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Clinical Manifestations and Factors Associated with Osteosarcopenic Obesity Syndrome: A Cross-Sectional Study in Koreans with Obesity

  • Yoo Mee Kim
  • Sunghoon Kim
  • Young Jun Won
  • Se Hwa KimEmail author
Original Research
  • 5 Downloads

Abstract

Demonstrating the clinical consequences of osteosarcopenic obesity (OSO) is complex. This study evaluated clinical manifestations and factors associated with bone and muscle loss in Koreans with obesity. This cross-sectional observational study enrolled Koreans with obesity aged ≥ 50 years from the Korea National Health and Nutrition Examination Survey. Clinical manifestations were compared among four groups: obesity (O), sarcopenic obesity (SO), osteopenic obesity (OO), and OSO. Factors associated with appendicular skeletal muscle mass (ASM) or bone mineral density (BMD) were evaluated. OSO increases with age in both sexes. Men with SO and OSO had increased cardiometabolic diseases and markers, percentages of body fat (BF %), and trunk fat (TF %), and decreased limb fat percentage (LF %). Women with SO and OSO had increased metabolic markers, BF %, and TF % but those with OSO had increased cardiometabolic diseases and lower LF %. Both sexes with OSO had decreased ASM and vitamin D, and higher vitamin D deficiency. BF % was negatively associated with ASM and femur BMD in both sexes. TF % was negatively and LF % was positively associated with ASM in both sexes and with femur BMD in women. Vitamin D was positively associated with femur BMD in men and with ASM and BMD at all sites in women. ASM and BMD were positively associated with each other. Appendicular muscle loss is metabolically significant regardless of bone loss in men; however, appendicular muscle loss with bone loss is metabolically more significant in women. Regional body composition, fat distribution, and vitamin D deficiency were associated with OSO phenotype in both sexes.

Keywords

Appendicular skeletal muscle mass Bone mineral density Body fat Bone loss Muscle loss Osteosarcopenic obesity 

Abbreviations

ALT

Alanine aminotransferase

ASM

Appendicular skeletal muscle mass

AST

Aspartate aminotransferase

BF %

Body fat percentage

BMD

Bone mineral density

BMI

Body mass index

CI

Confidence interval

Cr

Creatinine

CVA

Cerebrovascular accident

DBP

Diastolic blood pressure

DXA

Dual-energy X-ray absorptiometry

FM

Fat mass

H

Hours

HbA1c

Glycated hemoglobin

HDL-C

High-density lipoprotein cholesterol

HL

Hyperlipidemia

HOMA-IR

Homeostasis model assessment of insulin resistance

Ht

Height

HTN

Hypertension

iPTH

Intact parathyroid hormone

KNHANES

Korea National Health and Nutrition Examination Surveys

LDL-C

Low-density lipoprotein cholesterol

LF %

Limb fat percentage

LM

Lean mass

MetS

Metabolic syndrome

MI

Myocardial infarction

Min

Minutes

O

Obesity

OA

Osteoarthritis

OO

Osteopenic obesity

OSO

Osteosarcopenic obesity

SBP

Systolic blood pressure

SD

Standard deviation

SO

Sarcopenic obesity

T-C

Total cholesterol

TF %

Trunk fat percentage

TG

Triglycerides

T2D

Type 2 diabetes

WC

Waist circumference

Wt

Weight

25OHD

25-hydroxyvitamin D

Notes

Acknowledgements

We wish to acknowledge the Korea Centers for Disease Control and Prevention who performed the KNHANES. This work was supported by research fund of Catholic Kwandong University (CKURF-201805490001).

Authors Contributions

YMK and SK set up the study, analyzed the data, and wrote the manuscript. YJW and SHK contributed to the data analysis and reviewed/edited the manuscript. All authors contributed to the interpretation of results, critically revised the manuscript, and approved the final manuscript. SHK was the guarantor.

Compliance with Ethical Standards

Conflict of interest

Yoo Mee Kim, Sunghoon Kim, Young Jun Won, and Se Hwa Kim confirm that they have no conflict of interest related to this study.

Human and Animal Rights and Informed Consent

All procedures on participants were performed in accordance with ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Each participant gave written informed consent.

Supplementary material

223_2019_551_MOESM1_ESM.docx (17 kb)
Supplementary material 1 (DOCX 17 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Yoo Mee Kim
    • 1
    • 2
  • Sunghoon Kim
    • 3
  • Young Jun Won
    • 1
    • 4
  • Se Hwa Kim
    • 1
    • 2
    Email author
  1. 1.Division of Endocrinology and Metabolism, Department of Internal MedicineCatholic Kwandong University College of Medicine, International St. Mary’s HospitalIncheonSouth Korea
  2. 2.Institute for Translational and Clinical ResearchCatholic Kwandong University College of Medicine, International St. Mary’s HospitalIncheonSouth Korea
  3. 3.Department of Obstetrics and GynecologyYonsei University College of MedicineSeoulSouth Korea
  4. 4.Institute for Bio-Medical ConvergenceCatholic Kwandong University College of Medicine, International St. Mary’s HospitalIncheonSouth Korea

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