OBJECTIVES: Studies on the association of obesity and sarcopenia are conflicting. Some studies showed that obesity is associated with muscle loss and frailty while others showed that lower body mass index (BMI) is associated with increased sarcopenia. To date, there is paucity of data on sarcopenia and obesity among Filipinos. This study aims to determine the association of obesity and sarcopenia among Filipinos. METHODS: This is a cross sectional analytic study comparing sarcopenic versus nonsarcopenic in terms of obesity as measured by BMI and waist circumference (WC). Filipinos older than 40 years old were included. Obesity was defined using the World Health Organization (WHO) cutoff for BMI and WC. Sarcopenia was defined as low muscle mass and low muscle strength or physical performance. Population-specific cutoff points were used to define low muscle mass, strength, and performance. RESULTS: A total of 164 participants were included. The mean age is 60.33 years. Ten (6.10%) were sarcopenic and 4 (40.00%) of them were obese. Regression analysis showed that obesity is not significantly associated with increased sarcopenia (Incidence risk ratio [IRR], 14.62; 95% confidence interval [CI], 0.96–221.92; P = 0.05). However, age (IRR, 1.15; 95% CI, 1.09–1.21; P ≤ 0.01),WC (IRR, 0.92; 95% CI, 0.85–0.99; P = 0.02), smoking (IRR, 3.17; 95% CI, 1.11–9.03; P = 0.03), and alcoholic beverage drinking (IRR, 3.71, 95% CI, 1.26–10.89; P = 0.02) were found to be significant predictors of sarcopenia. CONCLUSIONS: There is no statistically significant association between obesity and increased risk of sarcopenia among participants, however, older age, smaller WC, smoking, and alcoholic beverage drinking were significant predictors of sarcopenia.
Adult ; Alcoholic Beverages ; Body Mass Index ; Drinking ; Humans ; Muscle Strength ; Obesity ; Odds Ratio ; Sarcopenia ; Smoke ; Smoking ; Waist Circumference ; World Health Organization

SYNOPSIS: In a rare case of thyrotoxicosis, transitioning in less than a month post-thyroidectomy from subclinical hyperthyroidism into frank hyperthyroidism, active thyroid hormone production was documented as coming from a metastatic focus in the occiput of the patient.CLINICAL PRESENTATION: A 63-year-old Filipino woman came in for a 4-year-duration left occipital mass measuring 9 cm x 8 cm, along with thyroid nodules which were 3-cm in the right lobe and 2-cm in the left lobe. Suspected to have metastatic thyroid carcinoma, she underwent total thyroidectomy. From a pre-operative subclinical hyperthyroid state, she developed overt symptoms and signs of thyrotoxicosis within one month post-operatively.PHYSICAL FINDINGS: One month post-thyroidectomy, the patient lost 5 percent of immediate post-op weight, was ambulatory, with a heart rate of 118 beats/min. Skin was warm and moist. On her left occiput was a 9 cm x 8 cm superficial mass. A 10-cm horizontal scar was seen on the anterior base of the neck, with no masses. There were fine finger tremors and + + + deep tendon reflexes.LABORATORY WORK-UP: Thyroid FNAB was suspicious for follicular tumor. Total thyroidectomy specimen showed follicular carcinoma, widely invasive, right and left lobes. Whole body 1-131 scintigraphy revealed functioning metastatic thyroid tissue in the head, corresponding to the palpated mass. Head CT scan revealed occipital calvarial metastasis with intracranial/ extradural extensions. From a pre-operative subclinical hyperthyroid state (FT4=22.2 pmol/L [NV 12-24 pmol/L], TSH=0.07 mm/L [NV 0.4-4 mIU/L]), patient became frankly hyperthyroid 1 month post-op (FT4=49.4 pmol/L, FT3= 30.4 pmol/L, TSH=0.06 mlU/L).Diagnosis: Follicular Thyroid Carcinoma Stage IVC S/P Total Thyroidectomy; Thyrotoxicosis (T4 type) secondary to Hyperfunctioning Occipital Bone Metastasis.TREATMENT/OUTCOME: The patient was given carbimazole and propranolol with resolution of thyrotoxic signs and symptoms. Still of good functional capacity, she now awaits palliative external beam radiotherapy and subsequent radioiodine therapy.SIGNIFICANCE: This is one of the less than 100 reported cases around the world, of thyrotoxicosis caused by hyperfunctioning thyroid carcinoma, since the first reported case in 1948.
Thyroid Cancer ; Thyrotoxicosis ; Metastatic Follicular Thyroid Carcinoma