[Diagnosis of sarcopenic obesity could add extra clinical implications to severe obesity]

Sarcopenic obesity (SO) is characterized by the coexistence of excess body fat and reduced muscle mass and strength. It is associated with increased cardiovascular and metabolic risk and entails greater disability, limiting patients' quality of life and increasing the risk of mortality.

To assess whether the diagnosis of SO adds an extra clinical impact in patients with severe obesity who are candidates for bariatric surgery.

Prospective observational study in 124 patients with severe obesity (BMI >40Kg/m² or BMI 35-40Kg/m² with comorbidities) aged 18 to 60years. Collection of sociodemographic, clinical, anthropometric, quality of life (EuroQol-5D), analytical variables and use of health resources. Evaluation of body composition by DXA (fat mass and appendicular lean mass [MMA]), muscle strength (hand grip dynamometry) and physical performance (Timed-up-and-Go). Diagnosis of SO according to ESPEN/EASO criteria.

28 patients (22.6%) had SO. Patients with SO had higher weight, BMI, waist circumference and calf (P<.05). Higher prevalence of arterial hypertension (AHT), type2 diabetes mellitus (DM2), hypertriglyceridemia (P<.05), and tendency to more complications (OSA, cholelithiasis, etc.). There were no significant differences in quality of life, drug consumption or health resources. Patients with SO showed worse physical performance (slower TUG; P<.05) and higher risk of falls (P<.05).

SO is frequent in candidates for bariatric surgery and is associated with worse cardiometabolic and functional profile, suggesting a higher clinical risk in these patients.