Sarcopenic obesiy is associated with lower tibial cortical area and thickness and poor physical function in community-dwelling older adults — ASN Events
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Sarcopenic obesiy is associated with lower tibial cortical area and thickness and poor physical function in community-dwelling older adults (#79)

David Scott 1 , Catherine A Shore-Lorenti 1 , Lachlan McMillan 1 , Ross A Clark 2 , Kerrie M Sanders 3 , Gustavo Duque 4 , Peter R Ebeling 1
  1. School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
  2. School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
  3. Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
  4. Department of Medicine-Western Precinct, Melbourne Medical School , The University of Melbourne, St Albans, Victoria, Australia

Objectives: To determine whether bone quality and physical function are compromised in sarcopenic obesity, and whether high intra- and inter-muscular adipose tissue (IMAT) plays a role.

Methods: Eighty-three community-dwelling older adults (mean age 72.8±5.4yrs; 53% women) underwent whole-body DXA to assess appendicular lean mass (ALM), body fat percentage, bone mineral content (BMC) and density (BMD). Peripheral quantitative computed tomography assessed mid-calf muscle and IMAT cross-sectional areas (CSA), and proximal tibial cortical volumetric BMD, area and thickness. Physical function assessments included muscle strength (dynamometry) and postural sway (computerised posturography). Sarcopenia was defined as either low relative ALM or hand grip strength according to the Foundation for the National Institutes of Health definition; obesity was defined as high body fat percentage (≥30% men; ≥40% women).

Results: Seventeen (20.5%) participants were sarcopenic obese. Obese alone and non-sarcopenic non-obese demonstrated better knee extension strength and postural sway than sarcopenic obese (all P<0.05). Non-sarcopenic non-obese and sarcopenic alone (both P<0.05) had significantly lower mid-calf IMAT (relative to muscle CSA) compared with sarcopenic obese, and obese alone also tended to have lower relative IMAT (B=-1.8%; 95% CI -3.7, 0.1; P=0.06). Non-sarcopenic non-obese had significantly greater proximal tibia cortical volumetric BMD (26.3mg/cm3; 3.0, 49.5), and obese alone had greater whole-body BMC (222.8g; 32.3, 413.3) and proximal tibial cortical area (32.6mm2; 5.0, 60.2) and thickness (0.5mm; 0.1, 0.9), than sarcopenic obese. Amongst components of sarcopenic obesity, only ALM was independently and positively associated with proximal tibial cortical area (8.8mm2; 4.6, 13.0) and thickness (0.07mm; 0.01, 0.14). Mid-calf IMAT was the only independent predictor of cortical volumetric BMD (-0.5mg/cm3; -1.04, -0.03).

Conclusions: Sarcopenic obesity is associated with lower proximal tibial cortical volumetric area and thickness, as well as poor muscle strength and balance. Higher amounts of IMAT may contribute to poor bone quality and physical performance in sarcopenic obesity.