A study following more than 5,000 participants for 12 years found that straightforward clinical measurements can help identify sarcopenic obesity without relying on complex imaging methods such as MRI and CT scans.
Researchers from the Federal University of São Carlos (UFSCar) in Brazil, working with scientists from University College London (UCL) in the United Kingdom, have found that having both excess abdominal fat and reduced muscle mass greatly increases the risk of death.
Their analysis showed that people with this combination faced an 83% higher risk of dying compared with individuals who did not have these conditions.
When fat gain and muscle loss collide
When these two problems occur together, they point to a more serious condition known as sarcopenic obesity. This disorder involves a gradual loss of muscle while body fat increases. Diagnosing it can be difficult, yet it has major consequences for older adults. Sarcopenic obesity is associated with declining independence, poorer quality of life, and a higher likelihood of falls and other health complications. The condition is also often linked to frailty syndrome.
”In addition to assessing the risk of death associated with abdominal obesity and low muscle mass, we were able to prove that simple methods can be used to detect sarcopenic obesity. This is important because the lack of consensus on diagnostic criteria for this disease makes it difficult to detect and treat,” says Tiago da Silva Alexandre, a professor in the Department of Gerontology at UFSCar and one of the authors of the study supported by FAPESP. “Thus, our findings allow older adults to have greater access to early interventions, such as nutritional monitoring and physical exercise, ensuring an improvement in quality of life.”
The findings were published in the journal Aging Clinical and Experimental Research and are based on 12 years of follow up involving 5,440 adults aged 50 or older who participated in the English Longitudinal Study of Ageing (ELSA).
Simple measurements can replace complex scans
Sarcopenic obesity is usually identified through advanced medical imaging and body composition tests, including magnetic resonance imaging, computed tomography, electrical bioimpedance, or densitometry. These techniques are capable of measuring body fat levels as well as reductions in muscle mass and function. Despite their precision, they are costly and often limited to specialized medical centers. As a result, diagnosing this condition in everyday clinical practice can be difficult.
“By correlating data from ELSA study participants, we found that simple measures, such as measuring abdominal circumference and estimating lean mass [using a consolidated equation that considers clinical variables such as age, sex, weight, race, and height], showed for the first time that it’s possible to screen these individuals early,” Alexandre celebrates.
The combined condition drives mortality risk
The research also highlighted how the interaction between muscle loss and abdominal fat can intensify metabolic problems. According to the analysis, people who had both conditions faced an 83% greater risk of death compared with those who had neither. Interestingly, the researchers observed that individuals with reduced muscle mass but without abdominal obesity had a 40% lower risk of death.
This contrast suggests that the combination of both factors may be particularly harmful. In addition, people who had abdominal obesity but maintained sufficient muscle mass did not show an increased risk of death.
“The study revealed that individuals with both conditions had an 83% higher risk of death compared to those who didn’t have them. We also found that the risk of death was reduced by 40% among those with low muscle mass and no abdominal obesity, a finding that reinforces the potential danger of the coexistence of the conditions. Interestingly, individuals with abdominal obesity but adequate muscle mass weren’t associated with an increased risk of death,” explains Valdete Regina Guandalini, a professor at the Federal University of Espírito Santo (UFES) and researcher in the Department of Gerontology at UFSCar. She is also the first author of the article.
Guandalini notes that excess body fat can intensify inflammatory processes in the body, triggering metabolic and catabolic changes that worsen muscle deterioration. “In addition to one condition interfering with the other, fat infiltrates the muscle and takes up its space. This systemic and progressive inflammation directly affects muscle tissue, compromising its metabolic, endocrine, immunological, and functional capabilities,” she says.
Defining risk with practical thresholds
Because researchers around the world have not yet agreed on a universal definition for sarcopenic obesity, the study relied on simpler criteria to identify the condition. Abdominal obesity was defined as a waist circumference greater than 102 centimeters for men and 88 centimeters for women.
Low muscle mass was classified as a skeletal muscle mass index below 9.36 kg/m² for men and below 6.73 kg/m² for women. These measurements allowed the team to estimate the risk of sarcopenic obesity using accessible clinical indicators rather than expensive imaging tests.
Reference: “Can simple measures from clinical practice serve as a proxy for sarcopenic obesity and identify mortality risk?” by Valdete Regina Guandalini, Patrícia Silva Tofani, Sara Souza Lima, Letícia Coelho Silveira, Natália Cochar-Soares, Thais Barros Pereira da Silva, Thales Batista de Souza, Mariane Marques Luiz, Paula Camila Ramírez, Roberta de Oliveira Máximo, Andrew Steptoe, Cesar de Oliveira and Tiago da Silva Alexandre, 19 November 2024, Aging Clinical and Experimental Research.
DOI: 10.1007/s40520-024-02866-9
This study was funded by the Economic and Social Research Council (Financing code: ES/T008822/11).
Never miss a breakthrough: Join the SciTechDaily newsletter.
Follow us on Google and Google News.