muscle mass) are linked to mobility impairments, falls, fragility fractures, disability and reduced quality of life, 1 , 3 and several acute and chronic conditions such as cachexia, sarcopenia, sarcopenic obesity, and type 2 diabetes. 1 , 4 , 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

Body composition reference ranges in community‐dwelling adults using dual‐energy X‐ray absorptiometry: the Australian Body Composition (ABC) Study

Kirk

Hassan

Brennan-Olsen

et al. 2021

J cachexia sarcopenia muscle

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“…Situated at the confluence between the actual trends in aging population and the increasing prevalence of obesity, SO is now an emerging health problem responsible for an increased disability in daily activities and reduced quality of life. The morbidity and mortality risk related to SO is greater than risk related to either obesity or sarcopenia alone (183)(184)(185). For example, in the British Regional Heart Study, a 6-year prospective study of ≥4,000 men aged 60-70 years, the mortality risk was 55.0% and increased in subjects with both sarcopenia and obesity compared with those with sarcopenia or obesity alone (186).…”

Section: Sarcopenic Obesity: a Separate And Different Entity?mentioning

confidence: 99%

Impact of Sarcopenia on the Severity of the Liver Damage in Patients With Non-alcoholic Fatty Liver Disease

et al. 2022

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An extensive body of the literature shows a strong interrelationship between the pathogenic pathways of non-alcoholic fatty liver disease (NAFLD) and sarcopenia through the muscle-liver-adipose tissue axis. NAFLD is one of the leading causes of chronic liver diseases (CLD) affecting more than one-quarter of the general population worldwide. The disease severity spectrum ranges from simple steatosis to non-alcoholic steatohepatitis (NASH), cirrhosis, and its complications: end-stage chronic liver disease and hepatocellular carcinoma. Sarcopenia, defined as a progressive loss of the skeletal muscle mass, reduces physical performances, is associated with metabolic dysfunction and, possibly, has a causative role in NAFLD pathogenesis. Muscle mass is a key determinant of the whole-body insulin-mediated glucose metabolism and impacts fatty liver oxidation and energy homeostasis. These mechanisms drive the accumulation of ectopic fat both in the liver (steatosis, fatty liver) and in the muscle (myosteatosis). Myosteatosis rather than the muscle mass per se, seems to be closely associated with the severity of the liver injury. Sarcopenic obesity is a recently described entity which associates both sarcopenia and obesity and may trigger worse clinical outcomes including hepatic fibrosis progression and musculoskeletal disabilities. Furthermore, the muscle-liver-adipose tissue axis has a pivotal role in changes of the body composition, resulting in a distinct clinical phenotype that enables the identification of the “sarcopenic NAFLD phenotype.” This review aims to bring some light into the complex relationship between sarcopenia and NAFLD and critically discuss the key mechanisms linking NAFLD to sarcopenia, as well as some of the clinical consequences associated with the coexistence of these two entities: the impact of body composition phenotypes on muscle morphology, the concept of sarcopenic obesity, the relationship between sarcopenia and the severity of the liver damage and finally, the future directions and the existing gaps in the knowledge.

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“…Dieses Risiko erfährt eine weitere Akzentuierung, wenn eine sog. sarkopene Adipositas besteht, das heißt, wenn ein hoher Fettanteil auf eine niedrige Muskelmasse trifft [ 8 ]. Gegenwärtig bemüht sich eine internationale Arbeitsgruppe, die Definition und Diagnose dieser wichtigen Entität zu vereinheitlichen [ 7 ].…”

Section: Die „Richtige“ Ernährung Im Alterunclassified

Ernährung im Alter – ein wesentlicher Schlüssel zum Erhalt der Funktionalität und Lebensqualität

Bauer

2021

Gastroenterologe

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Jenseits des 70. Lebensjahrs ist bei älteren Menschen regelhaft eine Abnahme der Muskelmasse sowie eine Zunahme der Fettmasse zu beobachten. Diese Veränderungen der Körperzusammensetzung stellen eine wesentliche Prädisposition für den im Alter drohenden Verlust an Funktionalität und Selbständigkeit dar. In diesem Kontext kommt der richtigen Ernährung sowie insbesondere dem Vermeiden einer Mangelernährung große Relevanz zu. Da die ältere Bevölkerung hinsichtlich der Geschwindigkeit und Ausprägung der Alterungsvorgänge sowie ihrer Komorbiditäten als äußerst heterogen zu betrachten ist, müssen Ernährungsempfehlungen individualisiert erfolgen. Mit Hinblick auf eine potenzielle Gefährdung durch eine Sarkopenie ist selbst eine beabsichtigte Gewichtsabnahme im Alter kritisch zu sehen. Fastenepisoden sollten generell vermieden werden. Dies betrifft insbesondere eine unzureichende Kalorienzufuhr im Kontext von akuten oder chronischen Erkrankungen. Im höheren Lebensalter sollten daher regelmäßige Gewichtskontrollen erfolgen, um das Auftreten einer Mangelernährung frühzeitig zu erkennen und entsprechende Maßnahmen einleiten zu können. Zum Erhalt der Muskelmasse und -funktion sollte eine gegenüber jüngeren Menschen erhöhte Eiweißzufuhr von 1,0 g/kgKG angestrebt werden. Bei älteren Menschen mit Sarkopenie wird dieses Ziel auf 1,2 g/kgKG angehoben. Während sich im Alter restriktive Diäten als nachteilig erweisen können, scheinen gesunde Ernährungsformen wie z. B. die mediterrane Ernährung den Erhalt der muskulären und kognitiven Funktion zu fördern.

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Falls, fractures, and areal bone mineral density in older adults with sarcopenic obesity: A systematic review and meta‐analysis

Cited by 71 publications

References 62 publications

Body composition reference ranges in community‐dwelling adults using dual‐energy X‐ray absorptiometry: the Australian Body Composition (ABC) Study

Body composition reference ranges in community‐dwelling adults using dual‐energy X‐ray absorptiometry: the Australian Body Composition (ABC) Study

Impact of Sarcopenia on the Severity of the Liver Damage in Patients With Non-alcoholic Fatty Liver Disease

Ernährung im Alter – ein wesentlicher Schlüssel zum Erhalt der Funktionalität und Lebensqualität

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