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Clin Nutr. 2018 Feb 15. pii: S0261-5614(18)30042-6. doi: 10.1016/j.clnu.2018.01.022. [Epub ahead of print]

Sarcopenic obesity and overall mortality: Results from the application of novel models of body composition phenotypes to the National Health and Nutrition Examination Survey 1999-2004.

Author information

1
Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK.
2
Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, UK.
3
Institute of Health and Society, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK.
4
Department of Experimental Medicine- Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University of Rome, 00185 Rome, Italy.
5
Pennington Biomedical Research Center, Baton Rouge, LA, USA.
6
Childhood Nutrition Research Centre, Institute of Child Health, University College of London, 30 Guilford Street, WC1N 1EH, London, UK.
7
Department of Agriculture, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada.
8
Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK. Electronic address: mario.siervo@ncl.ac.uk.

Abstract

BACKGROUND/OBJECTIVES:

There is no consensus on the definition of sarcopenic obesity (SO), resulting in inconsistent associations of SO with mortality risk. We aim to evaluate association of dual energy x-ray absorptiometry (DXA) SO models with mortality risk in a US adult population (≥50 years).

SUBJECTS/METHODS:

The study population consisted of 3577 participants aged 50 years and older from the 1999-2004 National Health and Nutrition and Examination Survey with mortality follow-up data through December 31, 2011. Difference in survival time in people with and without SO defined by three body composition DXA models (Model 1: body composition phenotype model; Model 2: Truncal Fat Mass (TrFM)/Appendicular Skeletal Muscle Mass (ASM) ratio model; Model 3: Fat Mass (FM)/Fat Free Mass (FFM) ratio). The differences between the models were assessed by the acceleration failure time model, and expressed as time ratios (TR).

RESULTS:

Participants age 50-70 years with SO had a significantly decreased survival time, according to the body composition phenotype model (TR: 0.92; 95% CI: 0.87-0.97), and TrFM/ASM ratio model (TR: 0.88; 95% CI: 0.81-0.95). The FM/FFM ratio model did not detect significant differences in survival time. Participants with SO aged 70 years and older did not have a significantly decreased survival time, according to all three models.

CONCLUSIONS:

A SO phenotype increases mortality risk in people of age 50-70 years, but not in people aged 70 years and older. The application of the body composition phenotype and the TrFM/ASM ratio models may represent useful diagnostic approaches to improve the prediction of disease and mortality risk.

KEYWORDS:

Body composition; Mortality; Sarcopenic obesity

PMID:
29499977
DOI:
10.1016/j.clnu.2018.01.022

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