Sarcopenia and obesity

Four body composition phenotypes exist in older adults: normal, sarcopenic, obese, and a combination of sarcopenic and obese. There is no consensus, however, on the definitions and classifications of these phenotypes and their etiology and consequences continue to be debated. The lack of standard definitions, particularly for sarcopenia and sarcopenic obesity, creates challenges for determining prevalence across different populations. The etiology of these phenotypes is multifactorial with complex covariate relationships. This review focuses on the current literature addressing the classification, prevalence, etiology, and correlates of sarcopenia, obesity, and the combination of sarcopenia and obesity, referred to as sarcopenic obesity.     

关注肝病患者肌少症

<正>肝病与营养一直是临床热点问题。近年来,人们对营养状况的关注已不再局限于传统的评判指标,逐渐重视人体成分组成及其功能在疾病发生发展过程中的变化和不良影响。肌少症(sarcopenia)与肝病的关系引人注目。肌少症亦称为肌肉衰减综合征,是指以骨骼肌质量减少、肌力下降和肌功能减退为特征的综合征。该名词由美国Irwin Rosenberg教授于1988年首先命名,其希腊语的词根"sarx"     

Sarcopenia,but not sarcopenic obesity,predicts mortality for older old men: A 3-year prospective cohort study

BackgroundThe prognostic significance of sarcopenia and sarcopenic obesity (SO) among older people remains controversial. The main aim of this study was to evaluate the mortality risk of sarcopenia and SO among men aged 75 years and older in Taiwan.MethodsThis prospective cohort study recruited all residents of the Banciao Veterans Home, a veterans retirement community in Taipei City in northern Taiwan. For all study participants, the demographic profile, comorbid medical conditions, biochemical markers, handgrip strength and gait speed, sarcopenia, SO, and all-cause mortality were collected during a 3-year follow-up period.ResultsIn the study, 680 residents participated. The prevalence of sarcopenia and SO was 60.3% and 19.7%, respectively. During the study period, 140 (20.6%) deaths were identified. The diseased individuals were older, more prone to having diabetes mellitus and sarcopenia, had lower serum levels of total cholesterol and triglycerides, but had no difference in SO. Comparisons between different statuses of SO showed that age; diabetes mellitus; metabolic syndrome; body mass index; waist circumference; handgrip strength; gait speed; systolic blood pressure; fasting plasma glucose; serum levels of total cholesterol, triglyceride, high-density lipoprotein; and mortality were all significantly different between the groups. Sarcopenia [odds ratio (OR), 2.64; 95% confidence interval (C.I.), 1.687–4.135; p < 0.001], diabetes mellitus (OR, 1.70; 95% CI, 1.083–2.267; p = 0.021) were independent risk factors for mortality; whereas the serum level of triglyceride was protective (OR, 0.99; 95% CI, 0.989–0.997; p = 0.001). The Cox proportional hazard model confirmed that sarcopenia was significantly associated with mortality with or without obesity.ConclusionThe mortality risk of sarcopenia significantly outweighed the survival benefits of obesity in old age. The unfavorable impact of SO may eventually result from sarcopenia, but not obesity.     

Alcohol and Metabolic-associated Fatty Liver Disease

The diagnosis of metabolic-associated fatty liver disease is based on the detection of liver steatosis together with the presence of metabolic dysfunction. According to this new definition, the diagnosis of metabolic-associated fatty liver disease is independent of the amount of alcohol consumed. Actually, alcohol and its metabolites have various effects on metabolic-associated abnormalities during the process of alcohol metabolism. Studies have shown improved metabolic function in light to moderate alcohol drinkers. There are several studies focusing on the role of light to moderate alcohol intake on metabolic dysfunction. However, the results from studies are diverse, and the conclusions are often controversial. This review systematically discusses the effects of alcohol consumption, focusing on light to moderate alcohol consumption, obesity, lipid and glucose metabolism, and blood pressure.     

Steatocholecystitis and Fatty Gallbladder Disease

Obesity has become an epidemic worldwide. It is accompanied by a multitude of medical complications including metabolic syndrome. Obesity may lead to fatty infiltration of multiple internal organs including liver, heart, kidney, and pancreas, causing organ dysfunctions. Fatty infiltration leads to chronic inflammation and tissue damage. Fatty infiltration in the liver results in nonalcoholic fatty liver disease, which is increasingly common nowadays. Recent studies in animals and humans indicate that obesity also is associated with fatty infiltration of gallbladder, resulting in cholecystosteatosis. The increased gallbladder lipids include free fatty acids, phospholipids, and triglycerides. Enhanced inflammation with an increased amount of fat in the gallbladder results in an abnormal wall structure and decreased contractility. In support of this notion, a recent experiment on the effect of Ezetimibe, which is a novel drug that inhibits intestinal fat absorption, on fatty gallbladder disease reveals that Ezetimibe can ameliorate cholecystosteatosis and restore in vivo gallbladder contractility. The proportion of cholecystectomies performed for chronic acalculous cholecystitis has increased significantly over the past two decades. An increase in gallbladder fat, which leads to poor gallbladder emptying and biliary symptoms, may partly explain this phenomenon. Although dietary carbohydrates have been demonstrated to be associated with fatty gallbladder disease, other potential modifiable environmental factors are not clear. The pathogenesis and prognosis of fatty gallbladder disease, including steatocholecystitis, and the relations of fatty gallbladder disease to nonalcoholic fatty liver disease, including steatohepatitis, and other components of metabolic syndrome are largely unknown. More research is needed to answer these questions.