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 FNS  Vol.5 No.20 , October 2014
Sarcopenic Obesity: Correlation with Clinical, Functional, and Psychological Status in a Rehabilitation Setting
Abstract: Obesity and sarcopenia combination, appropriately defined as sarcopenic obesity (SO), due to disproportionally reduced/low lean body mass compared to excess fat mass, may lead to disability. Aims: The aim of our study was to investigate the relationship among sarcopenic obesity, physical performance, disability, and quality of life in a rehabilitation setting. Methods: Participants were recruited among obese patients (BMI > 30 kg/m2) admitted to the rehabilitation facility at the Department of Experimental Medicine, Medical Physiopatology, Food Science and Endocrinology Section during a 1-year period. A multidimensional evaluation was performed through bioelectrical impedance analysis and anthropometry, handgrip strength test, Short Physical Performance Battery (SPPB), 6-minute walk test (6MWT) and blood chemistry parameters. Psychological status (SCL-90 questionnaire), quality of life, and comorbidity (Charlson comorbidity index score) were also evaluated. Obesity was diagnosed as increased fat mass by 35% in women and by 25% in men. Sarcopenia was defined if lean body mass (LBM) was <90% of the subject’s ideal LBM. Results: 79 patients (48 women and 31 men; mean age: 60.1 ± 11.5 years, and 58.6 ± 10.8 years, respectively) were enrolled. Results showed a high prevalence of SO (54.4%) in our samples of obese subjects. Sarcopenia was present not only among older obese adults but also among younger obese subjects, and was related to reduced functional performance, to inflammatory status and to worse psychological status and quality of life.
Cite this paper: Donini, L. , Poggiogalle, E. , Migliaccio, S. , Pinto, A. , Lubrano, C. and Lenzi, A. (2014) Sarcopenic Obesity: Correlation with Clinical, Functional, and Psychological Status in a Rehabilitation Setting. Food and Nutrition Sciences, 5, 2020-2031. doi: 10.4236/fns.2014.520213.
References

[1]   Baumgartner, R.N. (2000) Body Composition in Healthy Aging. Annals of the New York Academy of Sciences, 904, 437-448.
http://dx.doi.org/10.1111/j.1749-6632.2000.tb06498.x

[2]   Flegal, K.M., Carroll, M.D., Ogden, C.L. and Johnson, C.L. (2002) Prevalence and Trends in Obesity among US Adults, 1999-2000. JAMA, 288, 1723-1727.
http://dx.doi.org/10.1001/jama.288.14.1723

[3]   Villareal, D.T, et al. (2009) Obesity in Older Adults—A Growing Problem. Nutrition and Health: Handbook of Clinical Nutrition and Aging. 2nd Edition, Humana Press, New York, 263-277.

[4]   Roubenoff, R. (2004) Sarcopenic Obesity: The Confluence of Two Epidemics. Obesity Research, 12, 887-888.
http://dx.doi.org/10.1038/oby.2004.107

[5]   Stenholm, S., Harris, T.B., Rantanen, T., Visser, M., Kritchevsky, S.B. and Ferrucci, L. (2008) Sarcopenic Obesity: Definition, Cause and Consequences. Current Opinion in Clinical Nutrition and Metabolic Care, 11, 693-700.
http://dx.doi.org/10.1097/MCO.0b013e328312c37d

[6]   Waters, D.L. and Baumgartner, R.N. (2011) Sarcopenia and Obesity. Clinics in Geriatric Medicine, 27, 401-421.
http://dx.doi.org/10.1016/j.cger.2011.03.007

[7]   Zamboni, M., Mazzali, G., Fantin, F., Rossi, A. and Di Francesco, V. (2008) Sarcopenic Obesity: A New Category of Obesity in the Elderly. Nutrition, Metabolism Cardiovascular Diseases, 18, 388-395.
http://dx.doi.org/10.1016/j.numecd.2007.10.002

[8]   Kim, T.N., Yang, S.J., Yoo, H.J., Lim, K.I., Kang, H.J., Song, W., Seo, J.A., Kim, S.G., Kim, N.H., Baik, S.H., Choi, D.S. and Choi, K.M. (2009) Prevalence of Sarcopenia and Sarcopenic Obesity in Korean Adults: The Korean Sarcopenic Obesity Study. International Journal of Obesity, 33, 885-892.
http://dx.doi.org/10.1038/ijo.2009.130

[9]   Dominguez, L.J. and Barbagallo, M. (2007) The Cardiometabolic Syndrome and Sarcopenic Obesity in Older Persons. Journal of the Cardiometabolic Syndrome, 2, 183-189.
http://dx.doi.org/10.1111/j.1559-4564.2007.06673.x

[10]   Baumgartner, R.N., Wayne, S.J., Waters, D.L., Janssen, I., Gallagher, D. and Morley, J.E. (2004) Sarcopenic Obesity Predicts Instrumental Activities of Daily Living Disability in the Elderly. Obesity Research, 12, 1995-2004.
http://dx.doi.org/10.1038/oby.2004.250

[11]   Zamboni, M., Mazzali, G., Zoico, E., Harris, T.B., Meigs, J.B., Di Francesco, V., Fantin, F., Bissoli, L. and Bosello, O. (2005) Health Consequences of Obesity in the Elderly: A Review of Four Unresolved Questions. International Journal of Obesity, 29, 1011-1029.
http://dx.doi.org/10.1038/sj.ijo.0803005

[12]   Ritz, P. (2009) Obesity in the Elderly: Should We Be Using New Diagnostic Criteria? Journal of Nutrition, Health and Aging, 13, 168-169.
http://dx.doi.org/10.1007/s12603-009-0052-7

[13]   Davison, K.K., Ford, E.S., Cogswell, M.E. and Dietz, W.H. (2002) Percentage of Body Fat and Body Mass Index Are Associated with Mobility Limitation in People Aged 70 and Older from NHANES III. Journal of the American Geriatrics Society, 50, 1802-1809.
http://dx.doi.org/10.1046/j.1532-5415.2002.50508.x

[14]   Zoico, E., Di Francesco, V., Guralnik, J.M., Mazzali, G., Bortolani, A., Guariento, S., Sergi, G., Bosello, O. and Zamboni, M. (2004) Physical Disability and Muscular Strength in Relation to Obesity and Different Body Composition Indexes in a Sample of Healthy Elderly Women. International Journal of Obesity, 28, 234-241.

[15]   Baumgartner, R.N., Wayne, S.J., Waters, D.L., Janssen, I., Gallagher, D. and Morley, J.E. (2004) Sarcopenic Obesity Predicts Instrumental Activities of Daily Living Disability in the Elderly. Obesity Research, 12, 1995-2004.
http://dx.doi.org/10.1038/oby.2004.250

[16]   Prado, C.M., Wells, J.C., Smith, S.R., Stephan, B.C. and Siervo, M. (2012) Sarcopenic Obesity: A Critical Appraisal of the Current Evidence. Clinical Nutrition, 31, 583-601.
http://dx.doi.org/10.1016/j.clnu.2012.06.010

[17]   Lohman, T.G., Roche, A.F. and Martorell, R. (1992) Manuale di riferimento per la standardizzazione antropometrica. EDRA, Milano.

[18]   Lukaski, H.C., Bolonchuk, W.W., Hall, C.B. and Siders, W.A. (1986) Validation of Tetrapolar Bioelectrical Impedance Method to Assess Human Body Composition. Journal of Applied Physiology, 60, 1327-1332.

[19]   Deurenberg, P., Yap, M. and van Staveren, W.A. (1998) Body Mass Index and Percent Body Fat: A Meta-Analysis among Different Ethnic Groups. International Journal of Obesity, 22, 1164-1171.
http://dx.doi.org/10.1038/sj.ijo.0800741

[20]   Report of a WHO Expert Committee (1995) Physical Status: The Use and Interpretation of Anthropometry. WHO Technical Report Series 854, Geneva.

[21]   Joosen, A.M., Bakker, A.H. and Westerterp, K.R. (2005) Metabolic Efficiency and Energy Expenditure during Short-Term Overfeeding. Physiology and Behaviour, 85, 593-597.
http://dx.doi.org/10.1016/j.physbeh.2005.06.006

[22]   Norgan, N.G. and Durnin, J.V. (1980) The Effect of 6 Weeks of Overfeeding on the Body Weight, Body Composition, and Energy Metabolism of Young Men. American Journal of Clinical Nutrition, 33, 978-988.

[23]   Günther, C.M., Bürger, A., Rickert, M., Crispin, A. and Schulz, C.U. (2008) Grip Strength in Healthy Caucasian Adults: Reference Values. Journal of Hand Surgery, 33, 558-565.
http://dx.doi.org/10.1016/j.jhsa.2008.01.008

[24]   Guralnik, J.M., Simonsick, E.M., Ferrucci, L., Glynn, R.J., Berkman, L.F., Blazer, D.G., Scherr, P.A. and Wallace, R.B. (1994) A Short Physical Performance Battery Assessing Lower Extremity Function: Association with Self-Reported Disability and Prediction of Mortality and Nursing Home Admission. Journal of Gerontology, 49, M85-M94.
http://dx.doi.org/10.1093/geronj/49.2.M85

[25]   (2002) ATS Statement: Guidelines for the Six-Minute Walk Test. American Journal of Respiratory and Critical Care Medicine, 166, 111-117.
http://dx.doi.org/10.1164/ajrccm.166.1.at1102

[26]   Cruz-Jentoft, A.J., Baeyens, J.P., Bauer, J.M., Boirie, Y., Cederholm, T., Landi, F., Martin, F.C., Michel, J.P., Rolland, Y., Schneider, S.M., Topinková, E., Vandewoude, M. and Zamboni, M. (2010) Sarcopenia: European Consensus on Definition and Diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age and Ageing, 39, 412-423.
http://dx.doi.org/10.1093/ageing/afq034

[27]   Chetta, A., Zanini, A., Pisi, G., Aiello, M., Tzani, P., Neri, M. and Olivieri, D. (2006) Reference Values for the 6-min Walk Test in Healthy Subjects 20 - 50 Years Old. Respiratory Medicine, 100, 1573-1578.
http://dx.doi.org/10.1016/j.rmed.2006.01.001

[28]   Charlson, M., Szatrowski, T.P., Peterson, J. and Gold, J. (1994) Validation of a Combined Comorbidity Index. Journal of Clinical Epidemiology, 47, 1245-1251.
http://dx.doi.org/10.1016/0895-4356(94)90129-5

[29]   Donini, L.M., Brunani, A., Sirtori, A., Savina, C., Tempera, S., Cuzzolaro, M., Spera, G., Cimolin, V., Precilios, H., Raggi, A. and Capodaglio, P. (2011) Assessing Disability in Morbidly Obese Individuals: The Italian Society of Obesity Test for Obesity-Related Disabilities. Disability and Rehabilitation, 33, 2509-2518.
http://dx.doi.org/10.3109/09638288.2011.575529

[30]   Apolone, G. and Mosconi, P. (1998) The Italian SF-36 Health Survey: Translation, Validation and Norming. Journal of Clinical Epidemiology, 51, 1025-1036.
http://dx.doi.org/10.1016/S0895-4356(98)00094-8

[31]   Derogatis, L.R. and Savitz, K.L. (2000) The SCL-90-R and the Brief Symptom Inventory (BSI) in Primary Care. In: Maruish, M.E., Ed., Handbook of Psychological Assessment in Primary Care Settings, Vol. 236, Lawrence Erlbaum Associates, Mahwah, 297-334.

[32]   Donini, L.M., Poggiogalle, E., Migliaccio, S., Aversa, A. and Pinto, A. (2013) Body Composition in Sarcopenic Obesity: Systematic Review of the Literature. Mediterranean Journal of Nutrition and Metabolism, 6, 191-198.

[33]   Janssen, I. (2011) The Epidemiology of Sarcopenia. Clinics in Geriatric Medicine, 27, 355-363.
http://dx.doi.org/10.1016/j.cger.2011.03.004

[34]   Passmore, R., Meiklejohn, A.P., Dewar, A.D. and Thow, R.K. (1955) An Analysis of the Gain in Weight of Overfed Thin Young Men. British Journal of Nutrition, 9, 27-37.
http://dx.doi.org/10.1079/BJN19550007

[35]   Deurenberg, P., Yap, M.D., Wang, J., Lin, F.P. and Schmidt, G. (1999) The Impact of Body Build on the Relationship between Body Mass Index and Percent Body Fat. International Journal of Obesity, 23, 537-542.
http://dx.doi.org/10.1038/sj.ijo.0800868

[36]   Gallagher, D. and DeLegge, M. (2011) Body Composition (Sarcopenia) in Obese Patients: Implications for Care in the Intensive Care Unit. Journal of Parenteral and Enteral Nutrition, 35, 21S-28S.
http://dx.doi.org/10.1177/0148607111413773

[37]   Roth, S.M., Metter, E.J., Ling, S. and Ferrucci, L. (2006) Inflammatory Factors in Age-Related Muscle Wasting. Current Opinion in Rheumatology, 18, 625-630.
http://dx.doi.org/10.1097/01.bor.0000245722.10136.6d

[38]   Visser, M., Pahor, M., Taaffe, D.R., Goodpaster, B.H., Simonsick, E.M., Newman, A.B., Nevitt, M. and Harris, T.B. (2002) Relationship of Interleukin-6 and Tumor Necrosis Factor-Alpha with Muscle Mass and Muscle Strength in Elderly Men and Women: The Health ABC Study. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 57, M326-M332.
http://dx.doi.org/10.1093/gerona/57.5.M326

[39]   Forbes, G.B. (1999) Longitudinal Changes in Adult Fat-Free Mass: Influence of Body Weight. American Journal of Clinical Nutrition, 70, 1025-1031.

[40]   Lee, J.S., Visser, M., Tylavsky, F.A., Kritchevsky, S.B., Schwartz, A.V., Sahyoun, N., Harris, T.B. and Newman, A.B., For the Health ABC Study (2010) Weight Loss and Regain and Effects on Body Composition: The Health, Aging, and Body Composition Study. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 65, 78-83.
http://dx.doi.org/10.1093/gerona/glp042

[41]   Bouchard, D.R., Dionne, I.J. and Brochu, M. (2009) Sarcopenic/Obesity and Physical Capacity in Older Men and Women: Data from the Nutrition as a Determinant of Successful Aging (NuAge)—The Quebec Longitudinal Study. Obesity (Silver Spring), 17, 2082-2088.
http://dx.doi.org/10.1038/oby.2009.109

[42]   Jankowski, C.M., Gozansky, W.S., Van Pelt, R.E., Schenkman, M.L., Wolfe, P., Schwartz, R.S. and Kohrt, W.M. (2008) Relative Contributions of Adiposity and Muscularity to Physical Function in Community-Dwelling Older Adults. Obesity (Silver Spring), 16, 1039-1044.
http://dx.doi.org/10.1038/oby.2007.84

[43]   Cawthon, P.M., Fox, K.M., Gandra, S.R., Delmonico, M.J., Chiou, C.F., Anthony, M.S., Caserotti, P., Kritchevsky, S.B., Newman, A.B., Goodpaster, B.H., Satterfield, S., Cummings, S.R. and Harris, T.B., For the Health, Aging and Body Composition Study (2011) Clustering of Strength, Physical Function, Muscle, and Adiposity Characteristics and Risk of Disability in Older Adults. Journal of the American Geriatrics Society, 59, 781-787.
http://dx.doi.org/10.1111/j.1532-5415.2011.03389.x

[44]   Woo, J., Leung, J. and Kwok, T. (2007) BMI, Body Composition, and Physical Functioning in Older Adults. Obesity (Silver Spring), 15, 1886-1894.

[45]   Auyeung, T.W., Lee, J.S., Leung, J., Kwok, T. and Woo, J. (2013) Adiposity to Muscle Ratio Predicts Incident Physical Limitation in a Cohort of 3,153 Older Adults—An Alternative Measurement of Sarcopenia and Sarcopenic Obesity. Age, 35, 1377-1385.
http://dx.doi.org/10.1007/s11357-012-9423-9

[46]   Miljkovic, I. and Zmuda, J.M. (2010) Epidemiology of Myosteatosis. Current Opinion in Clinical Nutrition and Metabolic Care, 13, 260-264.
http://dx.doi.org/10.1097/MCO.0b013e328337d826

[47]   Schaap, L.A., Koster, A. and Visser, M. (2013) Adiposity, Muscle Mass, and Muscle Strength in Relation to Functional Decline in Older Persons. Epidemiologic Reviews, 35, 51-65.
http://dx.doi.org/10.1093/epirev/mxs006

[48]   Gonzalez-Correa, C.H., Caicedo-Eraso, J.C. and Villada-Gomez, J.S. (2013) Bioelectrical Impedance Analysis for Sarcopenic Obesity Diagnosis in Young Female Subjects. Journal of Physics: Conference Series, 434, Article ID: 012061.

[49]   Kyle, U.G., Genton, L., Karsegard, L., Slosman, D.O. and Pichard, C. (2001) Single Prediction Equation for Bioelectrical Impedance Analysis in Adults Aged 20 - 94 Years. Nutrition, 17, 248-253.
http://dx.doi.org/10.1016/S0899-9007(00)00553-0

[50]   Chien, M.Y., Huang, T.Y. and Wu, Y.T. (2008) Prevalence of Sarcopenia Estimated Using a Bioelectrical Impedance Analysis Prediction Equation in Community-Dwelling Elderly People in Taiwan. Journal of the American Geriatrics Society, 56, 1710-1715.

[51]   Kyle, U.G., Bosaeu, I., De Lorenzo, A., Deurenberg, P., Elia, M., Gomez, J.M., Heitmann, B.L., Kent-Smith, L., Melchior, J.C., Pirlich, M., Scharfetter, H., Schols, A. and Pichard, C. (2004) Bioelectrical Impedance Analysis—Part II: Utilization in Clinical Practice. Clinical Nutrition, 23, 1430-1453.
http://dx.doi.org/10.1016/j.clnu.2004.09.012

[52]   Poggiogalle, E., Migliaccio, S., Lenzi, A. and Donini, L.M. (2014) Treatment of Body Composition Changes in Obese and Overweight Older Adults: Insight into the Phenotype of Sarcopenic Obesity. Endocrine.

 
 
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