Prevalence of Sarcopenic Obesity and its Association with Functionality, Lifestyle, Biomarkers and Morbidities in Older Adults: the FIBRA-RJ Study of Frailty in Older Brazilian Adults

de Campos, Glaucia Cristina; Lourenço, Roberto Alves; Lopes, Claudia S.

doi:10.6061/clinics/2020/e1814

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ORIGINAL ARTICLE • Clinics 75 • 2020 • https://doi.org/10.6061/clinics/2020/e1814 copy

Prevalence of Sarcopenic Obesity and its Association with Functionality, Lifestyle, Biomarkers and Morbidities in Older Adults: the FIBRA-RJ Study of Frailty in Older Brazilian Adults

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVES:

To assess the prevalence of sarcopenic obesity and its association with functionality, lifestyle, biomarkers, and morbidities in older adults.

METHODS:

The study analyzed cross-sectional data from 270 older adults who participated in phase III of the Frailty in Brazilian Older People Study (Fragilidade em Idosos Brasileiros—Rio de Janeiro, FIBRA-RJ study-2013). They took part in a home interview surveying socioeconomic, demographic, lifestyle, morbidities, and functional data. Blood was collected for biochemical marker analysis and participants’ body composition was determined by dual-energy X-ray absorptiometry. For women, the diagnosis of sarcopenic obesity was defined at a body fat percentage ≥38% and appendicular skeletal muscle mass index (ASMMI) <5.45 kg/m². For men, a fat percentage ≥27% and ASMMI <7.26 kg/m² was defined as sarcopenic obesity. Multivariate analysis was performed using a multinomial regression model (95% confidence intervals), with sarcopenic obesity as the outcome.

RESULTS:

The prevalence of sarcopenic obesity was 29.3%. In the final fitted model, the variables that displayed statistically significant association with sarcopenic obesity were lower gait speed, self-reported medical diagnosis of arthrosis or arthritis, and high levels of glycemia.

CONCLUSION:

The study showed a high prevalence of sarcopenic obesity in non-institutionalized older adults in Brazil. The finding that this condition was associated with modifiable risk factors may provide insights into measures directed at prevention and reduction of the risk of sarcopenic obesity in this population subgroup.

Cross-Sectional Study; Elderly; Obesity; Sarcopenic Obesity

Characteristics		N (270)	(%)
Sex	Male	81	30.0
Ethnicity	Afro-descendent	99	36.7
Income bracket (^* * MW—Minimum Wages; MW)	0-2	49	19.1
	2.1-5	119	46.5
	>5	88	34.4
Age group (years)	65-74	101	37.4
	75-84	127	47.0
	≥85	42	15.6
Schooling (years)	Illiterate	1	0.4
	1-5	53	19.6
	6-11	125	46.3
	>12	91	33.7
Diabetes mellitus	Yes	68	25.3
Arthrosis/Arthritis	Yes	133	49.3
Tobacco use	Current smoker	12	4.4
	Smoked and stopped	97	35.9
	Never smoked	161	59.6
Alcohol consumption (daily)	Yes	37	13.7
Walking for exercise	Yes	64	23.7
Albumin (<3.5 mg/dl)	Deficit	22	8.2
C-reactive protein (≥0.5 mg/dl)	High	43	16.0
Glycaemia (≥100 mg/dl)	High	121	45.2
Body composition phenotypes	Eutrophic	70	26.4
	Obese	117	44.2
	Sarcopenic Obese	78	29.4
IADL^ IADL—Instrumental Activities of Daily Living.	Dependent	97	35.9
Gait speed	≤0.8m/s	118	43.9
Hand grip	Low	69	26.3

Variables		Eutrophy		Obesity		Sarcopenic obesity		p-value
Variables		N	(%)	N	(%)	N	(%)	p-value
Sex	Female	46	25	111	60.3	27	14.7	0.0001
Sex	Male	24	29.60	6	7.4	51	63
Ethnicity	White	39	23.35	69	41.3	59	35.33	0.021
Ethnicity	Afro-descendent	31	31.63	48	48.98	19	19.39	0.021
Income bracket (^* * MW—Minimum Wage; MW)	0-2	8	16.67	22	45.83	18	37.50	0.010
	2.1-5	30	25.86	60	51.72	26	22.41	0.010
	>5	29	33.33	26	29.89	32	36.78
Age group (years)	65-74	23	23.00	50	50.00	27	27.00	0.609
	75-84	34	27.42	52	41.94	38	30.65
	≥85	13	31.71	15	36.59	13	31.71
Schooling (years)	Illiterate	0	0.00	1	100.00	0	0.00	0.254
	1-5	14	28.00	26	52.00	10	20.00
	6-11	29	23.39	59	47.58	36	29.03
	≥12	27	30.00	31	34.44	32	35.56
Diabetes Mellitus	Yes	17	25.00	36	52.94	15	22.06	0.202
Diabetes Mellitus	No	53	27.04	81	41.33	62	31.63	0.202
Arthrosis/Arthritis	Yes	26	19.7	76	57.6	30	22.7	0.000
Arthrosis/Arthritis	No	44	33.1	41	30.8	48	36.1	0.000
Tobacco use	Yes	4	33.33	4	33.33	4	33.33	0.020
Tobacco use	No	40	25.3	82	51.9	36	22.8	0.020
	Smoked and stopped	26	27.4	31	32.6	38	40.0
Daily consumption of alcohol	Yes	7	18.92	12	32.43	18	48.65	0.022
Daily consumption of alcohol	No	63	27.63	105	46.05	60	26.32	0.022
Walking for exercise	Yes	19	30.16	19	30.16	25	39.68	0.029
Walking for exercise	No	51	25.25	98	48.51	53	26.24	0.029
Albumin	Normal	69	28.5	101	41.7	72	29.8	0.007
Albumin	Deficit	1	4.8	16	76.2	4	19.0	0.007
C-reactive protein	Normal	63	28.6	91	41.4	66	30.0	0.061
C-reactive protein	High	7	16.3	26	60.5	10	23.3	0.061
Glycemia	Normal	48	33.8	57	40.1	37	26.1	0.017
Glycemia	High	22	18.2	60	49.6	39	32.2	0.017
Gait speed	≤0.8m/s	20	17.4	62	53.9	33	28.7	0.004
Gait speed	>0.8m/s	50	33.6	54	36.2	45	30.2	0.004
Hand grip	Low	15	21.7	29	42	25	36.2	0.320
Hand grip	Normal	55	28.1	88	44.9	53	27.0	0.320
IADL^ IADL—Instrumental Activities of Daily Living.	Independent	47	27.6	76	44.7	47	27.6	0.820
IADL^ IADL—Instrumental Activities of Daily Living.	Dependent	23	24.2	41	43.2	31	32.6	0.820

Body Composition and Anthropometry	Obesity			Sarcopenic Obesity			Total
Body Composition and Anthropometry	N	Mean	SD	N	Mean	SD	N	Mean	SD	p-value
Fat Percentage (%)	117	44.9	3.7	78	35.6	4.5	265	38.5	7.5	<0.001
ASMMI (Kg/m²)^* * ASMMI—Appendicular Skeletal Muscle Mass Index.	117	7.5	1.7	78	5.1	0.8	265	5.9	2.0	<0.001
Weight (Kg)	117	73.6	12.5	78	67.4	12.6	265	68.0	13.4	<0.001
Waist Circumference (cm)	117	102.5	10.5	78	96.8	8.9	265	96.6	12.0	<0.001

	Sarcopenic Obesity
		Model 1	Model 2	Model 3	Final Model
Variables	OR (95%CI)	Adjusted OR (95%CI)	Adjusted OR (95%CI)	Adjusted OR (95%CI)	Adjusted OR (95%CI)
Gait speed
>0.8 m/s	1	1			1
≤0.8 m/s	1.83 (0.92-3.64)	2.01 (0.94-4.32)			2.43 (1.09-5.41)
Arthrosis
No	1	1			1
Yes	1.05 (0.54-2.05)	2.05 (0.92-4.53)			2.43 (1.05-5.63)
Diabetes mellitus
No	1	1			1
Yes	0.75 (0.34-1.65)	0.69 (0.29-1.67)			0.52 (0.19-1.37)
Smoking
Never smoked	1		1		1
Smoker	1.11 (0.25-4.77)		0.67 (0.13-3.51)		0.23 (0.03-1.75)
Smoked and stopped	1.62 (0.82-3.18)		0.94 (0.43-2.08)		0.75 (0.31-1.76)
Daily drinker
No	1		1		1
Yes	2.70 (1.05-6.92)		2.29 (0.81-6.46)		2.63 (0.84-8.20)
Walks
Yes	1		1		1
No	0.79 (0.38-1.60)		0.94 (0.42-2.09)		0.86 (0.36-2.02)
Albumin
Normal	1			1	1
Deficit	3.83 (0.41-35.15)			7.24 (0.72-72.85)	5.70 (0.54-59.89)
C-Reactive Protein
Normal	1			1	1
High	1.36 (0.48-3.80)			1.38 (0.45-4.19)	1.22 (0.37-4.02)
Glycemia
Normal	1			1	1
High	2.30 (1.17-4.52)			2.15 (1.02-4.55)	3.14 (1.34-7.32)

		Obesity
		Model 1	Model 2	Model 3	Final Model
Variables	OR (95%CI)	Adjusted OR (95%CI)	Adjusted OR (95%CI)	Adjusted OR (95%CI)	Adjusted OR (95%CI)
Gait speed
>0.8 m/s	1	1			1
≤0.8 m/s	2.87 (1.52-5.44)	2.01 (0.94-4.32)			3.12 (1.45-6.67)
Arthrosis
No	1	1			1
Yes	3.13 (1.69-5.80)	2.05 (0.92-4.53)			2.54 (1.20-5.39)
Diabetes mellitus
No	1	1			1
Yes	1.38 (0.70-2.71)	0.69 (0.29-1.67)			1.09 (0.42-2.81)
Smoking
Never smoked	1		1		1
Smoker	0.48 (0.11-2.05)		0.40 (0.08-1.86)		0.33 (0.06-1.73)
Smoked and stopped	0.58 (0.30-1.10)		0.90 (0.42-1.91)		0.80 (0.35-1.83)
Daily drinker
No	1		1		1
Yes	1.02 (0.38-2.74)		2.36 (0.75-7.43)		2.98 (0.89-9.97)
Walks
Yes	1		1		1
No	1.92 (0.93-3.94)		1.36 (0.60-3.10)		1.16 (0.48-2.78)
Albumin
Normal	1			1	1
Deficit	10.93 (1.41-84.34)			8.55 (1.05-69.35)	6.23 (0.72-53.74)
C-Reactive Protein
Normal	1			1	1
High	2.57 (1.05-6.28)			1.71 (0.64-4.58)	1.76 (0.63-4.93)
Glycemia
Normal	1			1	1
High	2.29 (1.23-4.27)			2.70 (1.32-5.55)	3.09 (1.33-7.14)

Faculdade de Medicina / USP Rua Dr Ovídio Pires de Campos, 225 - 6 and., 05403-010 São Paulo SP - Brazil, Tel.: (55 11) 2661-6235 - São Paulo - SP - Brazil
E-mail: clinics@hc.fm.usp.br

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[1] *Corresponding author. E-mail: glauciacampos@ig.com.br