Sarcopenic Obesity and Risk of Disability in Community-Dwelling Japanese Older Adults: A 5-Year Longitudinal Study.

OBJECTIVES: Previous studies have indicated that sarcopenic obesity is a risk factor for disability onset. However, these studies had disparities in terms of criteria for sarcopenia, study design, or study population. No longitudinal study has investigated the effect of sarcopenic obesity on disability onset in an Asian population using the Asian Working Group for Sarcopenia 2019 criteria for sarcopenia definition. Herein, we aimed to investigate the longitudinal effect of sarcopenic obesity on disability onset in Japanese older adults and extend the generalizability of results to other populations. DESIGN: Longitudinal cohort study. SETTING AND PARTICIPANTS: A total of 4197 Japanese older adults (mean age 74.6 ± 5.0 years, 54.2% women) formed our study population. MEASUREMENTS: Sarcopenia was identified using the Asian Working Group for Sarcopenia 2019 algorithm. Obesity was determined when body fat percentage was ≥25%, or when visceral fat content was ≥100 cm2 for either sex. Disability onset was defined as a new case of long-term care insurance system certification for 5 years from baseline. Missing values were managed with multi-imputation. Cox proportional hazard regression analysis was used with disability onset as dependent variable and group (nonsarcopenia/nonobesity as a reference, nonsarcopenia/obesity, sarcopenia/non-obesity, possible sarcopenia/obesity, possible sarcopenia/non-obesity, sarcopenic obesity) as explanatory variable, and was adjusted for potential confounding factors. RESULTS: When the nonsarcopenia/nonobesity group was used as the reference category, other groups such as possible-sarcopenia/nonobesity [hazard ratio (HR) 1.38, 95% confidential interval (95% CI) 1.29‒1.47, P < .028], possible-sarcopenia/obesity (HR 1.54, 95% CI 1.46‒1.62 P < .001), sarcopenia/nonobesity (HR 2.09, 95% CI 1.96‒2.23, P < .001), and sarcopenic obesity (HR 2.48, 95% CI 2.24‒2.75, P < .001) showed significantly increased HRs. CONCLUSIONS AND IMPLICATIONS: The risk of disability onset because of sarcopenic obesity was exceedingly higher compared with sarcopenia alone among community-dwelling older adults in Japan The health providers should consider assessing the co-existence of sarcopenia and obesity to screen for the risk of disability onset in the community-dwelling population.

Visceral fat area, waist circumference and metabolic risk factors in abdominally obese Chinese adults / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To examine the association of visceral adiposity as measured by VFA and WC with lipid and glucose metabolic biomarkers in abdominally obese Chinese adults, and to assess whether WC could be an indicator of visceral fat.</p><p><b>METHODS</b>WC and VFA were measured in 155 overweight and obese adults. A fasting blood sample was collected from participant (n = 118) whose VFA > or = 100 cm2 for analyses of lipid and glucose profile. The relationship between VFA and WC and biomarkers was investigated.</p><p><b>RESULTS</b>WC and VFA were significantly interrelated. The coincidence rate of abdominal obesity determined by Japanese VFA and Chinese WC criteria increased across age quartiles in women from 51.7% to 96.2%. A large WC was associated significantly with low HDL-cholesterol concentration (P < 0.01) and the association was weakened by additional control of VFA. WC and VFA were positively associated with glucose, hemoglobin A1c and insulin concentrations (P < 0.05 except for the association of VFA with insulin: P < 0.01), and all the associations were not significant by additional control of either WC or VFA. As WC quartiles increased, significant stepwise increments in triglyceride, glucose, hemoglobin A1c and insulin and descent in HDL-cholesterol were observed. However, triglyceride and HDL-cholesterol were not significantly different when compared across VFA quartiles.</p><p><b>CONCLUSION</b>Higher visceral fat was associated with an adverse lipid and glucose profile. WC can be a moderate predictor for visceral fat and provides a feasible measurement to estimate glucose metabolic risks. Further studies are warranted to establish age-specific WC cutoffs.</p>