Sarcopenic obesity and mortality risk in nursing home residents: a prospective cohort study based on six obesity indicators
10.3760/cma.j.issn.0254-9026.2025.07.015
- VernacularTitle:肌少性肥胖与养老机构老年人死亡风险:基于六种肥胖指标的前瞻性队列研究
- Author:
Xiaoyan CHEN
1
;
Mei LI
;
Sha HUANG
;
Shuyue LUO
;
Wenyi ZHANG
;
Wenhua JIANG
;
Ming YANG
Author Information
1. 四川大学华西医院老年医学中心,成都 610041
- Publication Type:Journal Article
- Keywords:
Obesity;
Waist-hip ratio;
Body fat;
Visceral fat;
Sarcopenia;
Prognosis
- From:
Chinese Journal of Geriatrics
2025;44(7):943-950
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between sarcopenic obesity(SO), defined by various obesity indicators, and mortality risk in older adults based on a prospective cohort from multiple nursing homes.Methods:Sarcopenia was diagnosed according to the 2019 consensus of the Asian Working Group for Sarcopenia.Obesity was defined using six different indicators: waist circumference(WC), waist-hip ratio(WHR), waist-height ratio(WHTR), body mass index(BMI), visceral fat area(VFA), and percentage of body fat(PBF).A prospective cohort of adults aged 60 and above was established across 15 nursing homes in Zigong City, with annual follow-ups on survival status conducted over two consecutive years.Cox proportional hazards regression models were employed to analyze the association between SO, defined by different obesity indicators, and mortality risk, calculating hazard ratios( HR)and their 95% confidence intervals( CI). Results:A total of 695 older adults were included in the study, of whom 67.1% were male.During the 2-year follow-up period, 88 participants died.The prevalence of SO as defined by WC, WHR, WHTR, BMI, VFA, PBF was found to be 17.6%, 30.1%, 48.9%, 3.0%, 28.3%, and 58.7%, respectively.When SO was defined using WC, WHR, WHTR, BMI, and VFA, there was no statistically significant difference in mortality rates between the SO and non-SO groups.However, when defined by PBF, the SO group exhibited a significantly higher mortality rate compared to the non-SO group(16.9% vs.6.6%, P<0.01).Cox proportional hazards regression analysis revealed that, compared to the non-SO group, the SO group defined by PBF had a significantly increased mortality risk( HR=2.81, 95% CI: 1.67-4.73, P<0.001).After adjusting for potential confounding factors, the mortality risk for the SO group remained significantly higher than that of the non-SO group( HR=1.97, 95% CI: 1.14-3.38, P=0.015). Conclusions:The prevalence of SO varies significantly across different obesity indicators.SO defined by PBF is significantly associated with mortality risk in nursing home residents.This study provides new evidence for further optimizing the diagnostic criteria for SO in this population.