Evaluation of muscle quality and its correlation with dietary intake in elderly with sarcopenic obesity / 中华老年医学杂志

ABSTRACT

Objective:To investigate the muscular quality and its related influencing factors in elderly with sarcopenic obesity.Methods:The internalized 696 elderly subjects meeting inclusion and exclusion criteria were divided into four groups including the sarcopenic obesity(n=55), sarcopenia(n=8), simple obesity(n=481)and normal control(n=152)groups.The intergroup difference was retrospectively analyzed in the parameters of body composition, dietary intake of total energy and three major nutrients and their proportions.Multiple linear regression analysis was used to analyze the influencing factors related to the occurrence of sarcopenic obesity in the elderly.Results:The sarcopenic obesity group versus normal control group showed a higher level or value in age, body mass index, waist-hip ratio, fat mass, percentage of body fat, visceral fat area, fasting blood glucose, estimated glomerular filtration rate( P<0.01 or 0.05), and showed a lower level or value in grip strength, skeletal muscle, skeletal muscle index, muscle quality(grip strength/limb skeletal muscle), intake of energy, carbohydrate, fat and protein, body weight-adjusted intake of energy and protein, as well as ideal body weight-adjusted intake of energy and protein( P<0.01). The detection rate of sarcopenic obesity was 7.90%(n=55), including 7.60% in males(n=48)and 11.48% in females(n=7 cases). The detection rate of sarcopenic obesity was increased along with increasing age with 0.07%(2/287)in 60-69 years old group, 4.94%(12/243)in 70-79 years old group, and 24.70%(41/166)in ≥80 years old group( χ2=87.76, P<0.01). Taking the median point of grip strength/limb skeletal muscle volume as the cutoff point, the decrease rate of muscle quality was 12.36%(86/696)in total elderly subjects, 2.63%(4/152)in the control group, 11.64%(86/635)in the obesity group, 37.5%(3/8)in the sarcopenia group and 41.82%(23/55)in the sarcopenic obesity group, with an increasing trend of the decrease of muscle quality, which had significant differences( χ2=62.25, P<0.01). Multiple logistic regression analysis showed that aging, excessive visceral fat area, insufficient protein intake and decreased basal metabolism were the independent risk factors for sarcopenic obesity in elderly people( P<0.01 or P<0.05). Conclusions:The incidence of decrease of muscle quality is higher in the elderly with sarcopenic obesity than other elderly groups.Sarcopenic obesity is correlated with aging, insufficient intake of protein, decreased basal metabolism and excessive visceral fat accumulation.Individual evaluation and support is necessary in elderly people with sarcopenic obesity.