Predictors of Sarcopenia in an Obese Asian Population

Sarcopenia is associated with obesity and might also be responsible for other disorders. Here, we investigated the prevalence of sarcopenia and its predictors in obese subjects. Subjects who underwent a medical health checkup and living-related liver donors were recruited. Obesity was defined as body mass index (BMI) ≥25 kg/m². Muscle mass was assessed using computed tomography at the 3^rd lumbar vertebra. The lowest quartile of the lumbar skeletal muscle index (LSMI) was considered sarcopenia. Among 466 obese subjects, 53 (11.4%) had sarcopenia. Subjects with sarcopenia were significantly older (mean 66.6 vs. 53.3 years) and had a significantly higher prevalence of hypertension (62.3 vs. 46.0%) and diabetes (45.3 vs. 31.0%), higher fibrosis-4 (FIB-4) index (mean 1.57 vs. 1.16), and higher atherosclerotic cardiovascular disease (ASCVD) risk score (mean 22.86% vs. 11.15%), whereas they had a significantly lower prevalence of female gender (13.2% vs. 27.8%), lower BMI (mean 26.4 vs. 27.4 kg/m²), and lower LSMI (mean 43 vs. 56 cm²/m²) than subjects without sarcopenia (all P < 0.05). On multivariate analysis, higher BMI (odd ratio [OR] = 0.599, P = 0.001) was independently associated with a reduced risk of sarcopenia, whereas higher ASCVD risk scores (OR = 1.045, P < 0.001) were independently associated with an increased risk of sarcopenia. Sarcopenia is significantly associated with lower BMI and higher cardiovascular risk in an obese Asian population.