Abstract

Background

Aging is associated with body composition changes that include a reduction of muscle mass or sarcopenia and an increase in visceral obesity. Thus, aging involves a muscle-fat imbalance with a shift toward more fat and less muscle. Therefore, sarcopenic obesity, defined as a combination of sarcopenia and obesity, is a global health phenomenon due to the increased aging of the population combined with the increased epidemic of obesity. Previous studies have shown inconsistent association between sarcopenic obesity and the risk of cardiovascular disease (CVD).

Aims

To systematically review the recent literature on the CVD risks associated with sarcopenic obesity and summarizes ways of diagnosis and prevention.

Methods

A systematic review of studies that reported the association between sarcopenic obesity and CVD risk in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations.

Results

Risk factors of sarcopenic obesity included genetic factors, aging, malnutrition, sedentary lifestyle, hormonal deficiencies and other molecular changes. The muscle-fat imbalance with increasing age results in an increase in the pro-inflammatory adipokines secreted by adipocytes and a decline in the anti-inflammatory myokines secreted by myocytes. This imbalance promotes and perpetuates a chronic low-grade inflammatory state that is characteristic of sarcopenic obesity. After application of exclusion criteria, only 12 recent studies were included in this review. The recent studies have shown a consistent association between sarcopenic obesity and cardiovascular disease risk although most of the studies are of cross-sectional design that does not confirm a causal relationship. In addition, most of the population studied were of Asian origin which may limit the generalizability of the results. Non-pharmacological interventions by exercise training and adequate nutrition appear to be useful in maintenance of muscle strength and muscle mass in combination with a reduction of adiposity to promote healthy aging.

Conclusions

Sarcopenic obesity appears to increase the risk of CVD in older people; however, future prospective studies of diverse population are still required. Although non-pharmacologic interventions are useful in reducing the risk of sarcopenic obesity, novel specific pharmacologic agents are lacking.

中文翻译：

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少肌性肥胖是老年人心血管疾病风险的决定因素：系统评价

摘要

背景

衰老与身体成分变化有关，包括肌肉量减少或肌肉减少以及内脏肥胖增加。因此，衰老涉及肌肉脂肪失衡，并转向更多的脂肪和更少的肌肉。因此，肌肉减少性肥胖被定义为肌肉减少症和肥胖症的组合，是由于人口老龄化加剧和肥胖症流行增加而导致的全球健康现象。先前的研究表明，少肌性肥胖与心血管疾病 (CVD) 的风险之间存在不一致的关联。

目标

系统回顾近期关于少肌性肥胖相关心血管疾病风险的文献，总结诊断和预防方法。

方法

根据系统评价和荟萃分析 (PRISMA) 建议的首选报告项目，对报告肌肉减少性肥胖与 CVD 风险之间关联的研究进行系统评价。

结果

少肌性肥胖的危险因素包括遗传因素、衰老、营养不良、久坐不动的生活方式、荷尔蒙缺乏和其他分子变化。随着年龄的增长，肌肉脂肪失衡导致脂肪细胞分泌的促炎脂肪因子增加，而肌细胞分泌的抗炎肌因子减少。这种不平衡促进并延续了一种慢性低度炎症状态，这是少肌性肥胖的特征。应用排除标准后，本综述仅纳入 12 项近期研究。最近的研究表明，肌肉减少性肥胖与心血管疾病风险之间存在一致的关联，尽管大多数研究都是横断面设计，并未证实因果关系。此外，所研究的大多数人口都是亚洲人，这可能会限制结果的普遍性。通过运动训练和充足营养进行的非药物干预似乎有助于维持肌肉力量和肌肉质量，同时减少肥胖以促进健康老龄化。

结论

肌肉减少性肥胖似乎会增加老年人患心血管疾病的风险；然而，未来仍需要对不同人群进行前瞻性研究。尽管非药物干预有助于降低肌肉减少性肥胖的风险，但缺乏新的特异性药物。