Yelda ÖZTÜRK, Serdar CEYLAN, Merve GÜNER OYTUN, Arzu OKYAR BAŞ, Meltem KOCA, Mert EŞME, Cafer BALCI, Burcu Balam DOĞU, Mustafa CANKURTARAN, Meltem HALİL

GERİATRİK HASTALARDA YENİ ESPEN/EASO SARKOPENİK OBEZİTE KRİTERLERİNİN DEĞERLENDİRİLMESİ

Giriş: Sarkopenik obezite (SO) prevalansı tüm dünyada artmaktadır. Tanısının konulması ve yönetimi önemlidir. Bu çalışma ayaktan geriatrik polikliniğine başvuran hastalarda sarkopenik obezite prevalansını yeni ESPEN/EASO kriterlerine göre belirlemeyi; ağırlık, boyun karesi ve vücut kütle indeksine (VKİ) göre düzeltilmiş iskelet kası kütlesinin etkisini ayrı ayrı incelemeyi hedefledi. Yöntemler: Bu kesitsel çalışmaya geriatri polikliniğine başvuran 65 yaş ve üstü hastalar dahil edildi. Antropometrik ölçümler, kas kuvveti (Takei dijital kavrama gücü dinamometresi) ve vücut kompozisyonu (Body Stat Quadscan 4000 biyoempedans cihazı) değerlendirildi. İskelet kası kütlesi (İKK); ağırlık (A), VKİ ve boyun karesine göre düzeltildi. Azalmış kas kütlesi, İKK/A, İKK/VKİ ve İKK/boy2 dahil olmak üzere 3 farklı şekilde değerlendirildi. SO prevalansı SO1 (İKK/A), SO2 (İKK/VKİ) ve SO3 (İKK/boy2) olarak verildi. Bulgular: Çalışmaya %62’ si kadın olan 214 yaşlı yetişkin dahil edildi. Artmış VKİ veya bel çevresi ile birlikte pozitif sarkopeni taraması olarak tanımlanan sarkopenik obezite taraması, hastaların %28,5'inde saptandı (n=61). Sarkopenik obezite prevalansı SO1 (İKK/A), SO2 (İKK/VKİ) ve SO3 (İKK/boy2) için sırasıyla %16,4, %15,0 ve %1,9 idi. Sonuç: İskelet kası kütlesi, ağırlık veya VKİ’ye göre düzeltildiğinde sarkopenik obezite prevalansı daha yüksektir. Boyun karesine göre düzeltilen iskelet kası kütlesinin kullanılması, SO prevalansını olduğundan az çıkmasına yol açabilir.

Anahtar Kelimeler:

sarkopenik obezite, obezite, sarkopeni, kas kütlesinde azalma

THE ASSESSMENT OF NEW ESPEN/EASO CRITERIA FOR SARCOPENIC OBESITY IN GERIATRIC OUTPATIENTS

Introduction: The prevalence of sarcopenic obesity (SO) is increasing worldwide. It is important to diagnose and manage it. This study aimed to determine the prevalence of sarcopenic obesity in geriatric outpatients according to the new ESPEN/EASO criteria by investigating the effect of skeletal muscle mass adjusted for weight, height square, and body mass index (BMI), separately. Methods: This cross-sectional study included patients aged 65 years and older, who applied to the geriatric outpatient clinic. Anthropometric measurements, muscle strength (Takei digital grip strength dynamometer), and body composition (Body Stat Quadscan 4000 bioimpedance analyzer) were taken. Skeletal muscle mass (SMM) was adjusted for weight (W), BMI, and height2. Reduced muscle mass was assessed in 3 different ways including SMM/W, SMM/BMI, and SMM/height2. The prevalence of SO were given as SO1 (SMM/W), SO2 (SMM/BMI), and SO3 (SMM/ height2) Results: There were 214 older adults included in the study with a 62% female rate. Sarcopenic obesity screening, defined by the concomitant existence of an elevated BMI or waist circumference, and positive sarcopenia risk was positive in 28.5% (n=61) of patients. The prevalences of sarcopenic obesity were 16.4%, 15.0%, and 1.9% for SO1 (SMM/W), SO2 (SMM/BMI), and SO3 (SMM/ height2) respectively. Conclusion: The prevalence of sarcopenic obesity is higher when skeletal muscle mass is adjusted by weight or BMI. Using skeletal muscle mass adjusted by height2 causes underestimation of SO.

Keywords:

sarcopenic obesity, obesity, sarcopenia, reduced muscle mass,

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1. Malandrino N, Bhat SZ, Alfaraidhy M, Grewal RS, Kalyani RR. Obesity and Aging. Endocrinol Metab Clin North Am 2023;52(2):317-339.
2. Wei S, Nguyen TT, Zhang Y, Ryu D, Gariani K. Sarcopenic obesity: epidemiology, pathophysiology, cardiovascular disease, mortality, and management. Front Endocrinol (Lausanne) 2023;14:1185221.
3. Donini LM, Busetto L, Bischoff SC, et al. Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement. Clin Nutr 2022;41(4):990-1000.
4. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. Jama 1963;185:914-919.
5. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9(3):179-186.
6. Rubenstein LZ, Harker JO, Salvà A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci 2001;56(6):M366-372.
7. Malmstrom TK, Morley JE. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia. J Am Med Dir Assoc 2013;14(8):531-532.
8. Bahat G, Yilmaz O, Kılıç C, Oren MM, Karan MA. Performance of SARC-F in Regard to Sarcopenia Definitions, Muscle Mass and Functional Measures. J Nutr Health Aging 2018;22(8):898-903.
9. Özsürekci C, Balcı C, Kızılarslanoğlu MC, et al. An important problem in an aging country: identifying the frailty via 9 Point Clinical Frailty Scale. Acta Clin Belg 2020;75(3):200-204.
10. Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. Cmaj 2005;173(5):489-495.
11. Deurenberg P, Pietrobelli A, Wang Z, Heymsfield S. Prediction of total body skeletal muscle mass from fat-free mass or intra-cellular water. International Journal of Body Composition Research 2004;2:107-114.
12. Donini LM, Busetto L, Bischoff SC, et al. Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement. Obes Facts 2022;15(3):321-335.
13. Lean ME, Han TS, Morrison CE. Waist circumference as a measure for indicating need for weight management. Bmj 1995;311(6998):158-161.
14. Bahat G, Kilic C, Topcu Y, Aydin K, Karan MA. Fat percentage cutoff values to define obesity and prevalence of sarcopenic obesity in community-dwelling older adults in Turkey. Aging Male 2020;23(5):477-482.
15. Bahat G, Tufan A, Kilic C, et al. Cut-off points for height, weight and body mass index adjusted bioimpedance analysis measurements of muscle mass with use of different threshold definitions. Aging Male 2020;23(5):382-387.
16. Bahat G, Tufan A, Tufan F, et al. Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition. Clin Nutr 2016;35(6):1557-1563.
17. Bahat G, Ozkok S. How to adjust muscle mass while defining sarcopenia component of sarcopenic obesity: is body weight sufficient enough to represent body size? Aging Clin Exp Res 2023;35(3):723-724.
18. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019;48(1):16-31.
19. Bahat G, Kilic C, Ilhan B, Karan MA, Cruz-Jentoft A. Association of different bioimpedanciometry estimations of muscle mass with functional measures. Geriatr Gerontol Int 2019;19(7):593-597.
20. Yang M, Hu M, Zhang Y, et al. Sarcopenic obesity is associated with frailty among community-dwelling older adults: findings from the WCHAT study. BMC Geriatr 2022;22(1):863.