The Applicability of the ESPEN and EASO-Defined Diagnostic Criteria for Sarcopenic Obesity in Japanese Patients after Stroke: Prevalence and Association with Outcomes

Abstract

Sarcopenic obesity is of growing research and clinical interest; however, validated diagnostic criteria are lacking. We therefore aimed to examine the prevalence of sarcopenic obesity as diagnosed by the criteria recently proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO), and its association with outcomes among patients after stroke. This study was based on a cohort of 760 Japanese patients after stroke admitted to a post-acute rehabilitation hospital. Sarcopenic obesity was diagnosed at admission according to the ESPEN and EASO criteria using reference values specific to Asians. Outcomes included the motor domain of the functional independence measure (FIM-motor) and the food intake level scale (FILS) at discharge. Multivariate linear regression models were used to assess the associations between sarcopenic obesity and outcomes. Among 760 patients (median age, 73 years; 352 women and 408 men), sarcopenic obesity was diagnosed in 34 patients (4.5%; 5.4% of women and 4.1% of men). In multivariate analyses, sarcopenic obesity was independently and negatively associated with FIM-motor (β = −0.048, p = 0.031) and FILS at discharge (β = −0.095, p = 0.046) in women. In contrast, in men, sarcopenic obesity showed an independent negative association with FIM-motor at discharge (β = −0.117, p < 0.001) but no statistically significant association with FILS at discharge (β = −0.004, p = 0.323). In conclusion, the prevalence of sarcopenic obesity diagnosed by the ESPEN and EASO-defined criteria was as low as 4.5% among Japanese patients after stroke. Furthermore, sarcopenic obesity was negatively associated with improvements in activities of daily living and dysphagia.

Sarcopenic obesity in nursing home residents: a multi-center study on diagnostic methods and their association with instrumental activities of daily living

“…After the release of the ESPEN/EASO consensus, some studies have embraced this definition and diagnostic criteria across various study populations, including stoke [ 24 ], rehabilitation [ 25 ], post-bariatric surgery [ 26 ], cancer [ 9 ], and community-dwelling older adults [ 5 , 27 ]. The reported prevalence of SO ESPEN in these studies ranged from 4.3 to 31.9%, whereas it reached 43.5% in our study population.…”

Screening ability and health assessment of calf circumference and upper arm circumference on sarcopenia in Chinese community-dwelling older people: need to be accurate and population-targeted

“…The results of Tessier et al's study [36] have indicated that sarcopenic older adults diagnosed by FNIH sarcopenia criteria have higher fat mass than non-sarcopenic older adults. The decrease in muscle mass in the elderly may be accompanied by an increase in adipose tissue, which is sarcopenic obesity, greatly associated with the risk of functional outcomes and health adverse in the older adults [37]. Thus, despite the conflicting results, we still suggest assessing fat mass of sarcopenic older adults in order to find those with sarcopenic obesity timely, enabling us to provide early and tailored intervention for this population.…”

Prognostic Value of Dysphagia for Activities of Daily Living Performance and Cognitive Level after Stroke

“…The sample size was calculated using data from our previous study, 32 ) the results of which showed that the motor FIM score of patients admitted to the hospital was normally distributed with a standard deviation of 26. For a true difference in means between those with and without dysphagia of 17, 33 ) a sample size of at least 65 participants was needed in each group to reject the null hypothesis with a power of 0.8 and an alpha error of 0.05, which would support the validity of our results.…”