Abstract：
Many studies support the idea that sarcopenic obesity (SO) could be considered a potential risk factor for negative health outcomes. These results have been inconsistent, and no umbrella reviews exist regarding this topic. Several databases until November 2023 were searched for systematic reviews with meta-analysis of observational studies (cross-sectional, case-control and prospective). For each association, random-effects summary effect sizes with correspondent 95% confidence intervals (CIs) were evaluated using the GRADE tool. Among the 213 papers initially screened, nine systematic reviews with meta-analysis were included, for a total of 384 710 participants. In cross-sectional and case-control studies, 30 different outcomes were analysed, and 18 were statistically significant. In any population addressed in cross-sectional and case-control studies, compared with non-SO, SO increased the prevalence of cognitive impairment (k = 3; odds ratio [OR] = 3.46; 95% CI: 2.24-5.32; high certainty of evidence), coronary artery disease (k = 2; OR = 2.48; 95% CI: 1.85-3.31) and dyslipidaemia (k = 3; OR = 2.50; 95% CI: 1.51-4.15). When compared with sarcopenia or obesity, the results were conflicting. In prospective studies, the association between SO-compared with non-SO-and other negative outcomes was supported by low/very low certainty of evidence and limited to a few conditions. Besides, no comparison with sarcopenia or obesity was provided. Finally, only a few studies have considered muscle function/physical performance in the diagnostic workup. SO could be considered a risk factor only for a few conditions, with the literature mainly based on cross-sectional and case-control studies. Future studies with clear definitions of SO are needed for quantifying the importance of SO-particularly when compared with the presence of only sarcopenia or obesity-and the weight of muscle function/physical performance in its definition.
摘要：
许多研究支持这样的观点，即肌萎缩性肥胖（SO）可以被认为是负面健康结果的潜在风险因素。这些结果不一致，并且没有关于这个主题的总括评论。在2023年11月之前搜索了几个数据库，以进行系统评价，并对观察性研究进行荟萃分析(横截面，病例对照和前瞻性)。对于每个协会，使用GRADE工具评估随机效应汇总效应大小和相应的95%置信区间(CI).在最初筛选的213篇论文中，包括9篇具有荟萃分析的系统综述，共384.710名参与者。在横断面和病例对照研究中，分析了30种不同的结果，和18有统计学意义。在横断面和病例对照研究中涉及的任何人群中，与非SO相比，SO增加了认知障碍的患病率（k=3；比值比[OR]=3.46；95％CI：2.24-5.32；证据的高确定性），冠状动脉疾病(k=2;OR=2.48;95%CI:1.85-3.31)和血脂异常(k=3;OR=2.50;95%CI:1.51-4.15).与肌肉减少症或肥胖相比，结果相互矛盾。在前瞻性研究中,SO-比较与非SO-和其他阴性结局之间的关联得到低/极低确定性证据的支持,并且仅限于少数情况.此外,未提供与肌肉减少症或肥胖的比较.最后,只有少数研究在诊断检查中考虑了肌肉功能/身体表现.只有在少数情况下，SO才能被认为是风险因素，文献主要基于横断面研究和病例对照研究。需要对SO进行明确定义的未来研究来量化SO的重要性-特别是与仅存在肌肉减少症或肥胖症相比时-以及其定义中的肌肉功能/身体表现的重量。
