Eric S Orwoll1, Katherine E Peters2, Marc Hellerstein3, Steven R Cummings4,5, William J Evans3,6, Peggy M Cawthon4,7. 1. Oregon Health and Science University, Portland. 2. San Francisco Coordinating Center, California. 3. Department of Nutritional Sciences and Toxicology, University of California, Berkeley. 4. Research Institute, California Pacific Medical Center, San Francisco. 5. Departments of Medicine, Epidemiology and Biostatistics, University of California, San Francisco. 6. Duke University Medical Center, Durham, North Carolina. 7. Department of Epidemiology and Biostatistics, University of California, San Francisco.
Abstract
BACKGROUND: The combination of sarcopenia and obesity has been associated with physical impairment in older people. However, previous research has relied on assessments of lean mass as a surrogate for muscle mass. We postulate that inaccurate measures of muscle mass may have obscured the role of obesity in sarcopenia and related outcomes. Our aim was to clarify the interactions of muscle and fat with physical performance and adverse outcomes using an accurate measure of muscle mass. METHODS: In a longitudinal study of >1,300 older men (mean age 84 years), we compared a direct measurement of muscle mass (D3 creatine dilution; D3Cr) with an approximation of muscle mass (appendicular lean mass [ALM] by dual-energy x-ray absorptiometry [DXA]) and their associations with measures of physical performance (gait speed, chair stand time) and adverse outcomes (incident injurious falls and mobility problems). We measured percent fat mass by DXA. RESULTS: Low D3Cr muscle mass was strongly associated with decreased performance and increased risk of adverse outcomes. Increased fat mass had little association after accounting for D3Cr muscle mass. In contrast, DXA ALM was minimally associated with performance or adverse outcomes, and fatness remained associated with both outcomes after accounting for DXA ALM. CONCLUSIONS: When an accurate assessment of muscle mass (rather than lean mass) is used, reduced muscle mass is highly associated with important outcomes and the negative effects of adiposity are minimal, suggesting that obesity has little relevance for the understanding of important adverse health outcomes of sarcopenia in older men.
BACKGROUND: The combination of sarcopenia and obesity has been associated with physical impairment in older people. However, previous research has relied on assessments of lean mass as a surrogate for muscle mass. We postulate that inaccurate measures of muscle mass may have obscured the role of obesity in sarcopenia and related outcomes. Our aim was to clarify the interactions of muscle and fat with physical performance and adverse outcomes using an accurate measure of muscle mass. METHODS: In a longitudinal study of >1,300 older men (mean age 84 years), we compared a direct measurement of muscle mass (D3 creatine dilution; D3Cr) with an approximation of muscle mass (appendicular lean mass [ALM] by dual-energy x-ray absorptiometry [DXA]) and their associations with measures of physical performance (gait speed, chair stand time) and adverse outcomes (incident injurious falls and mobility problems). We measured percent fat mass by DXA. RESULTS: Low D3Cr muscle mass was strongly associated with decreased performance and increased risk of adverse outcomes. Increased fat mass had little association after accounting for D3Cr muscle mass. In contrast, DXA ALM was minimally associated with performance or adverse outcomes, and fatness remained associated with both outcomes after accounting for DXA ALM. CONCLUSIONS: When an accurate assessment of muscle mass (rather than lean mass) is used, reduced muscle mass is highly associated with important outcomes and the negative effects of adiposity are minimal, suggesting that obesity has little relevance for the understanding of important adverse health outcomes of sarcopenia in older men.
Authors: Stephen A Stimpson; Scott M Turner; Lisa G Clifton; James C Poole; Hussein A Mohammed; Todd W Shearer; Greg M Waitt; Laura L Hagerty; Katja S Remlinger; Marc K Hellerstein; William J Evans Journal: J Appl Physiol (1985) Date: 2012-03-15
Authors: William J Evans; Marc Hellerstein; Eric Orwoll; Steve Cummings; Peggy M Cawthon Journal: J Cachexia Sarcopenia Muscle Date: 2019-03-21 Impact factor: 12.910
Authors: Jesse Zanker; Terri Blackwell; Sheena Patel; Kate Duchowny; Sharon Brennan-Olsen; Steven R Cummings; William J Evans; Eric S Orwoll; David Scott; Sara Vogrin; Gustavo Duque; Peggy M Cawthon Journal: Exp Gerontol Date: 2022-01-29 Impact factor: 4.032
Authors: Eric S Orwoll; Terri Blackwell; Steven R Cummings; Jane A Cauley; Nancy E Lane; Andrew R Hoffman; Andrew J Burghardt; William J Evans; Peggy M Cawthon Journal: J Gerontol A Biol Sci Med Sci Date: 2022-04-01 Impact factor: 6.591
Authors: Sarah A Purcell; Michelle Mackenzie; Thiago G Barbosa-Silva; Isabelle J Dionne; Sunita Ghosh; Mario Siervo; Ming Ye; Carla M Prado Journal: Front Physiol Date: 2021-01-21 Impact factor: 4.566
Authors: Everson A Nunes; Lauren Colenso-Semple; Sean R McKellar; Thomas Yau; Muhammad Usman Ali; Donna Fitzpatrick-Lewis; Diana Sherifali; Claire Gaudichon; Daniel Tomé; Philip J Atherton; Maria Camprubi Robles; Sandra Naranjo-Modad; Michelle Braun; Francesco Landi; Stuart M Phillips Journal: J Cachexia Sarcopenia Muscle Date: 2022-02-20 Impact factor: 12.910
Authors: Kexin Zhu; Jean Wactawski-Wende; Heather M Ochs-Balcom; Michael J LaMonte; Kathleen M Hovey; William Evans; Mahalakshmi Shankaran; Bruce R Troen; Hailey R Banack Journal: J Gerontol A Biol Sci Med Sci Date: 2021-08-13 Impact factor: 6.053