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Prevalence of sarcopenic obesity and association with metabolic syndrome in an adult Iranian cohort: The Fasa PERSIAN cohort study

Lookup NU author(s): Dr Mario Siervo, Dr Sofia Rubele, Dr Oliver Shannon, Dr Carla Prado, Professor Lorenzo Donini



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Wiley-Blackwell Publishing Ltd, 2021.

For re-use rights please refer to the publisher's terms and conditions.


Sarcopenic obesity (SO) is characterised by a concomitant high fat mass (FM) and low fat free mass (FFM) leading to an increased cardio-metabolic risk. This analysis aims to estimate the SO prevalence in Iranian adults and evaluate the association of SO with metabolic syndrome (MetS) risk. This cross-sectional analysis included 4296 subjects (age 35-70 years, 55.2% females). Body composition parameters, measured by bioelectrical impedance included: FM, FFM, appendicular lean mass (ALM) and skeletal mass index. SO was classified according to five criteria: (1) FM%-SMI; (2) FM%-ALM/% weight (wt%); (3) FM%-ALM/body mass index (BMI); (4) Residuals of ALM and FM and (5) FM/FFM Ratio. Multivariate logistic regression was applied to explore the association between SO models with MetS risk stratified by gender. Receiving operating characteristic (ROC) curves were used to identify the best FM/FFM ratio cut-off value for detecting MetS cases in males and females. The prevalence of SO varied between 4% and 26% depending upon the classification method. The prevalence of MetS was 12.8% and 31.6% in males and females, respectively. SO models based on ALM/wt% and FM/FFM ratio showed the strongest association with MetS risk in males (OR: 11.5, 95%CI: 7.5-17.7, p < 0.001 and OR: 10.1, 95%CI: 6.9-14.7, p < 0.001, respectively) and females (OR: 4.1, 95%CI: 3.0-5.6, p < 0.001 and OR: 4.6, 95%CI: 3.5-5.9, p < 0.001, respectively). SO is a prevalent condition in an adult Iranian population and the ALM/wt% and the FM/FFM ratio models of SO appeared to be associated with higher MetS risk.

Publication metadata

Author(s): Siervo M, Rubele S, Shannon OM, Prado CM, Donini LM, Zamboni M, Homayounfar R, Farjam M, Faghih S, Mazidi M

Publication type: Article

Publication status: Published

Journal: Clinical Obesity

Year: 2021

Volume: 11

Issue: 4

Print publication date: 01/08/2021

Online publication date: 04/05/2021

Acceptance date: 18/04/2021

Date deposited: 25/06/2021

ISSN (print): 1758-8103

ISSN (electronic): 1758-8111

Publisher: Wiley-Blackwell Publishing Ltd


DOI: 10.1111/cob.12459

PubMed id: 33946126


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