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Original Study
Association of Sarcopenia and Obesity With Multimorbidity in Korean Adults: A Nationwide Cross-Sectional Study

https://doi.org/10.1016/j.jamda.2016.07.005Get rights and content

Abstract

Objectives

Age-related muscle loss (sarcopenia) and increased fat mass (obesity) may contribute to chronic disease. Multimorbidity needs more complex health care and is associated with an elevated risk of mortality, disability, and poor quality of life. Sarcopenia and obesity together may be more closely associated with multimorbidity than either sarcopenia or obesity alone. However, a possible multimorbidity link with sarcopenic obesity is unknown. Thus, we aimed to investigate the association of sarcopenic obesity and multimorbidity in Korean adults.

Design/Setting

A nationwide cross-sectional study based on data from Korea National Health and Nutritional Examination Survey, 2008 to 2011.

Participants

Study participants included 10,118 adults aged ≥40 years.

Measurements

Skeletal muscle mass was measured using dual energy x-ray absorptiometry. Sarcopenia was defined as 1 standard deviation below the mean using the skeletal muscle mass index based on a young population reference group. Obesity was defined using the waist circumference sex-specific cutoff point for Asians.

Results

When examined individually, there was a significant association of sarcopenia [odds ratio (OR): 1.49, 95% confidence interval (CI): 1.31–1.70] and obesity (OR: 1.63, 95% CI: 1.45–1.84) with the risk of multimorbidity after being adjusted for potential covariates. When examined as sarcopenia and obesity combined, a greater increase in the risk of multimorbidity was found (OR: 3.0, 95% CI: 2.60–3.40) compared with either sarcopenia (OR: 1.50, 95% CI: 1.18–1.77) or obesity (OR: 1.80, 95% CI: 1.39–2.30) alone.

Conclusions

In conclusion, we found that sarcopenia and obesity are independently associated with the risk of multimorbidity, but with these conditions combined, sarcopenic obesity has a greater risk of multimorbidity.

Section snippets

Participants

In this nationwide cross-sectional study, we used the database from the Korea National Health and Nutritional Examination Survey (KNHANES) 2008 to 2011. The KNHANES is a series of cross-sectional surveys with nationally representative samples from the civilian, non-institutionalized, South Korean population, using a stratified and multistage probability cluster design.16, 17 The present study was restricted to participants aged ≥20 years who completed the health examination, including whole

Results

The participant's characteristics are shown in Table 1. The mean age was 54.8 (SE, 0.2) years and of the ASM index was 28.4% (SE, 0.1). Overall, 39.2% had hypertension, 2.6% had CVD, 2.1% had stroke, 12.5% had diabetes, 14.9% had arthritis, 12.7% had lung disease, 2.2% had cancer, and 14.8% had depression. Moreover, 26.9% had multimorbidity defined as 2 or more chronic diseases.

Table 2 shows the characteristics of participants classified according to whether they had sarcopenia, obesity, or

Discussion

Our results suggest that both sarcopenia and obesity contribute independently to increased risk of multimorbidity. In addition, we found that the greatest increased risk of multimorbidity was in the combined sarcopenic obesity group compared with either of the individual conditions. The risk of multimorbidity in sarcopenic obesity was 3.0 times higher compared with the nonsarcopenic and nonobese (normal) group. The estimated size of the sarcopenic obesity effect was greater than the estimated

Conclusion

In conclusion, the association between sarcopenia and/or obesity and multimorbidity was investigated in Korean adults. Our findings suggest that both objectively measured sarcopenia and abdominal obesity are associated with increased risk of multimorbidity independently of potential confounding factors. Moreover, sarcopenic obesity showed a greater risk of multimorbidity than sarcopenia or obesity alone. To examine the causal association from our findings, further longitudinal studies may be

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    The present study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Korea Ministry of Education (grant number: 2014R1A1A2059106).

    The authors declare no conflicts of interest.

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