The aim of this study was to evaluate the relationship between body composition determined by bioimpedanciometry (BIA) with quality of life (QoL) and functional capacity in patients with obesity and chronic osteoarthritis.

The design was a descriptive cross-sectional study in a sample of 467 patients (350 women and 117 men) with obesity and chronic osteoarthritis. Age, sex, body mass index (BMI), QoL WOMAC test (expressed as a percentage from total score) and BIA parameters (muscle mass index (MMI), fat mass index (FMI), phase angle (PA), BMI-adjusted PA, reactance (Xc) and resistance (RZ)) were recorded. Patients were divided according to total WOMAC score in four quartiles.

The mean age of the patients was 60.12 (10.87) years and 74.9% of the patients were women. The mean BMI was 40.14 (5.39) kg/m2 (M: 39.74 (5.52) vs. W: 40.27 (5.35) kg/m2, P = 0.36). Total WOMAC scores were 49.12 (22.15) % (M: 46.40 (21.58) vs. W: 51.10 (22.25)%, P < 0.05); for stiffness, the score was 47.73% (M: 44.35 (30.36) vs. W: 48.85 (28.45)%, P = 0.15); for pain, it was 52.26 (25.34)% (M: 50.73 (32.68) vs. W: 52.77 (22.39)%, P = 0.45); and for functional capacity, it was 49.07 (23.38)% (M: 45.48 (23.18) vs. W: 50.27 (23.35)%, P = 0.06). MMI and BMI-adjusted PA were negatively correlated with WOMAC functional capacity score (r = -0.16, P < 0.05 for both sexes).

In patients with obesity and chronic osteoarthritis, muscle mass determined by bioimpedanciometry could have a relationship with quality of life determined by the WOMAC test. The decrease in the phase angle adjusted by BMI was related to a slightly decrease in the quality of life.

To assess sarcopenia, sarcopenic obesity, physical performance in patients with acromegaly and compare the diagnostic performance of dual-energy X-ray absorptiometry (DXA) and multifrequency bioelectrical impedance analysis (BIA).

This cross-sectional study included 27 patients with acromegaly and 27 age-, sex-, and BMI-matched patients without acromegaly. Body composition was assessed using BIA and DXA. Lean mass indices included fat-free mass index (FFMI) and skeletal muscle index (SMI) via BIA, and the Baumgartner (BMG) and Foundation for the National Institutes of Health indices via DXA. Obesity parameters included fat mass index (FMI) and body fat percentage via BIA. Physical performance was evaluated using handgrip strength (HGS), Timed Up and Go (TUG), 4-m gait speed (4MGS), and the Short Physical Performance Battery (SPPB) tests. The strength, assistance in walking, rising from a chair, climbing stair and falls (SARC-F) questionnaire was also performed.

Strong correlations were observed between BIA and DXA body composition measures (r = 0.83, p < 0.01 for %BIA fat mass vs. %DXA fat mass; r = 0.80, p < 0.01 for SMI vs. BMG and r = 0.80, p < 0.01 for FFMI vs. BMG). Patients with acromegaly had significantly higher FFMI than patients without the disease (p = 0.03), but no difference in sarcopenic obesity prevalence (p = 0.50). Patients with acromegaly performed worse in the TUG and 4MGS tests, even after adjustment for confounders (p < 0.01 for both). No significant associations were found between SARC-F scores and lean mass or physical performance.

Patients with acromegaly showed impaired physical performance despite higher FFMI, with no differences in sarcopenic obesity. The SARC-F questionnaire showed limited diagnostic value in this population.

In recent years medical science and research are increasingly directed towards a holistic approach that considers health as global well-being rather than solely as the absence of disease. In this framework, lifestyle interventions and, in particular, physical exercise, are of crucial importance in prevention and treatment. Therefore, the purpose of this study is to describe this mutual interplay between physical behaviours, sarcopenia, and frailty, as well as to illustrate the role of structured exercise training in aging and disease.

Physical activity and exercise training are determinants of lifelong global wellness and healthy aging. On the contrary, sedentary behaviour and physical inactivity are strictly linked to frailty and pre-frailty, both in adults and the elderly, with or without chronic diseases. On the other hand, the presence of pathological conditions is associated with a more inactive and sedentary behaviour. The co-presence of these factors is characterized by a mutual causal exchange in which they are imbricated in a continuous mechanistic interplay that involves inflammation, sarcopenia, osteopenia, functional impairment and many other pathophysiological aspects that rapidly can lead to a status of frailty.

A sedentary lifestyle and physical inactivity critically affect alterations in body composition and loss in functional capacity, typically linked to aging and accelerated by chronic diseases. However, physical activity and exercise can counteract the onset of pre-frailty and frailty by conferring beneficial effects on the individual's overall well-being.

Obesity and sleep disorders are highly prevalent conditions with profound implications for public health. Emerging evidence highlights a bidirectional relationship between these two conditions, with each exacerbating the other in a complex interplay of behavioral, physiological, and hormonal mechanisms. Sleep deprivation and poor sleep quality contribute to energy imbalance through dysregulation of appetite hormones (e.g., leptin and ghrelin), increased caloric intake, and reduced physical activity. Conversely, sleep disorders such as obstructive sleep apnea syndrome (OSAS), insomnia, and restless leg syndrome (RLS) are significantly more common in individuals with obesity.

This review explores the pathophysiological mechanisms underlying this relationship, including the roles of inflammation, autonomic dysregulation, and neuroendocrine pathways. Sleep loss exacerbates metabolic syndrome components, including insulin resistance and dyslipidemia, further perpetuating weight gain. Similarly, obesity-induced sleep disorders lead to pro-inflammatory states, vascular dysfunction, and sympathetic overactivation, compounding cardiometabolic risks. Specific conditions like OSA and RLS are examined as models of this interdependence, emphasizing their shared pathways and clinical implications.

The bidirectional link between obesity and sleep disorders underscores the importance of integrating sleep assessment and management into obesity treatment strategies. Addressing this relationship could mitigate the progression of cardiometabolic comorbidities and improve overall health outcomes. Moreover, the intertwined dynamics between obesity, sleep disorders, and mental health-mediated by inflammatory pathways, hormonal dysregulation, and neurobehavioral factors-highlight the critical need for integrated treatment approaches targeting physical, psychological, and sleep-related dimensions to enhance health and quality of life.

Time-restricted feeding (TRF) is a dietary intervention that has been shown to have numerous health benefits. However, it is important to further investigate the potential effectiveness of TRF in addressing sarcopenic obesity (SO), which is characterized by a combination of age-related obesity and sarcopenia. In this study, 14-month-old C57BL/6J male mice were fed either regular chow diet or high-fat diet (HFD), and had either ad libitum or restricted access to food for 8 hours daily (Intervention for 7 months). For the human trial (ChiCTR2100052876), obese individuals (n=21) with a Body Mass Index ≥28 were recruited and instructed to adopt an 8-hour eating window and a 16-hour fasting period. Here, we found that the TRF intervention significantly reduced global fat mass (P < .001) and volume (P < .05), and increase lean mass compared to mice fed with HFD. Furthermore, TRF improved overall metabolic mobility (8h TRF+HFD vs. AL+HFD). This intervention also enhanced liver FGF21 protein levels (P < .01) and the expression of FGFR1 and FGF21 target genes in adipose and muscle tissues, thus improving mitochondrial quality control in these tissues. Notably, TRF interventions led to a significant decrease in serum FGF21 levels (P < .05). In the human trial, TRF intervention resulted in a significant reduction in weight (P < .001) and body fat levels (P < .001) among obese individuals, as well as a decrease in serum GLU (P < .001), insulin (P < .001), and TC levels (P < .05). Overall, the findings indicate that TRF intervention improves SO by regulating liver FGF21 expression, thereby enhancing FGF21 sensitivity in adipose and muscle tissues.

Obesity and sarcopenia are prevalent among older adults and associated with adverse health outcomes. The aims of the present study were to assess the prevalence of sarcopenic obesity, to evaluate the co-occurence of sarcopenia, obesity and malnutrition (risk) and to assess the association between specific characteristics and sarcopenic obesity/probable sarcopenic obesity in nursing home residents.

Three hundred eighty-seven nursing home residents with low to moderate care requirements from 20 nursing homes in Slovenia participated in the cross-sectional NutriCare study. Data on general patient characteristics, physical activity, usual dietary intake (estimated by a 2 × 24 h dietary recall and a food frequency questionnaire), malnutrition (risk) status (Mini Nutritional Assessment [MNA]), laboratory parameters, hand grip strength and body composition (estimated via BIA) were collected. Obesity was defined as a high body fat percentage. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People2 (EWGSOP2) criteria. Descriptive statistics were used to characterise the sample. Uni- and multivariable binary logistic regression analyses were performed to explore associations between the predictor variables and sarcopenic obesity.

The prevalence of obesity was 90.7% according to high fat mass and 38.3% according to BMI (≥ 30). Prevalences were 27.6% (sarcopenia) and 24.5% (sarcopenic obesity), respectively. Probable sarcopenic obesity (low hand grip strength combined with obesity) was found in 37.6% of participants. A co-occurence of malnutrition (risk) and sarcopenia was present in 11.9%, whereas a combination of malnutrition (risk) and obesity was found in 28.2%. In 9.6% of the participants, a combination of all three phenomena-sarcopenia, obesity and malnutrition (risk)-was identified. The multivariable logistic regression model shows that higher age (OR 1.07; CI 1.02, 1.11), male sex (OR 2.3; CI 1.22, 4.5) and higher energy intake (OR 1.13; CI 1.04, 1.22) were significantly associated with sarcopenic obesity. Male sex (OR 2.30; CI 1.33, 3.98), higher age (OR 1.07; CI 1.03, 1.11), higher care requirements (OR 2.14; CI 1.20, 3.79), lower MNA score (OR 0.88; CI 0.80, 0.97) and metabolic equivalent of tasks (MET minutes/week) (OR 0.99; CI 0.98, 1.00) were significantly associated with probable sarcopenic obesity.

The study indicates a notable prevalence of obesity and sarcopenic obesity among nursing home residents with lower to moderate care dependency. These findings underscore the importance of optimising nutritional intake and other modifiable lifestyle factors associated with such health conditions and implementing them into targeted, individualised interventions to reduce the risk of obesity and sarcopenic obesity and to improve health outcomes.

Metabolic and bariatric surgery (MBS) is a proven treatment for obesity. Yet weight loss is accompanied by loss of muscle which may predispose to sarcopenia. The prevalence of low muscle mass in older adults after MBS remains unexplored, even though this group is more vulnerable to sarcopenia.

This cross-sectional study investigated sarcopenia and low muscle mass by comparing adults older than 65 years with previous MBS (BAR) to patients following nonsurgical obesity management (CON). A sample size of 100 was estimated from appendicular lean mass (ALM) in a similar study in younger adults. Patients were recruited from the University Hospitals Leuven Obesity Clinic, Belgium. Study assessments included dual-energy X-ray absorptiometry, handgrip, short battery of physical performance, blood sampling and self-reported dietary intake. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People (EWGSOP1) criteria using obesity-specific cut-off points and sarcopenic obesity by the European Society for Enteral and Parenteral Nutrition (ESPEN) and the European Association of the Study of Obesity (EASO) consensus definition. Main endpoints were sarcopenia and ALM normalized to body mass index (%ALM/BMI). A multiple linear regression model was fitted to predict ALM.

We included 50 participants per group (male, BAR 40%, CON 35%). BAR participants were older (68.3 ± 3.2 years vs. 70.7 ± 3.9, p < 0.01), and more had diabetes (52% vs. 28%). BAR lost more bodyweight after MBS than CON following nonsurgical treatment (BAR 31.6 ± 9.5% vs. CON 12.1 ± 8.42%, p < 0.001). Fat free mass (FFM) was lower for BAR than for CON, but %ALM/BMI was not different (64.7 ± 18.1% vs. 62.6 ± 15.8, p = 0.53). Twenty percent to 56% of participants had low muscle mass, depending on sex and criterium, but only 3% met the criteria for sarcopenia and 9% for sarcopenic obesity. Protein intake tended to be higher in BAR than in CON (1.36 ± 0.36 g/kg FFM/day vs. 1.25 ± 0.27, p = 0.09). Most participants did not meet optimal protein intake recommendations after BMS nor for older adults in general. In the linear regression model, muscle mass increased with male sex, BMI, adiposity and protein intake and decreased with age, (adjusted R2 0.80). Neither BAR compared to CON nor surgery type or other clinical parameters influenced muscle mass.

Older adults with previous MBS were not more likely to develop sarcopenia than older adults following nonsurgical treatment. Rather, age, adiposity and low protein intake lower muscle mass, predisposing to sarcopenia.

clinicaltrials.gov identifier: NCT05582668.

Although previous studies have reported associations between sarcopenic obesity (SO) and metabolic syndrome (MetS), the findings remain inconsistent. This study aimed to investigate the associations between sarcopenia, obesity, and MetS, and to determine whether sarcopenic obesity synergistically increases the risk of MetS.

The data were extracted from the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015. Participants were categorized into five groups: non-sarcopenia non-obesity, non-sarcopenia obesity, non-obesity sarcopenia, possible SO, and SO. MetS was defined using the diagnostic criteria recommended by the National Cholesterol Education Program Adult Treatment Panel III. Logistic regression models were employed for both cross-sectional and longitudinal analysis.

In 2011, a total of 9322 participants were included in the cross-sectional analysis, with 3674 individuals followed up in 2015. In the cross-sectional study, non-sarcopenia obesity (OR = 9.20, CI: 8.06 to 10.50), possible SO (OR = 2.04, CI: 1.94 to 2.15), and SO (OR = 1.61, CI: 1.47 to 1.77) were associated with a higher prevalence of MetS. In contrast, non-obesity sarcopenia (OR = 0.85, CI: 0.74 to 0.98) was associated with a lower prevalence. In the longitudinal analysis, non-sarcopenia obesity (OR = 2.87, CI: 2.34 to 3.52) and possible SO (OR = 1.41, CI: 1.30 to 1.53) were associated with an increased incidence of MetS, while non-obesity sarcopenia (OR = 0.75, CI: 0.62 to 0.91) was associated with a reduced incidence. Notably, SO (OR = 1.00, CI: 0.80 to 1.25) was not associated with the incidence of MetS.

Possible SO, defined by low muscle mass, was not associated with subsequent new-onset MetS. This study highlights that the obesity component, rather than the muscle mass component, is the primary driver of MetS risk in middle-aged and older adults in China.

Colorectal cancer (CRC) patients often face nutritional disturbances, including malnutrition, changes in skeletal muscle index (SMI), and adipose tissue. We hypothesized that malnutrition, sarcopenia and nutritional disorders, as low muscle strength, low SMI, and reduced adipose tissue can negatively impact survival. This study aimed to assess the impact of malnutrition, SMI, muscle strength, sarcopenia, and adipose tissue on CRC patient survival. We analyzed 2 cohorts of CRC patients in this longitudinal study. Nutritional status was assessed by Patient-Generated Subjective Global Assessment (PG-SGA) and those classified as B and C were considered with malnutrition. Computed tomography (CT) scans of the third lumbar vertebra (L3) measured SMI and various adipose tissue fractions (visceral, subcutaneous, intramuscular, and total). Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). The primary outcome was 5-year overall survival. Of 266 patients (mean age 60.7 years, 53.0% male), 11.3% had sarcopenia, 27.0% were malnourished, and 40.0% died. After adjusting for clinical variables, Cox regression analysis showed that only Malnutrition (HR: 1.96; CI: 1.35-2.84; P ≤ .001) significantly impacted survival. In CRC patients, Malnutrition outweighs sarcopenia and adiposity as a predictor of survival in colorectal cancer patients.

Obesity adversely impacts musculoskeletal health, contributing to functional limitations and an increased risk for falls, fractures and disability. Weight loss can mitigate these effects, but strategies that neglect to incorporate evidence-based dietary and/or exercise approaches can exacerbate musculoskeletal and functional declines. Sustainable weight loss requires a personalised approach that prioritises adequate protein intake and essential nutrients to preserve musculoskeletal health. To enhance adherence and long-term success, dietary strategies should be practical, nutritionally balanced and cost-effective. Similarly, exercise programmes should be individually tailored and progressive, with resistance training central to any program prescribed in the context of weight loss, due to its critical role in maintaining muscle and bone mass and strength. When prescribing weight loss strategies involving lifestyle behaviour changes, clinicians must consider their patient's readiness to change. We have used the transtheoretical model of change framework as an example to identify a patient's level of readiness and provided associated motivational interviewing-based strategies to enhance adherence and engagement. This review outlines evidence-based, practical diet and exercise recommendations and behavioural strategies that can facilitate effective and sustainable weight loss, which is particularly important for at-risk populations such as older adults.

Across the spectrum of weight regain, ranging from cachexia rehabilitation and catch-up growth to obesity relapse, the recovery rate of body fat is often disproportionate relative to lean tissue recovery. Such preferential 'catch-up fat' is in part attributed to an increase in metabolic efficiency and embodied in the concept that 'metabolic adaptation' or 'adaptive thermogenesis' in response to large weight deficits can persist during weight regain to accelerate fat stores recovery. This paper reviews the evidence in humans for the existence of this thrifty metabolism driving catch-up fat within the framework of a feedback loop between fat stores depletion and suppressed thermogenesis. The search for its effector mechanisms suggests that whereas adaptive thermogenesis during weight loss results primarily from central suppression of sympathetic nervous system and hypothalamic-pituitary-thyroid axis, its persistence during weight regain for accelerating fat recovery is primarily mediated through peripheral tissue resistance to the actions of this systemic neurohormonal network. Emerging evidence linking it to an upregulation of skeletal muscle type 3 deiodinase (D3), the main thyroid hormone inactivating enzyme, along with slowed muscle metabolism and altered contractile properties, suggest that D3-induced muscle hypothyroidism is a key feature of such peripheral resistance. These findings underlying a role of skeletal muscle hypothyroidism in adaptive thermogenesis driving catch-up fat, but which can also concomitantly compromise muscle functionality, have been integrated into a mechanistic framework to explain how weight cycling and large weight fluctuations across the lifespan can predispose to sarcopenic obesity.

There is conflicting evidence regarding specific differences in body composition (i.e., body fat, lean, and bone) between people with multiple sclerosis (MS) and non-MS controls. The objective of this meta-analysis was twofold: (1) quantify overall and compartment-specific differences in body composition between people with MS and controls; and (2) identify individual and disease-specific moderators of any differences in body composition between groups.

A search of five electronic databases (MEDLINE, EMBASE, Cochrane Central, CINAHL, and Scopus) was performed by an information specialist.

Overall, 180 effects were derived from 37 studies, 155 (86.1 %) of which were negative, with a mean effect ∆ of -0.39 (95 %CI: -0.46, -0.32, Z = -10.86, p < 0.001) suggesting poorer overall body composition in people with MS. Disability status was significantly associated with overall effect size (β = 0.31, Z = 4.33, p < 0.0001); effects were significantly larger at higher disability levels. Regarding body fat, 55/61 (90.2 %) effects were negative, resulting in a mean effect ∆ of -0.32 (95 %CI: -0.43, -0.21, Z = -5.72, p < 0.001). With regards to lean tissue, 38/43 (88.4 %) effects were negative, with a mean effect ∆ of -0.38 (95 %CI: -0.56, -0.21, Z = -4.28, p < 0.001). Lastly, 62/76 (81.6 %) effects for bone mineral density were negative, with a mean effect ∆ of -0.44 (95 %CI: -0.55, -0.34, Z = -8.28, p < 0.001).

Current evidence supports poorer overall and compartment-specific body composition in people with MS, and this may be particularly relevant at higher disability. Strategies for managing body composition in MS should consider the need for maintaining lean mass and bone health, while managing obesity.

Background/Aim: Skeletal muscle mass index (SMI) and body fat percentage (BF%) are components of body mass index (BMI) but are considered to play independent roles. We aimed to clarify whether SMI and BF% are associated with nutritional markers independent of BMI in underweight women. Methods: This retrospective observational study included a total of 102 women aged 20-65 years who were referred to the outpatient nutrition evaluation clinic from 2022 to 2024 with a body mass index (BMI) < 17.5. We performed a multivariate analysis with SMI and BF% as independent variables and BMI, BMI ratio (present-to-age 20 ratio), grip strength, and biochemical nutritional indicators (vitamin B1 level (ng/mL), cholesterol level (mg/dL), lymphocyte count (/μL), and HbA1c (%) level) as dependent variables, adjusting for age. Results: Women aged 30.9 ± 10.2 years (yo) with a BMI of 17.0 ± 0.7 participated in this study. BMI (kg/m2) was positively associated with SMI (kg/m2) (β (95% CI): 1.6 [1.4, 1.9], p < 0.001) and BF% (0.2 [0.1, 0.2], p < 0.001), and the BMI ratio (present-to-age 20 ratio) was positively associated only with BF% (0.5 [0.05, 0.9], p = 0.03). Grip strength was positively associated with SMI (4.0 [1.4, 6.6], p = 0.003), and lymphocyte count was positively associated with BF% (β (36.2 [6.0, 66.5], p = 0.02). BMI was not associated with grip strength or lymphocyte count. Vitamin B1, cholesterol, and HbA1c were not associated with SMI, BF%, or BMI. Conclusions: These results indicate that SMI reflects BMI and grip strength, whereas BF% reflects BMI, the BMI ratio (present to age 20), and lymphocyte count. In addition to BMI and SMI, changes in BF% should also be noted in underweight women.

Severe respiratory infections pose a major challenge in clinical practice, especially in older adults. Body composition analysis could play a crucial role in risk assessment and therapeutic decision-making. This study investigates whether obesity or sarcopenia has a greater impact on mortality in patients with severe respiratory infections. The study focuses on the National Pandemic Cohort Network (NAPKON-SUEP) cohort, which includes patients over 60 years of age with confirmed severe COVID-19 pneumonia. An innovative approach was adopted, using pre-trained deep learning models for automated analysis of body composition based on routine thoracic CT scans.

The study included 157 hospitalized patients (mean age 70 ± 8 years, 41% women, mortality rate 39%) from the NAPKON-SUEP cohort at 57 study sites. A pre-trained deep learning model was used to analyze body composition (muscle, bone, fat, and intramuscular fat volumes) from thoracic CT images of the NAPKON-SUEP cohort. Binary logistic regression was performed to investigate the association between obesity, sarcopenia, and mortality.

Non-survivors exhibited lower muscle volume (p = 0.043), higher intramuscular fat volume (p = 0.041), and a higher BMI (p = 0.031) compared to survivors. Among all body composition parameters, muscle volume adjusted to weight was the strongest predictor of mortality in the logistic regression model, even after adjusting for factors such as sex, age, diabetes, chronic lung disease and chronic kidney disease, (odds ratio = 0.516). In contrast, BMI did not show significant differences after adjustment for comorbidities.

This study identifies muscle volume derived from routine CT scans as a major predictor of survival in patients with severe respiratory infections. The results underscore the potential of AI supported CT-based body composition analysis for risk stratification and clinical decision making, not only for COVID-19 patients but also for all patients over 60 years of age with severe acute respiratory infections. The innovative application of pre-trained deep learning models opens up new possibilities for automated and standardized assessment in clinical practice.

Background and Objectives: Despite their high prevalence, sarcopenia and sarcopenic obesity remain underdiagnosed worldwide, significantly impacting the health and quality of life of aging individuals. Due to their multifactorial nature, the current management strategies do not address their underlying pathogenesis. This systematic review aims to identify single-nucleotide polymorphisms (SNPs) associated with sarcopenia and/or sarcopenic obesity in humans. Materials and Methods. This systematic literature review followed the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)" guidelines and the protocol registered in PROSPERO. Extensive research was performed in six databases (PubMed, Web of Science, Cochrane Library, Scopus, ScienceDirect, and SpringerLink) using keywords such as "sarcopenia", "sarcopenic obesity", "single nucleotide polymorphisms", "SNPs", and "genetic variants". The Q-Genie and ROBINS-E tools were utilized to assess the quality of the included studies. Results: The final analysis included 12 studies, which were classified as good-quality according to the Q-Genie assessment and indicated a low to moderate risk of bias according to the ROBINS-E evaluation, collectively identifying 43 SNPs significantly associated with sarcopenia or sarcopenic obesity. Specifically, 24 SNPs were linked to sarcopenia, while 19 were associated with sarcopenic obesity. Conclusions: Understanding the implications of SNPs provides valuable insights into individual susceptibility and the variability observed across populations, potentially leading to more targeted and effective diagnostic and treatment strategies. Advancing clinical practice requires ongoing research into the genetic aspects of sarcopenia and sarcopenic obesity.

Obesity and heart failure (HF) represent two growing pandemics. In the general population, obesity affects one in eight adults and is linked with an increased risk for HF. Obesity is even more common in patients with HF, where it complicates the diagnosis of HF and is linked with worse symptoms and impaired exercise capacity. Over the past few years, new evidence on the mechanisms linking obesity with HF has been reported, particularly in relation to HF with preserved ejection fraction. Novel therapies inducing weight loss appear to have favourable effects on health status and cardiovascular risk. Against the backdrop of this rapidly evolving evidence landscape, HF clinicians are increasingly required to tailor their preventive, diagnostic, and therapeutic approaches to HF in the presence of obesity. This scientific statement by the Heart Failure Association of the European Society of Cardiology provides an up-to-date summary on obesity in HF, covering key areas such as epidemiology, translational aspects, diagnostic challenges, therapeutic approaches, and trial design.

The relationship between adipose-muscle distribution and its effect on migraine remains unclear. This study examines the association between muscle mass and migraine prevalence and evaluates potential mediation by systemic inflammatory biomarkers.

Using a cross-sectional design, we analyzed data from 10,400 participants in the National Health and Nutrition Examination Survey (NHANES) (1999-2004). The association between appendicular lean mass normalized to body mass index (ALM/BMI) and migraine prevalence was evaluated through weighted logistic regression and subgroup analyses. Mediation analyses were conducted to examine the potential mediating roles of inflammatory markers, including C-reactive protein (CRP), white blood cell count (WBC), and neutrophils, in the relationship between ALM/BMI and migraine prevalence. Genetic causality was investigated via two-sample Mendelian randomization (MR) using genome-wide association study (GWAS) data.

20% of total participants reported migraines. A higher ALM/BMI ratio was inversely associated with migraine after full adjustment (OR = 0.243; 95% CI: 0.122-0.487, p < 0.001). Vigorous activity reduced migraine susceptibility by 24% (OR = 0.760; 95% CI: 0.663-0.872, p < 0.001). CRP, WBC and neutrophils mediated 2.0% (p = 0.024), 3.1% (p = 0.011), and 2.8% (p = 0.019) of the ALM/BMI-migraine association, respectively. The inverse-variance weighted approach (IVW) in MR analysis indicated that higher basal metabolic rate (BMR) reduced migraine risk (OR = 0.996, 95% CI: 0.992-0.998, p = 0.004) and headache risk (OR = 0.998, 95% CI: 0.997-1.000, p = 0.018). Fat-free mass also exhibited protective effects on migraines (OR = 0.997, 95% CI: 0.994-1.000, p = 0.045).

Increased muscle mass is associated with reduced migraine risk, partially mediated by attenuating systemic inflammation. These findings provide us with an approach of health management to prevent migraines.

The Mini Nutritional Assessment - Short Form (MNASF) is an easy, quick, and validated tool for screening and diagnosing malnutrition among older individuals. Despite its clinical relevance, using body mass index (BMI) and a universal calf circumference (CC) cutoff might pose limitations. Therefore, our study aimed to investigate the potential of using sex-specific and BMI-adjusted CC cutoff values within the MNA-SF to classify nutritional status and assess its prognostic significance.

Older patients hospitalized with varied diagnoses were included. BMI and CC measurements were conducted by registered dietitians. MNA-SF, which considers either BMI or CC, was utilized to classify nutritional status. Patients scoring 0-7 points were classified as malnourished. Four different approaches for MNA-SF were considered: Traditional: i) using BMI, ii) the alternative/surrogate using a non-sex specific CC < 31 cm; Newly adapted approaches: iii) using sex-specific CC cutoff values ≤ 34 cm for men and ≤33 cm for women, without BMI adjustment factors; iv) using sex-specific BMI-adjusted CC cutoff values ≤ 34 cm for men and ≤33 cm for women. BMI adjustment factors were: -3 cm of CC for BMI 25-29.9 kg/m2, -7 cm for BMI 30-39.9 kg/m2, and -12cm for BMI ≥40 kg/m2. The prevalence of nutritional categories across different MNA-SF approaches was estimated. Cox regression analysis and Receiver Operating Characteristic (ROC) curve analysis were performed to evaluate and compare their predictive significance for overall survival.

This study included 242 patients (58.8 % men, median age of 68 years, interquartile range: 64 to 74). Cancer was the most frequent reason for hospitalization (36.6 %). Scores in MNA-SF were significantly lower when using sex-specific unadjusted & BMI-adjusted CC. The frequency of malnutrition ranged from 21.9 % (MNA-SF using BMI) to 41.7 % (MNA-SFadj.CC≤34/33). The incidence of mortality was significantly higher among malnourished patients classified using the sex-specific unadjusted (58.2 %) and BMI-adjusted CC approaches (63.3 %), compared to 38.2 % and 40 % when using BMI and the non-sex-specific CC < 31 cm, respectively. All approaches had similar survival prediction (area under the ROC curves 65-67 %), and were independently associated with mortality. Using BMI-adjusted CC with sex-specific cutoff values (≤33/34) within the MNA-SF significantly improved survival prediction sensitivity (63.6 % versus 38.2 % with BMI and 40 % with CC < 31). Malnourished patients classified by MNA-SF using sex-specific and BMI-adjusted CC cutoff values ≤ 33/34 exhibited the highest risk of mortality based on hazard ratios, compared to those classified by MNA-SF using BMI or CC < 31.

Our study demonstrates that using sex-specific, unadjusted, and BMI-adjusted CC cutoffs values within MNA-SF classified a greater number of patients at risk of or already experiencing malnutrition, as well as a higher incidence of mortality among malnourished individuals. These methods showed greater sensitivity and achieved a more balanced trade-off between sensitivity and specificity compared to traditional approaches (using BMI or CC < 31). Pending future validation, these approaches have potential to offer a more reliable alternative for assessing nutritional status and improving prognostication in this population.

Although bariatric and metabolic surgery (BS) has proved effective in the treatment of obesity based on the reduction in fat mass and the remission of comorbidities, there is also loss of lean mass after BS which could compromise muscle functionality. According to the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia is a disease associated with loss of muscle mass, strength, and function. Through a comprehensive review of the literature, we identified a range of studies focusing on evaluating sarcopenia-related parameters according to the EWGSOP2 consensus criteria, before and after BS. Although most studies reported reductions in skeletal muscle mass and absolute muscle strength after surgery, improvements in muscle functionality were generally achieved, independent of the type of BS.

To identify the risk factors for pressure injuries in individuals with spinal cord injuries (SCIs) who have sarcopenic obesity, comparing time-dependent changes in sacral region pressure in individuals with and without sarcopenic obesity.

An experimental time series study.

Single-center hospital.

Twenty-five adult participants with subacute and chronic paraplegia who visited our rehabilitation center, Republic of Korea, between May 2021 and June 2022.

Whole-body dual-energy X-ray absorptiometry was performed to diagnose sarcopenic obesity. After the participants were placed in the supine position for 1 hour, the average pressure (mmHg), peak pressure (mmHg), and total contact area (cm2) of the sacral region were measured using the pressure-mapping system.

Compared with the non-sarcopenic obesity group, the sarcopenic obesity group showed significant before-and-after differences in peak pressure. Furthermore, the risk factors that were significantly associated with peak pressure in the sarcopenic obesity group were the American Spinal Injury Association Impairment Scale score and the fat mass index.

Among participants with SCIs, the risk of pressure injuries is higher in the sarcopenic obesity group than in the non-sarcopenic obesity group. Notably, the risk of pressure injuries increases in participants who have complete injury and an increased fat mass index, indicating the importance of close monitoring and more active management to prevent pressure injuries in this subpopulation.

Fibrotic interstitial lung disease (ILD) is associated with high morbidity and mortality. Patients often exhibit impaired nutritional status and alterations in body composition, such as dynapenia and sarcopenia, which correlate with poor pulmonary function, reduced exercise tolerance and diminished quality of life. However, the impact of dynapenia and sarcopenia on prognosis has not been examined extensively in ILD patients. We assessed the impact of dynapenia and sarcopenia as risk factors for mortality and their prevalence in ILD.

Prospective cohort study. ILD was classified into idiopathic pulmonary fibrosis (IPF), connective tissue disease-related ILD (CTD-ILD) and chronic hypersensitivity pneumonitis (CHP). Patients over 18 years old with a confirmed diagnosis of ILD were included, while those with diagnoses of cancer, human immunodeficiency virus and neurological disease were excluded. Dynapenia and sarcopenia were determined according to EWGSOP2 criteria.

Ninety-eight ILD patients were included; 33.66% had IPF, 47.96% had CTD-ILD, and 18.37% had CHP. The mean age was 63.89 ± 12.02 years; 37.76% were male. The risk factors associated with mortality included dynapenia (HR: 2.04, 95% CI: 1.10-3.77, p = 0.022), sarcopenia (HR: 1.88, 95% CI; 1.00-3.33, p = 0.049) and exercise tolerance (HR: 0.99, 95% CI; 0.99-0.99, p = 0.023), adjusted for confounding variables. The prevalence of dynapenia was 45% in ILD; 51% in IPF, 35% in CTD-ILD and 61% in CHP. The prevalence of sarcopenia was 29%; both IPF (39%) and CHP (50%) had a higher prevalence of sarcopenia than CTD-ILD (14%).

Sarcopenia and dynapenia are independent risk factors for mortality in ILD.

The aim of this study was to develop consensus definitions and diagnostic criteria for sarcopenic obesity tailored to Asia-Oceania populations, a condition characterized by reduced skeletal muscle mass and function with excess adipose tissue.

Experts from various fields formed a working group under the Asia-Oceania Association for the Study of Obesity (AOASO) and the International Association of Gerontology and Geriatrics Asia/Oceania Region (IAGG-AOR). The group convened four meetings, employing the Delphi technique to achieve consensus on diagnostic criteria and management strategies for sarcopenic obesity.

The consensus defines sarcopenic obesity with a 3-step algorithm, including screening, diagnosis, and intervention. The screening criteria included BMI and waist circumference for obesity and calf circumference, the SARC-F, and the Finger Ring test for sarcopenia. The diagnostic criteria for sarcopenia include assessments of muscle mass (using dual-energy X-ray absorptiometry or bioelectrical impedance analysis), muscle strength (handgrip strength), and physical performance (gait speed, Short Physical Performance Battery, or the 5-Times Sit-to-Stand Test). Central obesity is the main concern for the diagnosis of obesity. The working group recommends a combination of dietary consultations, increased physical activity, resistance training, and the potential use of oral nutritional supplements and medications for managing sarcopenic obesity. The primary objective is to increase skeletal muscle mass and reduce adipose tissue mass.

The established criteria facilitate early recognition and management of sarcopenic obesity, highlighting the need for tailored interventions. Future research should focus on the long-term outcomes of these interventions and the development of pharmacological treatments.

Neurogenic bladder due to myelomeningocele (MMC) is a significant risk factor for chronic kidney disease in children. Cystatin C (CysC) is a more accurate GFR marker than creatinine as it is unaffected by muscle mass but may be influenced by fat mass and BMI. This study evaluates: (1) GFR measurement accuracy using CysC and creatinine in MMC-related neurogenic bladder, (2) the relationship between body composition via bioelectrical impedance analysis (BIA) and renal parameters, and (3) the use of BIA for non-invasive GFR and body composition assessment.

Forty children (median age 9.96 years) underwent serum creatinine, CysC testing, and BIA measurements. We assessed age, sex, spinal lesion level, anthropometric measurements, BMI, and activity using Hoffer's scale. GFR was calculated using five creatinine-based formulas, three CysC-based, and three combining CysC and creatinine, including BIA GFR as an alternative approach.

Creatinine-based GFR estimates were significantly higher than CysC-based GFR. Although only 30% of MMC patients met the traditional BMI criteria for overweight/obesity, 62.5% were obese based on BIA-measured body fat percentage. Significant differences were found in CysC and CysC-based GFR equations within BMI and fat mass groups. Positive correlations were observed between CysC and body weight, BMI percentiles, body fat mass and fat-to-muscle ratio. Muscle mass positively correlated with creatinine.

BIA-determined fat mass percentage is a more sensitive obesity indicator than BMI in MMC patients. CysC levels and CysC-based GFR equations are influenced by body fat mass, requiring consideration of adiposity to avoid misestimating renal impairment.

Background/Objectives: Sarcopenic obesity (SO), the coexistence of sarcopenia and obesity, poses serious health risks, such as increased mortality. Despite its clinical significance, key predictors of SO remain unclear, especially in severe obesity. This study aimed to identify independent predictors of SO in Italian older adults with obesity using a deep learning neural network. Methods: A cross-sectional study was conducted with hospitalized older adults diagnosed with severe obesity. SO was defined according to the 2022 ESPEN/EASO Statement Criteria, based on skeletal muscle function assessed by the five-repetition sit-to-stand test (5-SST) and body composition parameters evaluated using Dual X-ray Absorptiometry. A total of 42 independent variables were analyzed. Data normalization was performed using MinMaxScaler, and an optimal neural network architecture was selected via grid search with stratified 5-fold cross-validation. Model performance was assessed using accuracy, precision, recall, F1-score, AUC-ROC, and AUPRC metrics. Results: The correlation analysis revealed strong negative associations between SO and handgrip strength (HGS) (r = -0.785) and appendicular lean mass (ALM) (r = -0.745), as well as moderate correlations with 5-SST (r = 0.603), 30-second chair stand test (r = -0.474), 6-minute walking test (6m-WT) (r = 0.289), and waist circumference (WC) (r = 0.127). The deep learning model achieved an average classification accuracy of 72%, with a precision of 83% and an AUC of 0.9333. Conclusions: The main key predictors of SO were HGS, ALM, 5-SST, 30s-SST, 6m-WT, and WC in the early detection of this condition. The findings highlight deep learning's potential to improve SO diagnosis, risk assessment, clinical decision-making, and prevention in severely obese older adults.

Background/Objectives: Sarcopenia, abdominal obesity, and sarcopenic obesity are prevalent and clinically significant in older adults, each shaped by diverse biopsychosocial factors. However, integrative analyses using nationally representative data remain limited in Korea. Methods: We analyzed 2118 adults aged ≥65 years from the 2022-2023 Korea National Health and Nutrition Examination Survey (KNHANES). Body composition was classified into sarcopenia, abdominal obesity, and sarcopenic obesity. Guided by Engel's Biopsychosocial Model, we examined biological (e.g., sex, chronic disease, nutrition, exercise), psychological (e.g., stress, sleep, self-rated health), and social (e.g., income, education, living status) variables. Complex-sample multinomial logistic regression identified condition-specific associations. Results: Prevalence rates were 18.2% for sarcopenia, 41.0% for abdominal obesity, and 3.4% for sarcopenic obesity. Eating alone and a lack of resistance exercise were common risk factors across all three conditions. Sarcopenia was associated with male sex, insufficient dietary intake, alcohol consumption, poor self-rated health, and low household income. Abdominal obesity was linked to recent weight gain, hypertension, diabetes, prolonged sedentary time, perceived obesity, and low educational attainment. Sarcopenic obesity was associated with male sex, diabetes, elevated hs-CRP, perceived stress, poor self-rated health, and economic inactivity. Conclusions: Body composition abnormalities among older Korean adults are influenced by complex, condition-specific interactions across biological, psychological, and social domains. These findings emphasize the significance of adopting an integrative perspective that considers physical, psychological, and social health components when addressing age-related body composition issues.

Sarcopenic obesity is a clinical condition characterized by the coexistence of excess adiposity and impaired muscle function, associated with heightened cardiometabolic risk and frailty. The emergence of new incretin-based obesity management medications (OMMs), which allow unprecedented weight loss, has raised concerns regarding weight loss-induced fat-free mass (FFM) reduction, including skeletal muscle mass (SMM). This review examines recent findings on the prevalence, diagnosis, and implications of sarcopenic obesity, explores the effects of weight-loss interventions on body composition and their impact on health, and discusses strategies to preserve muscle mass.

Weight loss induced by incretin-based OMMs results in a variable but significant reduction in FFM. The extent to which this loss affects SMM and function remains uncertain. Nutritional strategies, particularly adequate protein intake, and structured exercise interventions, especially resistance training, play a key role in mitigating FFM loss. Digital health interventions and telemedicine-based exercise programs offer promising approaches for maintaining muscle health during weight loss.

The clinical significance of FFM loss during weight reduction remains debated. Future research should refine sarcopenic obesity diagnostic criteria, assess the long-term impact of FFM/SMM reduction during intentional weight loss, and evaluate interventions that optimize body composition while preserving functional health.

There are limited comparative studies between one-anastomosis gastric bypass (OAGB) vs Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on body composition and musculoskeletal health.

To compare changes in body composition, areal bone mineral density (aBMD), muscle strength, and physical function in the first year following OAGB, RYGB, and SG within a UK-based healthcare setting.

This is a secondary analysis of the BARI-LIFESTYLE trial in 119 adults (77% women; mean ± SD age 45.9 ± 10.3 years; body mass index 43.6 ± 5.5 kg/m2) who underwent OAGB (n = 19), RYGB (n = 39), and SG (n = 61). Body composition and aBMD by dual energy x-ray absorptiometry, handgrip strength, sit to stand (STS) test and 6-minute walking test (6MWT) were assessed presurgery and at 12 months postsurgery.

OAGB, RYGB, and SG exhibited similar reductions in body weight, body fat, and lean mass (within-group comparisons, P < .001). All surgery types were associated with reductions in aBMD at the total hip, femoral neck, and lumbar spine, which were more pronounced after OAGB and RYGB than after SG (all P < .03), though there was no difference between OAGB and RYGB. Despite reductions in absolute handgrip strength, relative handgrip strength, STS test, and 6MWT improved postsurgery (all P < .02), with no differences by surgical procedure.

OAGB, RYGB, and SG resulted in comparable weight loss, changes in body composition and improvements in relative muscle strength and physical function. OAGB and RYGB, compared with SG, led to greater BMD reductions at clinically relevant sites. Future long-term studies should explore whether these BMD reductions translate into a greater fracture risk.

While obesity rates increase worldwide, physical activity levels are reduced. Obesity and physical inactivity may be inversely related to the production of reactive oxygen species (ROS) and cause oxidative stress in the central nervous system. In this study, we aimed to investigate the effects of aerobic physical exercise on the oxidative balance of the prefrontal cortex of rats subjected to overnutrition during lactation. For this, male Wistar rats were subjected to overnutrition during lactation between postnatal day 3 to 21. On postnatal day 23, the two groups of animals were subdivided into trained and untrained animals. Trained rats were subjected to a treadmill training protocol for four weeks, five days/week, 60 min/day, at 50% of maximum running capacity. Our findings demonstrate that overnutrition impairs REDOX balance in the prefrontal cortex through increased prooxidants and reduced antioxidant defenses. On the contrary, exercise tends to restore most of these measures to control levels, possibly due to the increase in mRNA levels of Sirt1 and reduction in Il-6 in the prefrontal cortex. Overnutrition causes oxidative stress in the prefrontal cortex, while exercise re-covers most of its adverse effects through activating anti-inflammatory mechanisms.

Background: Hidradenitis suppurativa (HS) is a rare, debilitating, chronic inflammatory skin disease. This study aimed to investigate differences in body composition between patients with hidradenitis suppurativa (HS) and healthy controls, with a particular focus on sex-specific disparities, while also exploring secondary associations with muscle health and quality of life. Methods: Body composition was measured using a bioanalyzer and compared between HS individuals (n = 53) and controls (n = 50). Results: The mean BMI was significantly higher in the HS group than in the controls (median 29.6 vs. median 22.1; p < 0.001, effect size -0.581). The patients with HS had a significantly higher fat mass (mean 26.2 ± 22.7 vs. 16.3 ± 6.0; p < 0.001, effect size -0.400), level of visceral fat (median 9 vs. 2; p < 0.001, effect size -0.473), percentage of total body water (mean 45.9 ± 12.3 vs. 31.9 ± 14.3; p < 0.001, effect size -0.508), skeletal muscle index (median 8.9 vs. 7.3; p < 0.001, effect size -0.445), and bone mass (median 3.2 vs. 2.5; p < 0.001, effect size -0.421); at the same time, they had a significantly lower predicted muscle mass (median 19.8 vs. 47.3; p < 0.001, effect size -0.740) and percentage of skeletal muscle mass (mean 38.2 ± 7.8 vs. 42.3 ± 5.5; p = 0.008, effect size -0.263) in comparison to the controls. The HS group was also characterized by a higher metabolic age (median 65 vs. 21 years; p < 0.001, effect size -0.760) and basal metabolic rate (median 1927 vs. 1489 kcal; p < 0.001, effect size -0.444). Conclusions: Patients with HS exhibit a distinctive pattern in body composition parameters when compared to healthy controls, which may hold significant potential for enhancing diagnostic accuracy and monitoring disease progression. This study highlighted sex-specific differences in body composition, emphasizing the need to consider biological sex in the pathophysiology and clinical evaluation of HS. Further research is needed to explore the clinical utility of body composition analysis in disease progression, therapeutic response, and personalized management.

The prevalence of obesity is rising around the world, as the number of subjects dieting and experiencing weight loss followed by unintentional weight regain, the so-called weight cycling (WC). In this narrative review we sought to reveal the effects of WC on body composition as well as to evaluate if WC may represent a risk factor for sarcopenia and sarcopenic obesity. The relative changes in lean and fat compartments after WC have been shown to depend on several factors as the degree of energy deficit, the rate of weight loss and baseline body weight, as well as sex, age, physical activity and subject's metabolic or hormonal status. Effects of WC on body compartments may be underestimated depending on body composition measurements, interference of physical exercise, number of WC, age and population characteristics. Studies using the most precise methods to assess body composition changes, as well those with higher number of WC and/or including old subjects, show that with WC, lower fat free mass (FFM) is regained with a mismatch between muscle and fat. In addition, when WC is involuntary in old age, it drives and accelerates the age-related loss of FFM, in particular in frail populations. Finally, an association between WC and sarcopenia or sarcopenia obesity, was also observed when evaluating strength together with WC-related body composition changes. In conclusion WC may act as an accelerator of biological aging, and it could be further investigated as a potential risk factor for sarcopenia or sarcopenic obesity.

Studies comparing different operational definitions of sarcopenia (S) and sarcopenic obesity (SO) defined according to the ''European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity'' (ESPEN/EASO) criteria with functionality are scarce. Our aim is to investigate whether SO or S with different skeletal muscle mass (SMM) adjustments is better associated with functional disability.

This retrospective study was carried out in older individuals ≥ 65 years of age in a geriatric outpatient clinic. Probable and confirmed sarcopenia were evaluated with the revised European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, and SO with ESPEN/EASO consensus steps. For SMM component for both S and SO, different adjustments (weight, body mass index, and height square (W, BMI, H2 respectively)) were used. Functional disability was examined with activities of daily living (ADL), and instrumental ADL (IADL). Receiver operating characteristic (ROC) curves were drawn and area under ROC curve (AUC) were calculated to find which operational definition best predicts disability.

Data from 1477 older adults were screened. 408 participants (median age; 73 (65-101), 65% female) were included. Prevelance of SO was 6.9%. Probable sarcopenia, confirmed sarcopenia BMI-adjusted and confirmed sarcopenia W-adjusted were significantly associated with impaired IADL (p < 0.001), and showed fair accuracy for predicting IADL disability. Sarcopenic obesity did not show significant associations with ADL and IADL disability and didn't predict ADL and IADL disability. Only confirmed sarcopenia by BMI predicted ADL disability with poor accuracy. Among operational definitions of sarcopenia, probable sarcopenia had the highest sensitivity (83.6%) and negative predictive value (NPV) (94.2%) for predicting IADL disability.

We found that probable sarcopenia (with the highest sensitivity and NPV) and confirmed sarcopenia (BMI-adjusted with higher sensitivity and NPV than W-adjusted) were the most relevant for predicting IADL disability, but their diagnostic accuracy was limited. Confirmed sarcopenia by BMI predicted ADL disability with poor accuracy. Other operational definitions, including SO did not predict functional disability in our study. Future studies need to refine the definitions of SO and investigate its distinct impact on functional impairment compared to sarcopenia alone.

The global increase in life expectancy has led to a concomitant rise in diagnoses of sarcopenia. At the same time, the epidemic levels of obesity have given rise to the emergence of a complex condition known as sarcopenic obesity. Characterized by the simultaneous presence of loss of muscle mass and strength along with obesity or excess body fat, sarcopenic obesity represents a concerning health condition. Contrary to prevailing assumptions, sarcopenic obesity is not exclusive to older adults, as it may also manifest in individuals with obesity and chronic diseases and in those who undergo rapid weight loss. This juxtaposition of fat accumulation and muscle depletion epitomizes a harmful combination, especially in healthy adults. A precise definition of sarcopenic obesity and an understanding of how different body composition components affect functional parameters, comorbidities, and mortality rates are crucial for grasping the full extent and significance of this condition. Despite its multifaceted nature, sarcopenic obesity is often undiagnosed and undertreated, posing a considerable challenge to healthcare systems worldwide. In this review, we explore the intricate interplay of factors contributing to the development and consequences of sarcopenic obesity and discuss newly proposed diagnostic guidelines aimed at improved screening. Enhancing awareness and understanding of sarcopenic obesity is imperative for addressing its growing prevalence and mitigating its adverse health effects.

Sarcopenic obesity is characterized by the coexistence of sarcopenia and obesity, which has been demonstrated to be linked to insulin resistance. The triglyceride-glucose (TyG) index is a novel surrogate indicator of insulin resistance. However, the relationship between sarcopenic obesity and the TyG index remains unclear. This population-based study aimed to investigate the association between TyG index and sarcopenic obesity in adults.

This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), individuals aged over 45 years were categorized into sarcopenia, obesity, sarcopenic obesity, and control groups. Baseline characteristics were analyzed across these groups. Logistic regression models were employed to explore the association between the TyG index and sarcopenic obesity, adjusting for confounding variables. Subgroup analyses were conducted to explore the potential variations in this association across different demographic and clinical variables.

A total of 9,485 individuals were included in the study, with the sarcopenic obesity group exhibiting a higher TyG index (8.96 ± 0.61) compared to other groups (p < 0.001). A significant and independent association was observed between higher TyG index and increased likelihood of sarcopenic obesity, even after adjusting for confounders. Participants in the highest TyG index tertile had a 1.82-fold increase in the risk of sarcopenic obesity compared to those in the lowest tertile. Subgroup analyses revealed significant associations between TyG index and sarcopenic obesity across various demographic and clinical variables, particularly in individuals aged over 60 years, females, and those with chronic diseases.

The findings suggest a strong association between elevated TyG index and sarcopenic obesity in adults, independent of demographic and clinical factors. Further large-scale prospective studies are warranted to validate and expand upon these findings.

The diagnosis of sarcopenic obesity (SO) in patients with gastric cancer has been inconsistent among studies examining postoperative complications because diagnostic methods have not been standardized. This study aimed to clarify the differences in the prevalence of obesity with and without low hand grip strength (HGS) according to the diagnostic criteria proposed using the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) and identify the optimal model for predicting postoperative complications.

Patients who underwent radical gastrectomy for gastric cancer between April 2015 and March 2023 were included. According to the ESPEN/EASO diagnostic criteria, patients with a body mass index ≥ 25 kg/m2 who met the screening criteria were assessed for percent body fat (PBF) and skeletal muscle mass (SMM) adjusted by weight (SMM/W) and HGS. Depending on the respective cutoff values, six models of low SMM-obesity without HGS and six models of low HGS-obesity with HGS were set. The incidence of postoperative complication with the Clavien-Dindo classification grade 2 or higher was compared across models. Multivariate logistic regression analysis was performed to determine the risk model for postoperative complications, with significance set at p < 0.05.

The analysis included 1762 patients with a median age of 67.0 years; 1123 were men (63.7%). The prevalence of low SMM-obesity was significantly higher (5.4%-17.3%) than that of low HGS-obesity (1.2%-2.3%). Among those with low SMM-obesity, PBF > 20.2% for men and > 31.7% for women as well as SMM/W ≤ 42.9% for men and ≤ 35.6% for women had the highest postoperative complication incidence number of cases. This model was an independent risk factor for postoperative complications in the multivariate analysis (odds ratio: 1.671, 95% confidence interval: 1.204-2.299, and p = 0.002).

In obese patients with gastric cancer, the preoperative prevalence of low HGS-obesity or low SMM-obesity differed significantly. One of the low SMM-obesity model was associated with postoperative complication after gastrectomy.