Sarcopenic obesity in ageing: cardiovascular outcomes and mortality

Abstract

Obesity is a major public health issue with prevalence increasing worldwide. Obesity is a well-established risk factor for CVD and mortality in adult populations. However, the impact of being overweight or obese in the elderly on CVD and mortality is controversial. Some studies even suggest that overweight and obesity, measured by BMI, are apparently associated with a decreased mortality risk (known as the obesity paradox). Ageing is associated with an increase in visceral fat and a progressive loss of muscle mass. Fat mass is positively associated and lean mass is negatively associated with risk of mortality. Therefore, in older adults BMI is not a good indicator of obesity. Sarcopenia has been defined as the degenerative loss of muscle mass, quality and strength with age and is of major concern in ageing populations. Sarcopenia has previously been associated with increased risks of metabolic impairment, cardiovascular risk factors, physical disability and mortality. It is possible for sarcopenia to co-exist with obesity, and sarcopenic obesity is a new class of obesity in older adults who have high adiposity levels together with low muscle mass, quality or strength. Therefore, sarcopenia with obesity may act together to increase their effect on metabolic disorders, CVD and mortality. This review will discuss the available evidence for the health implications of sarcopenic obesity on CVD and mortality in older adults.

The Association Between Sarcopenic Obesity and Hypertension, Diabetes, and Abnormal Lipid Metabolism in Chinese Adults

“…At present, the association between hypertension and SO is mentioned in only a few reports. 40 The findings of the present study showed that hypertension has a significant association with SO. In this study, the DBP and SBP of the SO group were higher than those of the non-SO group, suggesting that blood pressure may be a predictive indicator of SO.…”

Sarcopenic Obesity Is Significantly Associated With Coronary Artery Calcification

“…Various studies have investigated the clinical significance of sarcopenia and SO in relation to cardiovascular disease (5). In a Japanese population study, sarcopenia was associated with greater arterial stiffness in women, suggesting that sarcopenia is associated with risk factors for atherosclerosis (25).…”

“…Sarcopenic obesity (SO) is the state in which sarcopenia and obesity coexist, presenting as both decreased muscle mass and increased adiposity. Previous studies have reported an association between SO and traditional cardiovascular risk factors, including metabolic syndrome, diabetes, and insulin resistance (5). However, the association between SO and cardiovascular outcomes remains unclear, as studies have shown conflicting results.…”

The Relevance of Diet, Physical Activity, Exercise, and Persuasive Technology in the Prevention and Treatment of Sarcopenic Obesity in Older Adults

“…These rates highly increase with age, reaching 48% in men and 27,5% in women, in those aged 80 years and above (4,7). The negative clinical impact of sarcopenic obesity on health, quality of life and health cots is enormous (8)(9)(10). This negative impact is particularly present in the aging population, where physical inactivity, limited exercise and poor nutritional intake (both over and under consumption of nutrients) may even further lead to metabolic and clinical complications (11)(12)(13).…”