背景:肌肉减少症肥胖是老年人的常见病,与过度肥胖和肌肉质量和力量不足有关。
目的:本研究旨在通过特定的生物电阻抗矢量分析(特定的BIVA),建立一种检测肌少症性肥胖个体生物电特征的方法,同时考虑到健康个体的特征,节瘤,和肥胖状况。
方法:样本由居住在撒丁岛(意大利)的915名50岁以上的意大利成年人(男性:74.6±8.8岁;女性:76.3±8.8岁)组成。该研究的最后一步还考虑了从2003-2004年国家健康和营养检查调查中检索的1590名21-49岁美国成年人的数据集。人体测量(身材,体重,腰部,手臂,和小腿周长)和全身生物电变量。在意大利样本中,应用生物电阻抗来估计脂肪量和骨骼肌量的相对含量。具有健康身体成分(NS-NO)的组,或与肌肉减少症(S)一致,肌肉减少性肥胖(S-O),根据欧洲专家指南(EWGSOP2和ESPEN-EASO)建议的界限来定义肥胖(O).特定的BIVA用于比较组,并确定年轻人耐受性椭圆中的肌少症肥胖区域。具有S-O的美国个体的特定载体的位置,根据DXA测量结果选择,也考虑过。
结果:在意大利样本的两种性别中,四组的生物电特性不同(p<0.001)。差异主要与向量长度有关,表明较高的脂肪量,在O和S-O组中更长,和相位角,细胞内/细胞外水和肌肉质量的代表,较低的肌肉减少组。S-O组的生物电矢量落在右象限,在年轻人的95%耐受性椭圆之外。具有S-O的美国样本的平均向量落在同一区域。在S-O区域内,女性有相似的生物电值,虽然男性表现出相角变异性,这与病情的严重程度有关。
结论:特定的BIVA检测到肌少症性肥胖个体的身体成分特性,因此,当与低握力值相关时,可以进行诊断。
Sarcopenic obesity is a common condition in the elderly associated with excessive adiposity and low muscle mass and strength.
This study aims to establish a method for detecting bioelectrical characteristics in individuals with sarcopenic obesity through specific Bioelectrical Impedance Vector Analysis (specific BIVA), while considering the characteristics of individuals with healthy, sarcopenic, and obese conditions.
The sample was composed by 915 Italian adults over 50 years of age (men: 74.6 ± 8.8 y; women:76.3 ± 8.8 y) living in Sardinia (Italy). A dataset of 1590 US adults aged 21 - 49 years retrieved from the 2003 - 2004 National Health and Nutrition Examination Survey was also considered in a final step of the study. Anthropometric (stature, weight, waist, arm, and calf circumferences) and whole-body bioelectrical variables were taken. In the Italian sample, bioelectrical impedance was applied to estimate the relative content of fat mass and skeletal muscle mass. Groups with healthy body composition (NS-NO), or consistent with sarcopenia (S), sarcopenic obesity (S-O), and obesity (O) were defined based on the cut-offs suggested by European expert guidelines (EWGSOP2 and ESPEN-EASO). Specific BIVA was applied to compare groups and to identify the area for sarcopenic obesity within young-adults tolerance ellipses. The position of the specific vector of US individuals with S-O, selected on the basis of DXA measurements, was also considered.
In both sexes of the Italian sample, the bioelectrical characteristics of the four groups were different (p < 0.001). The differences were mainly related to vector length, indicative of higher fat mass, which was longer in the O and S-O groups, and phase angle, a proxy of intracellular/extracellular water and muscle mass, lower in the sarcopenic groups. Bioelectrical vectors of the S-O group fell in the right quadrant, outside of the 95 % tolerance ellipses of young adults. The mean vector of the US sample with S-O fell in the same area. Within the S-O area, women had similar bioelectrical values, while men showed phase angle variability, which was related to the severity of the condition.
Specific BIVA detects body composition peculiarities of individuals with sarcopenic obesity, thus allowing their diagnosis when associated with low handgrip strength values.