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Sarcopenic obesity and overall mortality: Results from the application of novel models of body composition phenotypes to the National Health and Nutrition Examination Survey 1999–2004

Lookup NU author(s): Carla van Aller, Professor Bloss Stephan, Professor Lorenzo Donini, Dr Carla Prado, Dr Mario Siervo


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© 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism Background/Objectives: There is no consensus on the definition of sarcopenic obesity (SO), resulting in inconsistent associations of SO with mortality risk. We aim to evaluate association of dual energy x-ray absorptiometry (DXA) SO models with mortality risk in a US adult population (≥50 years). Subjects/Methods: The study population consisted of 3577 participants aged 50 years and older from the 1999–2004 National Health and Nutrition and Examination Survey with mortality follow-up data through December 31, 2011. Difference in survival time in people with and without SO defined by three body composition DXA models (Model 1: body composition phenotype model; Model 2: Truncal Fat Mass (TrFM)/Appendicular Skeletal Muscle Mass (ASM) ratio model; Model 3: Fat Mass (FM)/Fat Free Mass (FFM) ratio). The differences between the models were assessed by the acceleration failure time model, and expressed as time ratios (TR). Results: Participants age 50–70 years with SO had a significantly decreased survival time, according to the body composition phenotype model (TR: 0.92; 95% CI: 0.87–0.97), and TrFM/ASM ratio model (TR: 0.88; 95% CI: 0.81–0.95). The FM/FFM ratio model did not detect significant differences in survival time. Participants with SO aged 70 years and older did not have a significantly decreased survival time, according to all three models. Conclusions: A SO phenotype increases mortality risk in people of age 50–70 years, but not in people aged 70 years and older. The application of the body composition phenotype and the TrFM/ASM ratio models may represent useful diagnostic approaches to improve the prediction of disease and mortality risk.

Publication metadata

Author(s): Van Aller C, Lara J, Stephan BCM, Donini LM, Heymsfield S, Katzmarzyk PT, Wells JCK, Prado CM, Siervo M

Publication type: Article

Publication status: Published

Journal: Clinical Nutrition

Year: 2019

Volume: 38

Issue: 1

Pages: 264-270

Print publication date: 01/02/2019

Online publication date: 15/02/2018

Acceptance date: 12/01/2018

ISSN (print): 0261-5614

ISSN (electronic): 1532-1983

Publisher: Elsevier


DOI: 10.1016/j.clnu.2018.01.022


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