Osteosarcopenic Obesity Associated with Poor Physical Performance in the Elderly Chinese Community

Figures & data

Figure 1 Flowchart showing the steps in identification, allocation, and the classification of participants in to each of the categories: obese only (O), osteopenic obese (OO), sarcopenic obese (SO), and osteosarcopenic obese (OSO) in a population of obese older people.

Table 1 Body Composition Variables and Physical Performance of Study Population by Gender

	Male				Female
	O (n=25)	OO (n=38)	SO (n=12)	OSO (n=14)	O (n=59)	OO (n=122)	SO (n=16)	OSO (n=17)
Age	69.9±6.6	70.43±5.4	73.3±7.4	75.1±7.6	67.3±5.0	68.3±6.0	70.3±5.6	71.1±6.4
Height(cm)	170.1±6.4	172.1±4.1*	163.0±7.7*^†	162.4±5.9*^†	158.1±6.0	156.1±5.9	152.1±5.5*	151.6±3.4*
Weight(kg)	77.4±7.6	75.5±5.2*	66.3±7.7*^†	65.9±4.9*^†	67.9±7.7	65.6±7.9	52.5±5.6*^†	56.9±5.5*^†
BMI(kg/m^2)	26.7±1.7	25.5±2.4	25.0±2.5*	25.0±1.7	26.6±2.9	26.9±2.6	22.7±2.3*^†	24.7±2.4*
WHR	0.94±0.43	0.92±0.34	0.90±0.05*	0.97±0.07*	0.93±0.08	0.92±0.56	0.93±0.73	0.94±0.46
ASM(kg)	23.7±2.7	23.7±2.0	19.2±2.0*^†	18.4±2.0*^†	17.4±1.9	16.5±2.0	12.9±1.4*^†	13.1±0.6*^†
SMM(kg)	30.2±3.1	29.8±2.2	24.2±2.0*^†	23.3±1.1*^†	22.8±2.3	21.8±2.2*	17.2±1.5*^†	17.8±0.4*^†
TLM(kg)	52.0±5.1	51.3±3.4	42.5±3.4*^†	41.0±1.7*^†	40.0±3.8	38.5±3.6*	31.1±2.4*	32.3±0.8*^†
FFM(kg)	55.0±5.4	54.3±3.5	45.0±3.7*^†	43.4±1.8*^†	42.4±4.0	40.8±3.8*	33.1±2.5*^†	34.3±0.9*^†
VFA(%)	134.3±27.0	122.6±18.4	123.5±27.4	146.1±28.1	128.9±28.9	127.0±31.6	97.3±22.5*^†	123.6±32.8
PBF(%)	28.9±2.9	28.0±1.2	31.8±4.5*	34.0±4.5*^†	37.3±3.5	37.4±3.7	36.8±3.8	39.3±5.1
TBW(%)	52.6±5.1	53.2±0.9	50.4±3.2*	48.9±3.2*^†	46.3±2.5	46.2±2.7	46.6±2.8	44.8±3.8
Grip strength(kg)	30.8±6.9	30.2±7.0	27.5±6.8	24.5±8.0*	19.4±4.2	18.4±4.3	15.4±3.2*	14.7±3.4*^†
WS(m/s)	1.10±0.20	0.91±0.38	0.96±0.22	0.78±0.24*	1.06±0.14	1.02±0.17	0.95±0.18*	0.83±0.32*^†
TUGT(s)	9.7±3.7	11.3±8.2	9.9±1.8	14.1±8.3*	9.2±1.5	9.7±2.3	10.8±3.4*	14.0±6.1*^†

Notes: Data are presented as means± SD for age, height, weight, body mass index (BMI), waist-to-hip ratio (WHR), appendicular skeletal muscle mass (ASM), skeletal muscle mass (SMM), total lean mass (TLM), fat-free mass (FFM), visceral fat area (VFA), percent body fat (PBF), total body water (TBW), grip strength, 4-m walk test (WS) and time up and go test (TUGT). *P,0.05 versus O group; ^†P,0.05 versus OO group.

Abbreviations: O, obese only; OO, osteopenic obese; SO, sarcopenic obese; OSO, osteosarcopenic obese.

Table 2 Lifestyle Factors and Diseases of Study Population by Gender

	Male				Female
	O (n=25)	OO (n=38)	SO (n=12)	OSO (n=14)	O (n=59)	OO (n=122)	SO (n=16)	OSO (n=17)
IPAQ(Mets×minutes/wk)	4937.5±3876.8	4330.0±2298.2	4406.4±2390.6	2686.0±1941.2	5026.2±3763.9	4698.9±3620.6	4066.3±2386.2	2708.4±1910.6
Fall history(%)	12.7	14.3	8.3	28.6	14.5	17.5	6.3	27.3
Education>9yr(%)	14.3	14.3	8.3	0	17.7	11.1	18.8	0
Drinking (%)
Drink everyday	18.3	42.9	16.7	42.9	1.7	0	0	0
Drink occasionally	28.3	28.6	25.0	14.3	3.4	0	0	0
Ex-drinker	18.3	0	25.0	28.6	0.9	1.6	6.3	0
Never	35.0	28.6	33.3	14.3	94.0	98.4	93.7	100
Smoking(%)
Current smoker	34.5	16.7	31.3	37.5	12.9	9.5	0	18.2
Ex-smoker	39.7	50.0	25.0	12.5	75.8	81.0	0	72.7
Nonsmoker	25.9	33.3	43.8	50.0	11.3	9.5	0	9.1
Disease(%)
Depression	6.8	0	12.5	25.0	13.0	13.6	20.0	13.3
Diabetes	10.2	0	6.3	12.5	20.0	20.3	28.0	6.7
Hypertension	72.9	33.3	87.5	50.0	71.3	64.4	48.0	53.3
Hyperlipidemia	16.9	0	25.0	12.5	20.0	18.6	24.0	6.7
Heart disease	13.6	16.7	50.0	25.0	30.4	35.6	36.0	33.3

Notes: Data are presented as means± SD for International Physical Activity Questionnaire (IPAQ). Fall history, education level, drinking habits, smoking habits and diseases are in percentages.

Abbreviations: O, obese only; OO, osteopenic obese; SO, sarcopenic obese; OSO, osteosarcopenic obese.

Table 3 Adjusted Relationships of Grip Strength, WS, and TUGT Among OO, so, OB and OSO Groups^a

	Male				Female
	O	OO	SO	OSO	O	OO	SO	OSO
Grip strength(kg)
Crude	31.1(29.3,32.9)^b	29.7(24.1,35.5)	27.1(23.7,30.6)	25.6(20.7,30.4)	19.6(18.9,20.4)	18.4(17.3,19.4)	15.6(14.0,17.2)*^†	15.5(13.5,17.6)*
Age-, and BMI-adjusted	30.8(29.2,32.4)	29.9(25.1,34.6)	27.7(24.6,30.8)	27.0(22.7,31.3)	19.4(18.7,20.2)	18.4(17.4,19.5)	16.3(14.5,18.0)*	16.1(14.0,19.2)*
Multiple adjusted^c	31.0(29.3,32.6)	30.5(25.4,35.6)	27.4(24.1,30.7)	27.0(22.6,31.4)	19.4(18.6,20.2)	18.5(17.4,19.5)	16.4(14.5,18.2)*	16.1(13.9,18.3)*
WS(m/s)
Crude	1.08(1.02,1.14)	0.86(0.68,1.04)	1.03(0.92,1.14)	0.84(0.68,0.99)*	1.08(1.04,1.11)	1.01(0.97,1.01)	0.96(0.89,1.02)*	0.91(0.82,0.99)*
Age-, and BMI-adjusted	1.08(1.03,1.14)	0.85(0.69,1.02)	1.01(0.91,1.12)	0.84(0.69,0.99)*	1.07(1.04,1.10)	1.02(0.98,1.06)	0.97(0.90,1.04)	0.94(0.85,1.02)*
Multiple adjusted^c	1.08(1.02,1.13)	0.84(0.67,1.02)	1.02(0.91,1.13)	0.84(0.69,0.99)*	1.07(1.04,1.11)	1.02(0.98,1.06)	0.96(0.89,1.04)	0.93(0.84,1.02)*
TUGT(s)
Crude	9.05(8.13,9.98)	12.0(9.10,14.9)	9.56(7.79,11.3)	13.2(10.7,15.7)*	9.11(8.66,9.55)	9.78(9.15,10.4)	10.5(9.50,11.4)*	12.7(11.4,14.0)*^†‡
Age-, and BMI-adjusted	9.08(8.14,10.0)	12.0(9.17,14.8)	9.57(7.72,11.4)	13.0(10.4,15.5)*	9.18(8,76,9.60)	9.76(9.17,10.3)	10.4(9.41,11.4)*	12.4(11.2,13.6)*^†‡
Multiple adjusted^c	9.08(8.09,10.1)	13.3(10.3,16.3)	9.05(7.13,11.0)	13.3(10.6,15.9)*	9.17(8.73,9.61)	9.69(9.08,10.3)	10.5(9.41,11.5)	12.4(11.2,13.7)*^†

Notes: ^aAnalysis of covariance. ^bAdjusted least square mean (95% confidence interval) (all such values). ^cAdjusted for [age (continuous variable), body mass index (continuous variable), physical activity (IPAQ) (continuous variable), [smoking and drinking status were coded as dummy variables (current, former, and never; everyday, occasionally, former and never), educational≥9yr (no=0, yes=1), history of falls (no=0, yes=1) and the number of diseases which were divided into 3 groups. 1: no disease, 2:≤2 diseases, 3:≥3 diseases (depression;diabetes;hypertension; hyperlipidemia;heart disease]. 6. *P,0.05 versus O group; ^†P,0.05 versus OO group; ^‡P,0.05 versus SO group.

Abbreviations: O, obese only; OO, osteopenic obese; SO, sarcopenic obese; OSO, osteosarcopenic obese; WS, 4-m walk test; TUGT, time up and go test.