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Research article
Sarcopenic obesity and associations with mortality in older women and men – a prospective observational study
Åsa von Berens
Department of public health and caring sciences, clinical nutrition and metabolism
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8653-8028
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The combined effect of sarcopenia and obesity, i.e., sarcopenic obesity, has been associated with disability and worse outcomes in older adults, but results are conflicting. The objectives of this study were to describe the prevalence of sarcopenic obesity (SO) in older adults, and to examine how the risk of mortality is associated with SO and its various components.
Methods: Data were obtained from two Swedish population studies, the Gothenburg H70 Birth Cohort Studies of 521 women and men at the age of 75, and the Uppsala Longitudinal Study of Adult Men (ULSAM), which included 288 men aged 87 years. Sarcopenia was defined using the recently updated EWGSOP2 definition. Obesity was defined by any of three established definitions: body mass index ≥30 kg/m2, fat mass >30%/ >42% or waist circumference ≥88 cm/≥102 cm for women and men, respectively. The Kaplan-Meier survival curve and the Cox proportional hazard model were used for 10-year and 4-year survival analyses in the H70 and ULSAM cohorts, respectively.
Results: SO was observed in 4% of the women and 11% of the men in the H70 cohort, and in 10% of the ULSAM male cohort. The 75-year-old women with SO had a higher risk (HR 3.25, 95% confidence interval (1.2-8.9)) of dying within ten years compared to those with a “normal” phenotype. A potential similar association with mortality among the 75-year-old men was not statistically significant. In the older men aged 87 years, obesity was associated with increased survival.
Conclusions: SO was observed in 4-11% of community-dwelling older adults. In 75-year-old women SO appeared to associate with an increased risk of dying within ten years. In 87-year-old men, the results indicated that obesity without sarcopenia was related to a survival benefit over a four-year period.
Keywords
Older adults, sarcopenic obesity, EWGSOP2, prevalence, mortality
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On 06 May, 2020
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On 25 Mar, 2020
Submission checks complete
On 24 Mar, 2020
Editor invited
On 24 Mar, 2020
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Editorial decision: Minor revision
On 10 Mar, 2020
Review #1 received
Received 07 Feb, 2020
Reviewer #1 agreed
On 04 Feb, 2020
Reviewers invited
Invitations sent on 04 Feb, 2020
Editor assigned
On 02 Feb, 2020
Submission checks complete
On 01 Feb, 2020
Editor invited
On 01 Feb, 2020
No comments provided
Editorial decision: Major revision
On 16 Dec, 2019
Review #2 received
Received 10 Dec, 2019
Reviewer #2 agreed
On 19 Nov, 2019
Review #1 received
Received 16 Oct, 2019
Reviewer #1 agreed
On 01 Oct, 2019
Reviewers invited
Invitations sent on 24 Jul, 2019
Editor assigned
On 09 Jul, 2019
Submission checks complete
On 27 Jun, 2019
Editor invited
On 24 Jun, 2019
First submitted
On 10 Jun, 2019
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Geriatrics & Gerontology
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This preprint is under consideration at BMC Geriatrics. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Sarcopenic obesity and associations with mortality in older women and men – a prospective observational study
Åsa von Berens
Department of public health and caring sciences, clinical nutrition and metabolism
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8653-8028
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 4
Posted 19 May, 2020
No community comments so far
Editor assigned
On 06 May, 2020
Editor invited
On 05 May, 2020
Submission checks complete
On 27 Jun, 2019
No comments provided
Editorial decision: Minor revision
On 01 May, 2020
Editor assigned
On 25 Mar, 2020
Submission checks complete
On 24 Mar, 2020
Editor invited
On 24 Mar, 2020
No comments provided
Editorial decision: Minor revision
On 10 Mar, 2020
Review #1 received
Received 07 Feb, 2020
Reviewer #1 agreed
On 04 Feb, 2020
Reviewers invited
Invitations sent on 04 Feb, 2020
Editor assigned
On 02 Feb, 2020
Submission checks complete
On 01 Feb, 2020
Editor invited
On 01 Feb, 2020
No comments provided
Editorial decision: Major revision
On 16 Dec, 2019
Review #2 received
Received 10 Dec, 2019
Reviewer #2 agreed
On 19 Nov, 2019
Review #1 received
Received 16 Oct, 2019
Reviewer #1 agreed
On 01 Oct, 2019
Reviewers invited
Invitations sent on 24 Jul, 2019
Editor assigned
On 09 Jul, 2019
Submission checks complete
On 27 Jun, 2019
Editor invited
On 24 Jun, 2019
First submitted
On 10 Jun, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The combined effect of sarcopenia and obesity, i.e., sarcopenic obesity, has been associated with disability and worse outcomes in older adults, but results are conflicting. The objectives of this study were to describe the prevalence of sarcopenic obesity (SO) in older adults, and to examine how the risk of mortality is associated with SO and its various components.
Methods: Data were obtained from two Swedish population studies, the Gothenburg H70 Birth Cohort Studies of 521 women and men at the age of 75, and the Uppsala Longitudinal Study of Adult Men (ULSAM), which included 288 men aged 87 years. Sarcopenia was defined using the recently updated EWGSOP2 definition. Obesity was defined by any of three established definitions: body mass index ≥30 kg/m2, fat mass >30%/ >42% or waist circumference ≥88 cm/≥102 cm for women and men, respectively. The Kaplan-Meier survival curve and the Cox proportional hazard model were used for 10-year and 4-year survival analyses in the H70 and ULSAM cohorts, respectively.
Results: SO was observed in 4% of the women and 11% of the men in the H70 cohort, and in 10% of the ULSAM male cohort. The 75-year-old women with SO had a higher risk (HR 3.25, 95% confidence interval (1.2-8.9)) of dying within ten years compared to those with a “normal” phenotype. A potential similar association with mortality among the 75-year-old men was not statistically significant. In the older men aged 87 years, obesity was associated with increased survival.
Conclusions: SO was observed in 4-11% of community-dwelling older adults. In 75-year-old women SO appeared to associate with an increased risk of dying within ten years. In 87-year-old men, the results indicated that obesity without sarcopenia was related to a survival benefit over a four-year period.
Figure 1