Association between bone health and dynapenic obesity in postmenopausal women.

AIM: The combination of dynapenia (age-related muscle weakness) and obesity is referred to as dynapenic obesity. We examined the associations between dynapenic obesity and cortical bone thickness and trabecular bone density. METHODS: The participants were 797 community-dwelling postmenopausal women (with an average age of 62.5 years) who were stratified into normopenia without obesity, dynapenia without obesity (dynapenia), normopenia with obesity (obesity) and dynapenia with obesity (dynapenia obesity) groups based on their grip strength and body fat percentage. Cortical bone thickness and trabecular bone density were measured using ultrasonic bone densitometry. The participants were further divided into those with low cortical bone thickness and low trabecular bone density. Logistic regression analysis was used to identify associated factors. RESULTS: Individuals with dynapenia (odds ratio [OR] 1.77, 95% confidence interval [CI] 1.16-2.68), obesity (OR 2.46, 95% CI 1.62-3.75) and dynapenic obesity (OR 4.07, 95% CI 2.44-6.79) all significantly increased the odds of low cortical bone thickness. Conversely, the odds of low trabecular bone density were significantly lower in the obesity group (OR 0.65, 95% CI 0.43-0.99) and dynapenic obesity group (OR 0.60, 95% CI 0.37-0.97). CONCLUSIONS: Dynapenic obesity was found to be associated with cortical bone thinning that might compromise bone health. Postmenopausal women with dynapenic obesity might need to be closely monitored for preserving bone health. Geriatr Gerontol Int 2024; 24: 378-384.

Dynapenic Abdominal Obesity and Metabolic Health in Non-Geriatric Patients with Obesity.

Background: Dynapenic abdominal obesity (DAO) is the combination of low muscle strength and high central adiposity, which can lead to functional and cardiometabolic impairments. Objective: The aim of this study was to examine the relationship between DAO and metabolic parameters in non-geriatric patients with obesity. Methods: All patients seen in the obesity outpatient clinic during a random month, along with 30 healthy individuals, were included in the study. Body mass index (BMI), waist circumference (WC), hip circumference (HC), serum fasting blood glucose, triglyceride, high-density lipoprotein, low-density lipoprotein (LDL), insulin, and glycated hemoglobin (HbA1c) levels were measured. Muscle function tests were conducted. Hypertension and diabetes mellitus diagnoses were recorded. DAO was determined using handgrip strength and WC. Metabolic syndrome was defined based on International Diabetes Federation (IDF) criteria. Data were analyzed using SPSS. Results: A total of 106 individuals participated in the study, including 76 individuals with obesity as the case group and 30 healthy individuals as the control group. In the case group, BMI, WC, HC, and chair stand test results were higher compared to the control group. There was no significant difference between the case and control groups in terms of gait speed or handgrip test results. In the case group, 30 people (39.5%) had dynapenic obesity (DO), and in the control group, 8 people (26.7%) had DO. There was no significant difference in DO rates between the case and control groups. In the case group, the HbA1c level was higher in DO (+) group than DO (-) group. In the control group, DO (+) group had higher LDL and HbA1c level than DO (-) group. No significant difference was observed in other search parameters between the DO (+) and DO (-) groups in both the case and control groups. Conclusion: DAO is common among people with obesity and contributes to a poor prognosis, increased morbidity, and mortality. Therefore, including its treatment in the management of obesity is crucial for individuals of all age ranges.

Sleep duration affects the sequential change of body mass index and muscle strength: a contribution to dynapenic obesity.

BACKGROUND: With aging, body mass index (BMI) increases and muscle strength declines, resulting in dynapenic obesity. It remains unknown whether and how sleep duration contributes to the sequence of BMI and muscle strength change in the progression of dynapenic obesity. METHODS: Data were derived from the first two waves of China Health and Retirement Longitudinal Study. Sleep duration was self-reported. BMI was calculated and grip strength (GS) was measured to reflect muscle strength. The effect of baseline sleep duration on the sequential change of BMI and GS was assessed using two mediation models considering the nonlinear associations between them. The moderating effect of metabolic disorder was also tested. RESULTS: Totally 4986 participants aged ≥ 50 years (50.8% females) with complete information on variables were included. Baseline BMI fully mediated the nonlinear association between sleep duration and follow-up GS change, but baseline GS did not mediate between sleep duration and follow-up BMI change for older men and women. Short sleep duration positively affected BMI-induced GS change (ß = 0.038; 95%CI, 0.015-0.074), while this favorable effect became nonsignificant for moderate sleep duration (ß = 0.008; 95% CI, -0.003-0.024) and turned negative with prolonged sleep duration (ß = - 0.022; 95%CI, - 0.051 to - 0.003). This nonlinear mediation effect was more pronounced in older women who are relatively metabolically healthy at baseline. CONCLUSION: For older adults in China, the influence of sleep duration on BMI-induced GS change but not the GS-induced BMI change suggested the contribution of sleep duration to the sequential course in the progression of dynapenic obesity. Sleep duration deviated either above or below normal range may confer adverse impact on GS through BMI. Strategies addressing sleep and obesity jointly to improve muscle function and delay the progression of dynapenic obesity are required.

Associations of Dynapenic Obesity and Sarcopenic Obesity with the Risk of Complications in COVID-19.

Ageing is associated with changes in body composition, such as low muscle mass (sarcopenia), decreased grip strength or physical function (dynapenia), and accumulation of fat mass. When the accumulation of fat mass synergistically accompanies low muscle mass or reduced grip strength, it results in sarcopenic obesity and dynapenic obesity, respectively. These types of obesity contribute to the increased risk of cardiovascular disease and mortality in the elderly, which could increase the damage caused by COVID-19. In this review, we associated factors that could generate a higher risk of COVID-19 complications in dynapenic obesity and sarcopenic obesity. For example, skeletal muscle regulates the expression of inflammatory cytokines and supports metabolic stress in pulmonary disease; hence, the presence of dynapenic obesity or sarcopenic obesity could be related to a poor prognosis in COVID-19 patients.

Slow gait speed is associated with dynapenic obesity in Mexican ambulatory older adults.

An increased risk of slow gait speed (GS) has been reported among older adults with decreased muscle strength, coupled with a concomitant increase in body fat known as dynapenic obesity (DO); however, these two conditions together have rarely been studied. The objective of this study was to determine the association between GS and DO in older Mexican ambulatory adults. A cross-sectional study was conducted; body fat percentage, and muscle strength and GS using EWGSOP criteria, were measured in 126 older ambulatory Mexican adults, with a mean age of 71 years old. The association was evaluated using controlled logistic regression models. Among ambulatory older adults with slow GS, the risk of DO was 3.4 times higher than among those without, controlling for age and sex (p<0.01). In conclusion, slow GS in ambulatory older adults can be a useful indicator for the early identification of DO.

Dynapenic obesity as an associated factor to lipid and glucose metabolism disorders and metabolic syndrome in older adults - Findings from SABE Study.

BACKGROUND & AIMS: There is little evidence showing that dynapenic obesity is associated with lipid and glucose metabolism disorders, high blood pressure, chronic disease and metabolic syndrome. Our aim was to analyze whether dynapenic abdominal obesity can be associated with lipid and glucose metabolism disorders, high blood pressure, metabolic syndrome and cardiovascular diseases in older adults living in São Paulo. METHODS: This cross-sectional study included 833 older adults who took part of the third wave of the Health, Well-being and Aging Study in 2010. Based on waist circumference (>88 cm women and >102 cm men) and handgrip strength (<16 kg women and <26 kg men), four groups were identified: non-dynapenic/non-abdominal obese (ND/NAO), abdominal obese alone (AOA), dynapenic alone (DA) and dynapenic/abdominal obese (D/AO). Dependent variables were blood pressure, lipid profile, fasting glucose and glycated-haemoglobin, metabolic syndrome and cardiovascular diseases. Logistic regression was used to analyze the associations between dynapenia and abdominal obesity status and lipid and glucose metabolic profiles, blood pressure, cardiovascular diseases and metabolic syndrome. RESULTS: The fully adjusted models showed that D/AO individuals had higher prevalence of low HDL plasma concentrations (OR = 2.51, 95%CI: 1.40-4.48), hypertriglyceridemia (OR = 2.53, 95%CI: 1.43-4.47), hyperglycemia (OR = 2.05, 95%CI: 1.14-3.69), high glycated-haemoglobin concentrations (OR = 1.84, 95%CI: 1.03-3.30) and metabolic syndrome (OR = 12.39, 95%CI: 7.38-20.79) than ND/NAO. Dynapenic and D/AO individuals had higher prevalence of heart disease (OR = 2.05, 95%CI: 1.17-3.59 and OR = 1.92, 95%CI: 1.06-3.48, respectively) than ND/NAO. CONCLUSION: D/AO was associated with high prevalence of lipid and glucose metabolism disorders and metabolic syndrome while dynapenia and D/AO were associated with high prevalence of heart disease.

Prevalence of dynapenic obesity and sarcopenic obesity and their associations with cardiovascular disease risk factors in peritoneal dialysis patients.

BACKGROUND: Dynapenic obesity and sarcopenic obesity increase cardiovascular disease (CVD) and mortality in nonuremic patients. The present study was designed to determine the prevalence of dynapenic obesity and sarcopenic obesity and their associations with CVD risk factors in peritoneal dialysis (PD) patients. METHODS: All eligible PD patients in Tehran peritoneal dialysis centers were included in this cross-sectional study. Skeletal muscle mass and fat mass were assessed using bioelectrical impedance analysis. Muscle strength and physical performance were determined using hand grip strength and a 4-meter walk gait speed test, respectively. In addition, a 5-mL blood sample was obtained from each patient. RESULTS: The prevalence of dynapenic obesity and sarcopenic obesity were 11.4% and 3.8% in PD patients, respectively. Serum high-sensitive C-reactive protein (hs-CRP), soluble intercellular adhesion molecule type 1, triglyceride, total cholesterol, and low-density lipoprotein cholesterol were significantly higher in PD patients with dynapenic obesity than in dynapenic nonobese and nondynapenic nonobese patients. Similarly, serum concentrations of CVD risk factors in PD patients with sarcopenic obesity were higher than in nonsarcopenic nonobese patients, but these differences were statistically significant only for serum hs-CRP and triglyceride. In addition, muscle strength and skeletal muscle mass percentage were negatively associated with markers of inflammation and dyslipidemia, whereas body fat percentage was positively associated with these CVD risk factors. CONCLUSION: This study indicates that although the prevalence of dynapenic obesity and sarcopenic obesity are relatively low in PD patients, these disorders may be associated with CVD risk factors.

Prevalence of dynapenic obesity and sarcopenic obesity and their associations with cardiovascular disease risk factors in peritoneal dialysis patients

BACKGROUND: Dynapenic obesity and sarcopenic obesity increase cardiovascular disease (CVD) and mortality in nonuremic patients. The present study was designed to determine the prevalence of dynapenic obesity and sarcopenic obesity and their associations with CVD risk factors in peritoneal dialysis (PD) patients. METHODS: All eligible PD patients in Tehran peritoneal dialysis centers were included in this cross-sectional study. Skeletal muscle mass and fat mass were assessed using bioelectrical impedance analysis. Muscle strength and physical performance were determined using hand grip strength and a 4-meter walk gait speed test, respectively. In addition, a 5-mL blood sample was obtained from each patient. RESULTS: The prevalence of dynapenic obesity and sarcopenic obesity were 11.4% and 3.8% in PD patients, respectively. Serum high-sensitive C-reactive protein (hs-CRP), soluble intercellular adhesion molecule type 1, triglyceride, total cholesterol, and low-density lipoprotein cholesterol were significantly higher in PD patients with dynapenic obesity than in dynapenic nonobese and nondynapenic nonobese patients. Similarly, serum concentrations of CVD risk factors in PD patients with sarcopenic obesity were higher than in nonsarcopenic nonobese patients, but these differences were statistically significant only for serum hs-CRP and triglyceride. In addition, muscle strength and skeletal muscle mass percentage were negatively associated with markers of inflammation and dyslipidemia, whereas body fat percentage was positively associated with these CVD risk factors. CONCLUSION: This study indicates that although the prevalence of dynapenic obesity and sarcopenic obesity are relatively low in PD patients, these disorders may be associated with CVD risk factors.

Influence of Protein Intake, Race, and Age on Responses to a Weight-Reduction Intervention in Obese Women.

BACKGROUND: Women have higher rates of obesity than men and develop more pronounced functional deficits as a result. Yet, little is known about how obesity reduction affects their functional status, including whether their responses differ when protein intake is enhanced. OBJECTIVE: The aim of this study was to confirm the feasibility of delivery of a higher-protein (balanced at each meal) calorie-restricted diet in obese women and determine its efficacy for influencing function and retention of lean mass. METHOD: Obese community-dwelling women [n = 80; body mass index (in kg/m2), in means ± SDs: 37.8 ± 5.9; aged 45-78 y; 58.8% white] were enrolled in a weight-loss (-500 kcal/d) study and randomly assigned to either a Control-Weight-Loss (C-WL; 0.8 g protein/kg body weight) group or a High-Protein-Weight-Loss (HP-WL; 1.2 g protein/kg body weight; 30 g protein 3 times/d) group in a 1:2 allocation. Primary outcomes were function by 6-min walk test (6MWT) and lean mass by using the BodPod (Life Measurement, Inc.) at 0, 4, and 6 mo. RESULTS: Both groups reduced calorie intakes and body weights (P < 0.001), and the feasibility of the HP-WL intervention was confirmed. The 6MWT results improved (P < 0.01) at 4 mo in the HP-WL group and at 6 mo in both groups (P < 0.001). Both groups improved function by several other measures while slightly decreasing (P < 0.01) lean mass (-1.0 kg, C-WL; -0.6 kg, HP-WL). Weight loss was greater in white than in black women at both 4 mo (6.0 ± 3.6 compared with 3.7 ± 3.4 kg; P < 0.02) and 6 mo (7.2 ± 4.8 compared with 4.0 ± 4.7 kg; P < 0.04) and tended to be positively related to age (P < 0.06). CONCLUSIONS: A clinically important functional benefit of obesity reduction was confirmed in both study groups, with no significant group effect. Our findings of racial differences in response to the intervention and a potential influence of participant age lend support for further studies sufficiently powered to explore the interaction of race and age with functional responses to obesity reduction in women. This trial was registered at clinicaltrials.gov as NCT02033655.

Dynapenic obesity and lower extremity function in elderly adults.

OBJECTIVES: Little is known about the relationship between dynapenic obesity and physical function in older Asian populations. This study aimed to examine the relationship of dynapenic obesity and lower extremity function in Chinese elderly adults. METHODS: Data were from a cross-sectional study (n = 616). Based on the World Health Organization Asian Criteria of Obesity and handgrip strength tertiles, 4 independent groups were classified as follows: nondynapenia/nonobesity, dynapenia-alone, obesity-alone, and dynapenic obesity. Lower extremity function was evaluated with a 20-meter gait speed test, balance test, and self-reported mobility disability. RESULTS: Compared with the dynapenic obesity group, the adjusted odds ratios (ORs) and 95% confidential intervals (CIs) for slow gait speed in men were 0.55 (0.27-0.86) in the nondynapenia/nonobesity group, 0.78 (0.31-0.96) in the dynapenia-alone group, and 0.86 (0.16-0.95) in the obesity-alone group. The corresponding ORs (95% CIs) in women were 0.46 (0.27-0.71), 0.80 (0.17-0.93), and 0.73 (0.15-0.91), respectively. Compared with the dynapenic obesity group, the adjusted ORs (95% CIs) for mobility disability in men were 0.41 (0.26-0.62) in the nondynapenia/nonobesity group, 0.61 (0.16-0.85) in the dynapenia-alone group, and 0.72 (0.28-0.88) in the obesity-alone group. The corresponding ORs (95% CIs) in women were 0.37 (0.17-0.81), 0.51 (0.27-0.96), and 0.53 (0.26-0.83), respectively. No significant difference was observed among the 4 groups with respect to the balance test score in both sexes (P < .01). CONCLUSIONS: Dynapenic obesity was associated with a greater risk of slow gait speed and mobility disability compared with dynapenia-alone or obesity-alone.

Disability associated with obesity, dynapenia and dynapenic-obesity in Chinese older adults.

OBJECTIVES: Whether the combination of obesity and low muscle strength (dynapenic-obesity) would cause greater impairment of the activities of daily living (ADL)/instrumental activities of daily living (IADL) than obesity alone and low muscle strength alone (dynapenia) remains unclear. The aim of this study was to reveal the possible independent and additive effects of dynapenia and obesity on ADL/IADL disability in an older Chinese population. METHODS: A cross-sectional study, including 616 community-dwelling older adults, was conducted in China from 2010 to 2012. Based on the World Health Organization Asian Criteria of Obesity and handgrip strength tertiles, 4 independent groups were identified as follows: nondynapenia/nonobesity, dynapenia alone, obesity alone, and dynapenic-obesity. The Katz Index of Independence in ADL was used to assess ADL disability, whereas 6 IADL items of the Older Americans Resources and Services (OARS) multidimensional functional assessment questionnaire were used to assess IADL disability. RESULTS: The prevalence of ADL and IADL disability was 21.1% and 28.9% in the dynapenic-obesity group, 15.5% and 22.6% in the dynapenia alone group, 13.1% and 19.6% in the obesity alone group, and 11.9% and 12.9% in the nondynapenia/nonobesity group, respectively. After adjusting for the covariates, in comparison with the dynapenic-obesity group, the adjusted odds ratios (95% confidence interval) for ADL disability were 0.36 (0.13-0.73) in the nondynapenia/nonobesity group, 0.51 (0.20-0.78) in the dynapenia-alone group, and 0.40 (0.11-0.61) in the obesity-alone group. The corresponding data for IADL disability were 0.55 (0.20-0.93), 0.82 (0.39-0.98), and 0.61 (0.30-0.91), respectively. CONCLUSION: Dynapenia, obesity, and dynapenic-obesity were associated with an increased risk of ADL/IADL disability. Dynapenic-obesity was associated with a greater risk of ADL/IADL disability in comparison with dynapenia or obesity alone.