Asociación entre obesidad sarcopénica con resistencia a la insulina y síndrome metabólico / Association between sarcopenic obesity with insulin resistance and metabolic syndrome

IntroducciónExiste un debate en cuanto a si la obesidad sarcopénica conduce a mayor riesgo de síndrome metabólico (SM) en adultos jóvenes.ObjetivosDeterminar la asociación entre obesidad sarcopénica y el SM y resistencia la insulina (RI).MétodosEstudio transversal retrospectivo durante 5 años. Se incluyeron sujetos de la consulta de especialidad entre 18 y 55 años, con IMC≥35 con comorbilidad o IMC≥40 con y sin comorbilidad. La asociación se calculó mediante odds ratio (OR) con intervalos de confianza del 95% (IC 95%).ResultadosDoscientos cincuenta y cuatro sujetos fueron analizados, el 76,4% fueron mujeres, la edad promedio fue de 38,36±8,78 años. El OR de RI en sujetos con o sin obesidad sarcopénica fue de 2,224 (IC 95%, 1,127-4,389; p=0,02). El OR del SM en sujetos con o sin sarcopenia fue de 1,045 (IC 95%: 0,624-1,748; p=0,868). Se encontró una diferencia entre la masa grasa en el grupo con RI vs. sin RI de 60,58±14,4kg vs. 53,98±12,2kg (p<0,001); igualmente entre el IMC y masa muscular de 46,15±6,78kg/m2 vs. 43,51±6,11kg/m2 (p<0,05) y 30,05±7,48kg vs. 27,86±5,91kg (p<0,05) respectivamente.ConclusiónLa asociación de obesidad sarcopénica con RI en adultos jóvenes resultó significativa, no así con el SM. Nuestros hallazgos enfatizan la necesidad de tomar conciencia sobre la importancia del mantenimiento de la masa magra en sujetos con obesidad. (AU)

BackgroundThere is a debate as to whether sarcopenic obesity leads to an increased risk of metabolic syndrome (MS) in young adults.ObjectiveTo determine the association between sarcopenic obesity with MS and insulin resistance (IR).MethodsA 5-year retrospective cross-sectional study. Subjects of the specialty consultation between 18 and 55 years old, with BMI≥35 with comorbidity or BMI≥40 with and without comorbidity were included. The association was calculated using an odds ratio (OR) with 95% confidence intervals (95% CI).ResultsTwo hundred and fifty-four subjects were analyzed, 76.4% were women and average age was 38.36±8.78 years. The OR of IR in subjects with or without sarcopenic obesity was 2.224 (95% CI, 1127 to 4389, P=.02). The OR of MS in subjects with or without sarcopenia was 1.045 (95% CI, 0.624 to 1.748, P=.868). A difference was found between the fat mass in the group with IR vs. without IR of 60.58±14.4kg vs. 53.98±12.2kg (P<.001); likewise, between the BMI and muscle mass of 46.15±6.78kg/m2 vs. 43.51±6.11kg/m2 (P<.05) and 30.05±7.48kg vs. 27.86±5.91kg (P<.05) respectively.ConclusionThe association between sarcopenic obesity with IR in young adults was significant, but not with MS. Our findings emphasize the need to become aware of the importance of maintaining lean mass in obese subjects. (AU)

Association between sarcopenic obesity with insulin resistance and metabolic syndrome. / Asociación entre obesidad sarcopénica con resistencia a la insulina y síndrome metabólico.

BACKGROUND: There is a debate as to whether sarcopenic obesity leads to an increased risk of metabolic syndrome (MS) in young adults. OBJECTIVE: To determine the association between sarcopenic obesity with MS and insulin resistance (IR). METHODS: A 5-year retrospective cross-sectional study. Subjects of the specialty consultation between 18 and 55 years old, with BMI≥35 with comorbidity or BMI≥40 with and without comorbidity were included. The association was calculated using an odds ratio (OR) with 95% confidence intervals (95% CI). RESULTS: Two hundred and fifty-four subjects were analyzed, 76.4% were women and average age was 38.36±8.78 years. The OR of IR in subjects with or without sarcopenic obesity was 2.224 (95% CI, 1127 to 4389, P=.02). The OR of MS in subjects with or without sarcopenia was 1.045 (95% CI, 0.624 to 1.748, P=.868). A difference was found between the fat mass in the group with IR vs. without IR of 60.58±14.4kg vs. 53.98±12.2kg (P<.001); likewise, between the BMI and muscle mass of 46.15±6.78kg/m2 vs. 43.51±6.11kg/m2 (P<.05) and 30.05±7.48kg vs. 27.86±5.91kg (P<.05) respectively. CONCLUSION: The association between sarcopenic obesity with IR in young adults was significant, but not with MS. Our findings emphasize the need to become aware of the importance of maintaining lean mass in obese subjects.

Sarcopenic obesity: a new challenge in the clinical practice. / Obesidad sarcopénica: un nuevo reto en la clínica práctica.

Sarcopenic obesity has been associated with greater disability, morbidity and mortality. However, at present, there are few studies regarding the role of sarcopenia in the evolution of the comorbidities associated with obesity in individuals less than 65 years of age. The pathogenesis is multifactorial and uncompletely ilucidated, but it seems that inflammatory mediators and insulin resistance play an important role. Although there is no clear consensus on its definition and diagnostic methods, there is a growing interest in finding biomarkers useful for the detection and monitoring. Regarding the treatment, a multimodal approach is recomended, based on dietary recommendations, exercise and eventually bariatric surgery.

Sarcopenic obesity in community-dwelling older women, determined by different diagnostic methods.

INTRODUCTION: Background: sarcopenic obesity (SO) decreases functional capacity, favors loss of autonomy, and is associated with increased mortality in the elderly. The prevalence of sarcopenic obesity differs according to the chosen diagnostic method and/or the population studied. Objective: to identify sarcopenic obesity in community-dwelling elderly women using different diagnostic methods. Methods: this is a cross-sectional study involving 138 elderly women enrolled in an Open University of the Third Age. Sarcopenia was defined according to three criteria: a skeletal muscle index (SMI) ≤ 6.42 kg/m²; reduced muscle strength, defined by handgrip strength (HS) < 20 kg/f; and reduced physical performance, determined by a usual gait speed (GS) < 0.8 m/s. Obesity was diagnosed when body mass index (BMI) > 28 kg/m², waist circumference (WC) > 88 cm, total body fat percentage (TBF%) determined by bioelectric impedance analysis (BIA) ≥ 38%, and value for triceps skinfold (TS) ≥ 85th percentile. Sarcopenic obesity is the coexistence of sarcopenia and obesity. Results: the prevalence of sarcopenia and severe sarcopenia was 14.5% and 3.6%, respectively. The highest prevalence of obesity was found using WC (69.6%) and TBF% (52.9%) (p < 0.001). The highest prevalence of sarcopenic obesity was found using TBF% (9.4%) and WC (6.5%) (p < 0.001). Sarcopenic obesity according to BMI was only 0.7%. Conclusion: the prevalence of sarcopenic obesity was high and depended on the diagnostic criteria applied. The association of TBF% with the diagnosis of sarcopenia was the method that identified the highest prevalence of sarcopenic obesity.

INTRODUCCIÓN: Antecedentes: la obesidad sarcopénica (SO) disminuye la capacidad funcional, favorece la pérdida de autonomía y se asocia a mayor mortalidad en los ancianos. La prevalencia de la obesidad sarcopénica difiere según el método de diagnóstico elegido y/o la población estudiada. Objetivo: identificar la obesidad sarcopénica en mujeres ancianas que viven en la comunidad utilizando diferentes métodos de diagnóstico. Métodos: este es un estudio transversal en el que participaron 138 mujeres ancianas inscritas en una Universidad Abierta de la Tercera Edad. La sarcopenia se definió de acuerdo con tres criterios: un índice de músculo esquelético (SMI) ≤ 6.42 kg/m²; fuerza muscular reducida, definida por una fuerza de empuñadura (HS) < 20 kg/f, y rendimiento físico reducido, determinado por una velocidad de marcha habitual (GS) < 0,8 m/s. La obesidad se diagnosticó si: índice de masa corporal (IMC) > 28 kg/m², perímetro de la cintura (WC) > 88 cm, porcentaje de grasa corporal total (TBF%) determinado por análisis de impedancia bioeléctrica (BIA) ≥ 38%, y valor de pliegue cutáneo del tríceps (TS) ≥ percentil 85. La obesidad sarcopénica es la coexistencia de sarcopenia y obesidad. Resultados: la prevalencia de la sarcopenia y la sarcopenia severa fue del 14,5% y 3,6%, respectivamente. La mayor prevalencia de obesidad se encontró mediante el WC (69,6%) y el porcentaje de TBF (52,9%) (p < 0,001). La prevalencia más alta de obesidad sarcopénica se encontró utilizando el % de TBF (9,4%) y el WC (6,5%) (p < 0,001). La obesidad sarcopénica según el IMC fue solo del 0,7%. Conclusión: la prevalencia de la obesidad sarcopénica fue alta y dependió de los criterios diagnósticos aplicados. La asociación del TBF% con el diagnóstico de sarcopenia fue el método que identificó la prevalencia más alta de obesidad sarcopénica.

Algunos aspectos de interés relacionados con la obesidad sarcopénica / Some aspects of interest related to sarcopenic obestiy

Se describen algunos aspectos de interés sobre la obesidad sarcopénica, entre ellos: el concepto, la prevalencia, el diagnóstico y las consecuencias desde el punto de vista clínico. Para ello se revisaron varios artículos sobre el tema en estudio, teniendo en cuenta su calidad y actualidad, según criterio de los autores. La referida obesidad representa los cambios en la composición del músculo, con disminución de su masa, lo que contribuye a aminorar su fuerza y desempeño, asociado a la infiltración grasa de este. Su prevalencia es variable según el criterio aplicado para su diagnóstico (4,4 a 84,0 por ciento en hombres, y desde 3,6 a 94,0 por ciento en mujeres), el que se realiza siguiendo criterios clínicos y complementarios. Sus consecuencias pueden ser escasas al inicio, pero con el tiempo se produce la disminución del rendimiento físico, por lo que se dificulta la realización de actividades habituales de la vida diaria, provoca, por ello, discapacidad y dependencia, un mayor uso de recursos hospitalarios y sociales, y una peor calidad de vida(AU)

Some aspects of interest on sarcopenic obesity were described including concept, prevalence, diagnosis and consequences from the clinical viewpoint. To this end, several articles on this topic were reviewed, taking into account their quality and updating, according to the author's criteria. Obesity represents the changes in the muscle composition with reduction of its mass, which contributes to reduce its strength and performance, associated to fat infiltration in it. Its prevalence is variable according to the criteria applied for its diagnosis (4.4 for 84 percent in men and 3.6 for 94 percent in women) based on clinical and supplementary criteria. Its effects are few at the beginning but as time goes by, the physical performance diminishes, so it is difficult to perform daily activities leading to disability and dependence, greater use of hospital and social resources and low quality of life(AU)

Algunos aspectos de interés relacionados con la obesidad sarcopénica / Some aspects of interest related to sarcopenic obestiy

Se describen algunos aspectos de interés sobre la obesidad sarcopénica, entre ellos: el concepto, la prevalencia, el diagnóstico y las consecuencias desde el punto de vista clínico. Para ello se revisaron varios artículos sobre el tema en estudio, teniendo en cuenta su calidad y actualidad, según criterio de los autores. La referida obesidad representa los cambios en la composición del músculo, con disminución de su masa, lo que contribuye a aminorar su fuerza y desempeño, asociado a la infiltración grasa de este. Su prevalencia es variable según el criterio aplicado para su diagnóstico (4,4 a 84,0 por ciento en hombres, y desde 3,6 a 94,0 por ciento en mujeres), el que se realiza siguiendo criterios clínicos y complementarios. Sus consecuencias pueden ser escasas al inicio, pero con el tiempo se produce la disminución del rendimiento físico, por lo que se dificulta la realización de actividades habituales de la vida diaria, provoca, por ello, discapacidad y dependencia, un mayor uso de recursos hospitalarios y sociales, y una peor calidad de vida(AU)

Some aspects of interest on sarcopenic obesity were described including concept, prevalence, diagnosis and consequences from the clinical viewpoint. To this end, several articles on this topic were reviewed, taking into account their quality and updating, according to the author's criteria. Obesity represents the changes in the muscle composition with reduction of its mass, which contributes to reduce its strength and performance, associated to fat infiltration in it. Its prevalence is variable according to the criteria applied for its diagnosis (4.4 for 84 percent in men and 3.6 for 94 percent in women) based on clinical and supplementary criteria. Its effects are few at the beginning but as time goes by, the physical performance diminishes, so it is difficult to perform daily activities leading to disability and dependence, greater use of hospital and social resources and low quality of life(AU)