Dataset Information

Poor Physical Function as a Marker of Sarcopenia in Adults with Class II/III Obesity.

ABSTRACT: Background:Adults with class II/III obesity [body mass index (in kg/m2) ?35] may present with a phenotype characterized by low lean mass and excess fat mass, a condition known as sarcopenic obesity (SO). Little is known about the prevalence and relevance of SO in these individuals, primarily due to a lack of relevant diagnostic criteria. Objective:Here, we explored the definition of SO based on physical function as an outcome of interest in adults with class II/III obesity and applied this definition to compare clinical characteristics between SO and non-SO patients. Methods:In this cross-sectional analysis, patients' demographic, anthropometric, and biochemical characteristics, as well as comorbidities and physical activity levels, were collected at an obesity specialty clinic prior to any treatment. Body composition was assessed by dual-energy X-ray absorptiometry. Physical function was assessed by self-reported difficulties with activities of daily living (ADLs) from an 11-item questionnaire. Five SO definitions were tested against reported difficulty with ADLs with the use of receiver operating characteristic (ROC) analysis. Results:A total of 120 subjects (86% women) aged 46 ± 11 y were included. Based on ROC analysis, SO was best defined by an appendicular skeletal mass (ASM)/weight x 100 (%) <19.35% for women and <24.33% for men, resulting in a prevalence of 25% (n = 30, women 22.3%, men 41.2%). SO was significantly associated with older age, higher waist circumference, higher triglycerides, greater use of antihypertensive medications, and lower physical activity. Conclusions:In this sample of adults with class II/III obesity, difficulties with ADLs were best associated with measures of ASM in relation to total body weight. Patients identified with SO using this criterion presented with poorer clinical outcomes such as factors of elevated cardiometabolic risk.

SUBMITTER: Johnson Stoklossa CA

PROVIDER: S-EPMC6201683 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Poor Physical Function as a Marker of Sarcopenia in Adults with Class II/III Obesity.

Johnson Stoklossa Carlene A CA Ghosh Sunita S SS Forhan Mary M Sharma Arya M AM Terada Tasuku T Siervo Mario M Baracos Vickie E VE Padwal Raj S RS Hung Pam A PA Sawyer Michael B MB Maia Yara Lm YL Prado Carla M CM

Current developments in nutrition 20171218 3

<h4>Background</h4>Adults with class II/III obesity [body mass index (in kg/m<sup>2</sup>) ≥35] may present with a phenotype characterized by low lean mass and excess fat mass, a condition known as sarcopenic obesity (SO). Little is known about the prevalence and relevance of SO in these individuals, primarily due to a lack of relevant diagnostic criteria.<h4>Objective</h4>Here, we explored the definition of SO based on physical function as an outcome of interest in adults with class II/III obes ...[more]

PMID: 30377678

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Project description:Objectives:Obesity-related physiological changes can limit improvements of obese subjects after training. The aim was to investigate obesity, muscular strength, and physical function in community-dwelling nonsarcopenic old adults. Methods:Nonsarcopenic subjects (N=229, 73.7?±?5.7 years; 21% normal weight, 42% overweight, and 37% obese based on body mass index (BMI)) participated in a 12-week resistance exercise program. Leisure time physical activity (LTPA), body composition (dual-energy X-ray absorptiometry), quadriceps strength (maximum voluntary isometric contraction; absolute and relative to body weight), and physical function in terms of 6-minutes-walk-for-distance (6MWD) and timed up and go (TUG) were measured baseline and endpoint. Results:At baseline, normal weight participants had lower absolute quadriceps strength (-43?±?22?N, P=0.015) than obese, but better quadriceps strength relative to body weight (1.4?±?0.7?N/kg, P < 0.001), 6MWD (53?±?27?m, P < 0.001), and TUG (-1.4?±?0.7?sec, P ? 0.001). LTPA was positively associated with 6MWD and TUG (both P < 0.05), but based on general linear models, differences in LTPA between BMI categories did not explain differences in 6MWD and TUG between BMI categories. During the program, dropout (11.9%) and attendance (85%) were similar between BMI groups. After the intervention, body composition and physical function significantly improved in all three BMI categories; however, normal weight participants lost more body fat (-1.53?±?0.78%, P=0.014), gained more lean mass (0.70?±?0.36?kg, P < 0.001) and relative quadriceps strength (0.31?±?0.16?N/kg, P=0.017), and improved more on the 6MWD (24?±?12?m, P < 0.001) but gained less grip strength (-2.4?±?1.3?N/kg, P=0.020) compared to obese. There were no differences in TUG or absolute quadriceps strength changes between the BMI strata. Physical function at baseline as well as training success of overweight participants was located between the normal weight and obesity groups. Conclusion:Nonsarcopenic obese community-dwelling old adults have lower physical function than their normal weight counterparts. This difference is not explained by lower LTPA. A 12-week resistance exercise program improves body composition and physical function in normal weight, overweight, and obese old adults; however, obese participants experience less favorable changes in body composition and physical function than normal weight individuals. This trial is registered with NCT01074879.

Project description:BackgroundLung transplant (LTX) can provide a survival benefit and improve physical function for selected patients with advanced pulmonary disease. Sarcopenia is a systemic muscle-failure that can be found in a variety of life stages and disabilities. In this study, we follow the evolution of each variable defined in sarcopenia and the outcomes in LTX recipients with post-transplant sarcopenia.MethodsPatients who underwent LTX at Tohoku University Hospital between 2013 and 2018 were consecutively included in the retrospective cohort study, with follow-up to 2019. Sarcopenia was defined by low muscle mass (the cross-sectional area (CSA) of erector spinae muscle (ESM) in thoracic CT with a threshold < 17.24 cm2/m2) and either low muscle strength (hand-grip with a threshold of < 26 kg in males and of < 18 kg in females) or physical performance (6-min walk distance with a threshold < 46.5% of predicted distance).ResultsFifty-five recipients were included into the study, of whom 19 patients were defined as sarcopenic and 36 as non-sarcopenic. The muscle mass improved after transplant in both sarcopenic and non-sarcopenic individuals: the median ESM-CSA enlarged from 17.25 cm2/m2 in 2 months post-LTX to 18.55 cm2/m2 in 12 months (p < 0.001) and 17.63 cm2/m2 in 36 months (p < 0.001) in non-sarcopenic individuals, while in sarcopenic patients it improved from 13.36 cm2/m2 in 2 months to 16.31 cm2/m2 in 12 months (p < 0.005) and 18.01 cm2/m2 in 36 months (p < 0.001). The muscle mass in sarcopenia substantially recovered to close to non-sarcopenic conditions within 36-months (p < 0.001 in 2 months and p = 0.951 in 36 months). Accordingly, muscle strength and physical performance in both groups improved over time. No difference in survival was seen in both groups (Log-rank p = 0.096), and sarcopenia was not associated with an overall hazard of death (p = 0.147). There was no difference in the cumulative incidence of chronic lung allograft dysfunction between patients with or without sarcopenia (Log-rank p = 0.529).ConclusionsEven patients with post-transplant sarcopenia have a chance to recover physical function to levels close to those without sarcopenia several years post LTX.

Dataset Information

Poor Physical Function as a Marker of Sarcopenia in Adults with Class II/III Obesity.

Publications

Poor Physical Function as a Marker of Sarcopenia in Adults with Class II/III Obesity.

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