Association of Sarcopenic Obesity with the Risk of All-cause Mortality Among Adults over a Broad Range of Different Settings: a Updated Meta-analysis

Background: Previous cohort studies investigating the association between sarcopenic obesity (SO) and all-cause mortality among adult people have been inconsistent. We performed a meta-analysis to determine if SO is a predictor of all-cause mortality.

Methods: Prospective cohort studies that evaluated the association between SO and mortality in older people were identified via a systematic search of three electronic databases (PubMed, EMBASE, and the Cochrane Library). A random-effects model was applied to combine the results. We considered the methods recommeded by consensuses (dual X-ray absorptiometry,bio-impedancemetry, anthropometric measures or CT scan) to assess sarcopenic obesity.

Results: Of the 603 studies identified through the systematic review, 23 (Participants: 50866) were included in the meta-analysis. The mean age ranged from 50 to 82.5 years.SO was significantly associated with a higher risk of all-cause mortality among adult people (pooled HR = 1.21, 95% confidence interval [95% CI] = 1.10-1.32, p < 0.001, I = 64.3%). Furthermore, the subgroup analysis of participants showed that SO was associated with all-cause mortality (pooled HR = 1.14, 95% CI: 1.06-1.23) among community-dwelling adult people; similarly, this association was found in hospitalized patients (pooled HR = 1.65, 95% CI: 1.17-2.33). Moreover, the subgroup analysis demonstrated that SO was associated with all-cause mortality when using skeletal muscle mass (SMM) criteria, muscle strength criteria, and skeletal muscle index (SMI) criteria (HR = 1.12, 95% CI: 1.01-1.23; HR = 1.18, 95% CI: 1.05-1.33; and HR = 1.53, 95% CI: 1.13-2.07, respectively). In addition, we analyzed SO on the basis of obesity definition and demonstrated that participants with a SO diagnosis based on waist circumference (WC) (HR = 1.24, 95% CI: 1.09-1.40), body mass index (BMI) (HR = 1.29, 95% CI: 1.04-1.59), or visceral fat area (HR = 2.54, 95% CI: 1.83-3.53) have a significantly increase mortality risk compared with those without SO.

Conclusion: Based on our update of existing scientific researches, SO is a significant predictor of all-cause mortality among older people, particularly hospitalized patients. Therefore, it is important to diagnose SO and to treat the condition to reduce mortality rates among older people.