Association of anthropometric measures with fat and fat-free mass in the elderly: The Rotterdam study.

The decrease in fat-free mass (FFM) seen in many elderly people is usually associated with an increase in fat mass (FM), a state referred to as sarcopenic obesity. It is not clear which anthropometric measures are best used to identify sarcopenic obesity. We therefore evaluated which anthropometric measures are differentially associated with FM and FFM. The anthropometric measures tested were body mass index (BMI), waist circumference (WC), and a body shape index (ABSI = WC/(BMI(2/3)*Height(1/2))). FM and FFM were estimated by dual-energy X-ray absorptiometry. An index-score was calculated for both FM (FMI) and FFM (FFMI) by dividing FM and FFM by height. Multivariable linear regression models were used to assess the associations of BMI, WC and ABSI with FMI and FFMI among 3612 participants (2092 women) from the prospective population-based Rotterdam Study. In multivariate models adjusted for confounders, BMI and WC were positively associated with both FMI and FFMI in men and women. ABSI was positively associated with FMI (β 1.01, 95% confidence interval (95%CI) 0.85, 1.17) and negatively associated with FFMI (β -0.28, 95%CI -0.38, -0.17) in men. In women, ABSI was not associated with FMI and was positively associated with FFMI (β 0.18, 95%CI 0.10, 0.26). While BMI and WC were both positively associated with FM and FFM, ABSI showed a differential association with FM and FFM in men, but not in women. Since sarcopenic obesity is associated with decreased FFM and increased FM, ABSI could be a useful tool for identifying men at higher risk of sarcopenic obesity.

Dhana K ，Koolhaas CM ，Schoufour JD ，Rivadeneira F ，Hofman A ，Kavousi M ，Franco OH ... -  《-》

Identification of sarcopenic obesity in adults undergoing orthopaedic surgery: Relationship between "a body shape index" (ABSI) and fat-free mass. A cross -sectional study.

Tomažič A ，Žvanut B ，Grbac LV ，Jurdana M ... -  《PLoS One》

Inverse relationship between "a body shape index" (ABSI) and fat-free mass in women and men: Insights into mechanisms of sarcopenic obesity.

Sarcopenic obesity may be defined by a high fat to fat-free mass (FM/FFM) ratio. Skeletal muscle may be negatively influenced by the pro-inflammatory milieu associated with visceral fat, while the loading effect induced by a heavier body mass index (BMI) may enhance muscle anabolism. Recently, a new anthropometric measure based on waist circumference (A Body Shape Index, ABSI) was developed. In this study we have assessed the predictive power of ABSI on the FFM index (FFMI), a surrogate marker of lean mass. Standard anthropometric parameters and ABSI as well as body composition data (fat and fat-free mass determined by bioelectrical impedance analysis) were assessed in 111 female and 89 male overweight/obese subjects, with no clinically significant co-morbidities. Groups with higher- or lower-ABSI were identified according to median values of this index. In women and men, ABSI did not correlate with BMI, while multiple linear regression indicated that BMI (β-coefficients: 0.62 and 0.77, respectively) and ABSI (β-coefficients: -0.26 and -0.22, respectively) independently predicted FFMI (multiple R: 0.72 and 0.83, respectively, P < 0.001). Men and women with lower-ABSI exhibited significantly greater FFMI than the higher-ABSI groups for comparable values of BMI. In men, ABSI was correlated positively with C-reactive protein (CRP) (R = 0.30; P < 0.05) and negatively with the reciprocal of insulin (R = 0.28; P < 0.05), an index of insulin sensitivity. FM/FFM ratio significantly (P < 0.01) correlated with CRP (R = 0.31) in women only. ABSI, a recently introduced marker of abdominal adiposity, may contribute to define the risk of sarcopenia in overweight/obese individuals.

Biolo G ，Di Girolamo FG ，Breglia A ，Chiuc M ，Baglio V ，Vinci P ，Toigo G ，Lucchin L ，Jurdana M ，Pražnikar ZJ ，Petelin A ，Mazzucco S ，Situlin R ... -  《-》

Relationship of Fat Mass Index and Fat Free Mass Index With Body Mass Index and Association With Function, Cognition and Sarcopenia in Pre-Frail Older Adults.

Body mass index (BMI) is an inadequate marker of obesity, and cannot distinguish between fat mass, fat free mass and distribution of adipose tissue. The purpose of this study was twofold. First, to assess cross-sectional relationship of BMI with fat mass index (FMI), fat free mass index (FFMI) and ratio of fat mass to fat free mass (FM/FFM). Second, to study the association of FMI, FFMI and FM/FFM with physical function including sarcopenia, and cognition in pre-frail older adults. Cross-sectional study of 191 pre-frail participants ≥ 65 years, 57.1% females. Data was collected on demographics, cognition [Montreal Cognitive Assessment (MoCA)], function, frailty, calf circumference, handgrip strength (HGS), short physical performance battery (SPPB) and gait speed. Body composition was measured using InBody S10. FMI, FFMI and FM/FFM were classified into tertiles (T1, T2, T3) with T1 classified as lowest and T3 highest tertile respectively and stratified by BMI. Higher FFMI and lower FM/FFM in the high BMI group were associated with better functional outcomes. Prevalence of low muscle mass was higher in the normal BMI group. FMI and FM/FFM were significantly higher in females and FFMI in males with significant gender differences except for FFMI in ≥ 80 years old. Small calf circumference was significantly less prevalent in the highest tertile of FMI, FM/FMI and FFMI. Prevalence of sarcopenic obesity and low physical function (HGS, gait speed and SPPB scores) were significantly higher in the highest FMI and FM/FFM tertile. Highest FFMI tertile group had higher physical function, higher MoCA scores, lower prevalence of sarcopenic obesity and sarcopenia, After adjustment, highest tertile of FFMI was associated with lower odds of sarcopenia especially in the high BMI group. Highest tertile of FM/FFM was associated with higher odds of sarcopenia. Higher BMI was associated with lower odds of sarcopenia. FFMI and FM/FFM may be a better predictor of functional outcomes in pre-frail older adults than BMI. Cut-off values for healthy BMI values and role of calf circumference as a screening tool for sarcopenia need to be validated in larger population. Health promotion intervention should focus on FFMI increment.

Merchant RA ，Seetharaman S ，Au L ，Wong MWK ，Wong BLL ，Tan LF ，Chen MZ ，Ng SE ，Soong JTY ，Hui RJY ，Kwek SC ，Morley JE ... -  《Frontiers in Endocrinology》

Fat and fat-free mass as important determinants of body composition assessment in relation to sarcopenic obesity.

Fat and fat-free/muscle mass and their ratio reflecting the possible presence of obesity or sarcopenic obesity are important in assessing body composition. The aim of the work was to assess the use of fat and fat-free mass and their ratio in the diagnosis of sarcopenic obesity, as well as correlations with selected anthropometric, somatic and biochemical parameters and indices. The object of the study was a group of 201 women (20-68 aged) randomly selected from the population without the presence of a serious disease or without the use of medication. Body composition was assessed by the MFBIA method (InBody 720). We used the ratio of fat to fat-free mass (FM/FFM) to define sarcopenic obesity. A Biolis 24i Premium biochemical analyzer was used to determine biochemical parameters. Using FM and FFM values and their mutual ratio, we identified women with a healthy body weight (28.9%), obese women (58.2%) and women with sarcopenic obesity (12.9%). Values of anthropometric parameters (body weight, BMI, WC, WHR, WHtR, BAI, FM (kg, %), FMI, VFA, FFM (kg), FFMI, SMM (kg), SMMI, ICW, ECW, TBW, CHC, HC), with the exception of FFM (%), SMM (%) and TBW (%), increased significantly with increasing FM/FFM values, so the highest values were found in subjects with sarcopenic obesity. In the case of biochemical parameters, with increasing FM/FFM values, the values of T-CH, LDL, TAG, GLU, hs-CRP, UA, systolic and diastolic blood pressure also increased, so the highest values were again found in women with sarcopenic obesity. HDL values, on the contrary, decreased. FM/FFM had the strongest positive association with the proportion of fat mass on body weight (r=0.989), then with FMI (r=0.980), FM (r=0.965), VFA (r=0.938), WHtR (r=0.937), BMI (r=0.922), WC (r=0.901. We found the strongest negative association with the proportion of FFM on body weight (r=-0.989), the proportion of total body water (r=-0.988) and the proportion of skeletal muscle mass (r=-0.987). FM/FFM correlates excellently with FM and VFA and can be implemented to diagnose obesity. In order to comprehensively evaluate the state of health and body composition, the proportionality of not only fat, but also fat-free/muscle mass should be analyzed, because it turns out that a negative impact on health and survival is associated not only with an excessive amount of adipose tissue, but also with a lower muscle mass.

Gažarová M ，Bihari M ，Šoltís J 《-》