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The Importance of Muscle Versus Fat Mass in Sarcopenic Obesity: A Re-evaluation Using D3-Creatine Muscle Mass Versus DXA Lean Mass Measurements.

Publication ,  Journal Article
Orwoll, ES; Peters, KE; Hellerstein, M; Cummings, SR; Evans, WJ; Cawthon, PM
Published in: J Gerontol A Biol Sci Med Sci
June 18, 2020

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.

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Published In

J Gerontol A Biol Sci Med Sci

DOI

EISSN

1758-535X

Publication Date

June 18, 2020

Volume

75

Issue

7

Start / End Page

1362 / 1368

Location

United States

Related Subject Headings

  • Sarcopenia
  • Risk Factors
  • Reproducibility of Results
  • Physical Functional Performance
  • Obesity
  • Mobility Limitation
  • Male
  • Longitudinal Studies
  • Humans
  • Gerontology
 

Citation

APA
Chicago
ICMJE
MLA
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Orwoll, E. S., Peters, K. E., Hellerstein, M., Cummings, S. R., Evans, W. J., & Cawthon, P. M. (2020). The Importance of Muscle Versus Fat Mass in Sarcopenic Obesity: A Re-evaluation Using D3-Creatine Muscle Mass Versus DXA Lean Mass Measurements. J Gerontol A Biol Sci Med Sci, 75(7), 1362–1368. https://doi.org/10.1093/gerona/glaa064
Orwoll, Eric S., Katherine E. Peters, Marc Hellerstein, Steven R. Cummings, William J. Evans, and Peggy M. Cawthon. “The Importance of Muscle Versus Fat Mass in Sarcopenic Obesity: A Re-evaluation Using D3-Creatine Muscle Mass Versus DXA Lean Mass Measurements.J Gerontol A Biol Sci Med Sci 75, no. 7 (June 18, 2020): 1362–68. https://doi.org/10.1093/gerona/glaa064.
Orwoll ES, Peters KE, Hellerstein M, Cummings SR, Evans WJ, Cawthon PM. The Importance of Muscle Versus Fat Mass in Sarcopenic Obesity: A Re-evaluation Using D3-Creatine Muscle Mass Versus DXA Lean Mass Measurements. J Gerontol A Biol Sci Med Sci. 2020 Jun 18;75(7):1362–8.
Orwoll, Eric S., et al. “The Importance of Muscle Versus Fat Mass in Sarcopenic Obesity: A Re-evaluation Using D3-Creatine Muscle Mass Versus DXA Lean Mass Measurements.J Gerontol A Biol Sci Med Sci, vol. 75, no. 7, June 2020, pp. 1362–68. Pubmed, doi:10.1093/gerona/glaa064.
Orwoll ES, Peters KE, Hellerstein M, Cummings SR, Evans WJ, Cawthon PM. The Importance of Muscle Versus Fat Mass in Sarcopenic Obesity: A Re-evaluation Using D3-Creatine Muscle Mass Versus DXA Lean Mass Measurements. J Gerontol A Biol Sci Med Sci. 2020 Jun 18;75(7):1362–1368.
Journal cover image

Published In

J Gerontol A Biol Sci Med Sci

DOI

EISSN

1758-535X

Publication Date

June 18, 2020

Volume

75

Issue

7

Start / End Page

1362 / 1368

Location

United States

Related Subject Headings

  • Sarcopenia
  • Risk Factors
  • Reproducibility of Results
  • Physical Functional Performance
  • Obesity
  • Mobility Limitation
  • Male
  • Longitudinal Studies
  • Humans
  • Gerontology