Sarcopenia and Sarcopenic Obesity in Patients Undergoing Orthopedic Surgery

Abstract

BackgroundThe purpose of this retrospective study was to determine the prevalence of sarcopenia and sarcopenic obesity among patients who underwent orthopedic surgery (OS).MethodsA total of 222 patients were reviewed immediately after or prior to OS. In the control group, 364 patients from outpatient departments (OPDs) who did not have any OS were enrolled. Whole-body dual-energy X-ray absorptiometry was used to analyze body composition. Skeletal muscle mass was adjusted for height squared, total body weight, and height and fat mass (residuals). Obesity was defined as body mass index (BMI) > 25.0 kg/m2.ResultsThe prevalence of sarcopenia in the OS group was 25.7%, 44.1%, and 26.6%, respectively, according to the 3 different criteria. The prevalence was significantly lower in the OPD group (6.0%, 33.1%, and 14.8%, respectively). The highest rates of sarcopenia with height-adjusted definition were seen in patients with a femoral neck fracture. In the multivariate analysis, factors associated with sarcopenia were male gender, older age, and lower BMI (odds ratio [OR]: 28.38, 1.03, and 1.83, respectively) when muscle mass was adjusted for height, whereas male gender, older age, and higher BMI were associated with sarcopenia (OR: 1.04, 2.57, and 1.83, respectively) when adjusted for weight. When residuals were used as a cutoff, decreased BMI and total hip bone mineral density (0.1 g/cm2) were independent risk factors associated with sarcopenia (OR: 1.09 and 1.05). The prevalence of sarcopenic obesity ranged from 1.8% to 21.2%.ConclusionsOur study demonstrated a high prevalence of sarcopenia among OS patients.

Association between obesity with low muscle mass and dialysis mortality

“…For those on dialysis, nutrition is another important issue and protein‐energy malnutrition is a non‐traditional risk factor for mortality . Sarcopenic obesity, which is highly prevalent in the elderly, in those on maintenance dialysis and liver cirrhosis, might be a novel risk factor for dialysis mortality …”

“…6 Sarcopenic obesity, which is highly prevalent in the elderly, in those on maintenance dialysis and liver cirrhosis, might be a novel risk factor for dialysis mortality. [18][19][20] The aim of the study is to evaluate whether obesity with low muscle mass is associated with dialysis mortality or not. We analyse multiple risk factors and comorbid conditions at the start of the dialysis, including skeletal muscle mass index (SMMI), BMI as well as wellknown risk factors for dialysis mortality in a regional hospital.…”

The impact of sarcopenic obesity on knee and hip osteoarthritis: a scoping review

“…Low lean mass was associated with pain and impaired function in subjects with normal BMI, but not with obesity (no significant differences between NSO and SO groups). Ji et al [ 60 ], 2016 To identify the prevalence of SO in knee and hip orthopedic surgery (OS) patients Cross-sectional Korean orthopedic surgery patients (hip or knee TJA or femoral fracture repair) (OS, n = 222) compared to control non-surgical outpatients (non-OS, n = 364) BMI > 25 kg/m 2 DXA ASM/height 2 , ASM/weight, and ASM/height and fat mass (residuals) Retrospective analysis of data. No assessment of muscle strength or function SO prevalence ranged from 1.3–35.4% in TKA and 0–18.4% in THA patients depending on definition used.…”

“…Publication dates ranged from 2005 to 2017, with the majority ( n = 8, 73%) published in the last three years, potentially indicating a growing awareness and understanding of sarcopenic obesity. Ten of the eleven studies were cross-sectional [ 60 – 69 ], and one longitudinal [ 59 ]. Four studies (36.4%) were secondary analyses of the Korea National Health and Nutrition Examination Survey (KNHANES) population cohort [ 61 , 63 , 64 , 68 ], two (18.2%) were secondary analyses of the North American Osteoarthritis Initiative (OAI) population cohort [ 59 , 62 ], one (9%) was a secondary analysis of the French Knee and Hip OsteoArthritis Long-term Assessment (KHOALA) cohort [ 69 ], and the remaining four (36.4%) were independent studies with cohorts from Korea [ 60 ], Thailand [ 65 ], Japan [ 67 ] and the Netherlands [ 66 ].…”

“…Ten of the eleven studies were cross-sectional [ 60 – 69 ], and one longitudinal [ 59 ]. Four studies (36.4%) were secondary analyses of the Korea National Health and Nutrition Examination Survey (KNHANES) population cohort [ 61 , 63 , 64 , 68 ], two (18.2%) were secondary analyses of the North American Osteoarthritis Initiative (OAI) population cohort [ 59 , 62 ], one (9%) was a secondary analysis of the French Knee and Hip OsteoArthritis Long-term Assessment (KHOALA) cohort [ 69 ], and the remaining four (36.4%) were independent studies with cohorts from Korea [ 60 ], Thailand [ 65 ], Japan [ 67 ] and the Netherlands [ 66 ]. Eight studies focused on osteoarthritis of the knee joint [ 59 , 61 – 65 , 67 , 68 ], with two additional studies examining both knee and hip [ 60 , 69 ], and one solely on hip osteoarthritis [ 66 ].…”