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Cited by 24Nutrition and Health in AgingBody Composition Measurement TechniquesMuscle Physiology and Disorders

Identification of factors associated with sarcopenic obesity development: Literature review and expert panel voting

Open access
Pinel, A., Guillet, C., Capel, F., Pouget, M., De Antonio, M., Pereira, B., Topinkova, E., Eglseer, D. +5 more·2024·Clinical Nutrition
DOI 10.1016/j.clnu.2024.04.033
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Abstract

Sarcopenic obesity (SO) is defined as the combination of excess fat mass (obesity) and low skeletal muscle mass and function (sarcopenia). The identification and classification of factors related to SO would favor better prevention and diagnosis. The present article aimed to (i) define a list of factors related with SO based on literature analysis, (ii) identify clinical conditions linked with SO development from literature search and (iii) evaluate their relevance and the potential research gaps by consulting an expert panel. From 4746 articles screened, 240 articles were selected for extraction of the factors associated with SO. Factors were classified according to their frequency in the literature. Clinical conditions were also recorded. Then, they were evaluated by a panel of expert for evaluation of their relevance in SO development. Experts also suggested additional factors. Thirty-nine unique factors were extracted from the papers and additional eleven factors suggested by a panel of experts in the SO field. The frequency in the literature showed insulin resistance, dyslipidemia, lack of exercise training, inflammation and hypertension as the most frequent factors associated with SO whereas experts ranked low spontaneous physical activity, protein and energy intakes, low exercise training and aging as the most important. Although literature and expert panel presented some differences, this first list of associated factors could help to identify patients at risk of SO. Further work is needed to confirm the contribution of factors associated with SO among the population overtime or in randomized controlled trials to demonstrate causality.

AI snapshot

Written from the paper’s full text.

TL;DR

This scoping review and expert panel identified factors associated with sarcopenic obesity (SO), extracting 39 factors from 240 selected articles and adding 11 expert-suggested factors. Literature frequency and expert rankings differed, but both highlighted lifestyle, metabolic, and aging-related factors as relevant to SO development.

Key findings

  • From 4,746 screened articles, 240 were selected; 619 reported factors were grouped into 39 unique literature-derived factors, plus 11 factors suggested by the expert panel.
  • The most frequent literature factors were insulin resistance (50, 11.2%), dyslipidemia (43, 9.6%), exercise training (30, 6.7%), inflammation (28, 6.3%), and hypertension (27, 6.0%).
  • The expert panel ranked spontaneous physical activity (mean 1.41), proteins (1.37), energy intake (1.37), exercise training (1.27), and aging (1.22) as the most important factors.
  • Clinical conditions in the selected articles were most often “aging” (126, 41.0%); 41 studies (13.4%) were not linked to a specific clinical condition other than SO.

Methods

  • Literature search followed PRISMA-ScR guidance using PubMed and Embase on March 31, 2021, for articles published January 1, 2000–March 31, 2021, in humans older than 18, focusing on sarcopenia AND obesity, with BMI >25 kg/m² and English original articles.
  • Five scientists performed study selection; data extracted included publication details, associated diseases, clinical conditions, treatments, and factors significantly associated with SO.
  • A 14-expert panel scored factors from 0 to 10 in two rounds; scores were standardized, and literature frequency was categorized as not found, low (1–9 times), moderate (10–19 times), or high (20 and more).

Limitations

  • The paper states that only English-language articles were included, the analysis predated the 2022 ESPEN/EASO SO definition consensus, variability in SO cut-offs was not considered, factor types were heterogeneous, some studies came from the same populations or cohorts, and statistical analyses could not determine a restrictive set of key factors.
  • The paper states that causality cannot be established from this review and that further longitudinal or randomized controlled trials are needed.
  • Evident from the text: expert rankings are subjective, literature frequency does not reflect study quality or risk of bias, and the search ended in March 2021, so later evidence is not captured.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.clnu.2024.04.033

Cites

60 of 60 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 38 cited sources checked · 0 supported · 0 flagged

  • Findingreasoning

    The most frequent factors from the literature were related to obesity-related metabolic dysfunctions (insulin resistance, dyslipidemia, inflammation, hypertension, diabetes) and sedentary lifestyle (exercise training, spontaneous physical activity).

    “We firstly set up a list of factors from which the most frequent ones were related to obesity-related metabolic dysfunctions (insulin resistance, dyslipidemia, inflammation, hypertension, diabetes) and sedentary lifestyle (exercise training, spontaneous physical activity).”
    Quote in the paperSubstantial claim
  • Findingown data

    Spontaneous physical activity, energy intake and proteins were the three most important factors to the experts.

    “Spontaneous physical activity, energy intake and proteins were the three most important factors to the experts.”
    • Also stated in: § Abstract · plain
      “experts ranked low spontaneous physical activity, protein and energy intakes, low exercise training and aging as the most important.”
    Quote in the paperSubstantial claim
  • Findingown data

    Fifteen out of 17 articles depicted a positive association of dietary proteins, amino acids and derivates or a negative association of lower protein intake with SO.

    “Fifteen out of 17 articles depicted a positive association of dietary proteins, amino acids and derivates or a negative association of lower protein intake with SO.”
    Quote in the paperSubstantial claim
  • Findingown data

    Thirty-nine unique factors were extracted from the papers.

    “Thirty-nine unique factors were extracted from the papers and additional eleven factors suggested by a panel of experts in the SO field.”
    • Also stated in: § 3.2. Synthesis of results · plain
      “these factors were gathered in more general terms to reach a final list of 39 factors extracted from the literature.”
    Quote in the paperSubstantial claim
  • Findingown data

    Insulin resistance, dyslipidemia, exercise training and inflammation were the most frequent factors cited as related to SO.

    “Insulin resistance, dyslipidemia, exercise training and inflammation were the most frequent factors cited as related to SO.”
    • Also stated in: § Abstract · plain
      “The frequency in the literature showed insulin resistance, dyslipidemia, lack of exercise training, inflammation and hypertension as the most frequent factors associated with SO”
    Quote in the paperSubstantial claim
  • May combine two claims. 30
  • Classified as probably not a substantial claim. 23
  • The quote only partly states this claim. 1

  • May combine two claims.

    Findingown data

    Exercise training as intervention, aging, unbalanced diet and inflammation were rated as relevant factors to consider by the experts.

    “Exercise training as intervention, aging, unbalanced diet and inflammation were rated as relevant factors to consider.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Each other factor represented less than 4% of the total number of factors.

    “Each other factor represented less than 4% of the total number of factors.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Forty-one studies were not linked with any specific clinical condition other than sarcopenic obesity and represented 13.4% of the total number of articles.

    “Forty one studies were not linked with any specific clinical condition other than sarcopenic obesity and represented 13.4% of the total number of articles.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Chronic kidney disease, dyslipidemia and hypertension were rated as less important by experts but were found frequently in the literature (respectively 41st, 42nd, 44th positions).

    “Inversely, some factors were rated as less important but were found frequently in the literature: chronic kidney disease, dyslipidemia and hypertension, (respectively 41st, 42nd, 44th positions).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Energy intake, myosteatosis and quality of life, which were not commonly reported in the literature, were considered as important by the experts (3rd, 8th and 12th positions, respectively).

    “Energy intake, myosteatosis and quality of life which were not commonly reported in the literature were considered as important by the experts (3rd, 8th and 12th positions, respectively).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Hypertension and spontaneous physical activity were also frequently associated with SO.

    “Then hypertension and spontaneous physical activity were also frequently associated with SO.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    From 4746 articles screened, 240 articles were selected for extraction of factors associated with SO.

    “From 4746 articles screened, 240 articles were selected for extraction of the factors associated with SO.”
    • Also stated in: § 3.1. Selection of sources of evidences · plain
      “Two hundred and forty articles remained.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Some biological factors were suggested as not relevant (serum prealbumin/albumin, antioxidant status, genetic variation and hemoglobin).

    “some biological factors were suggested as not relevant (serum prealbumin/albumin, antioxidant status, genetic variation and hemoglobin).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Some factors are always or mostly described as positively associated with SO (e.g. insulin resistance, dyslipidemia, inflammation, osteopenia, aging, etc.), or negatively associated with SO (e.g. exercise training, spontaneous physical activity, sleep, smoking).

    “Some factors are always or mostly described as positively associated with SO (e.g.insulin resistance, dyslipidemia, inflammation, osteopenia, aging, etc.), or negatively associated with SO (e.g.exercise training, spontaneous physical activity, sleep, smoking).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The frequency of clinical conditions decreased below 10% for diabetes, osteoporosis, cardiovascular diseases, postmenopausal status, arthritis, chronic kidney diseases, non-alcoholic fatty liver disease, and respiratory diseases.

    “Then the frequency decreased below 10% (diabetes, osteoporosis, cardiovascular diseases, postmenopausal status, arthritis, chronic kidney diseases, non-alcoholic fatty liver disease, respiratory diseases) and below 2% (endocrine disorders, cancer, cirrhosis, hormone-dependent cancer, chronic diseases, colorectal cancer, human immunodeficiency virus, intestinal disorders, liver diseases, muscular D”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The frequency of clinical conditions decreased below 2% for endocrine disorders, cancer, cirrhosis, hormone-dependent cancer, chronic diseases, colorectal cancer, human immunodeficiency virus, intestinal disorders, liver diseases, muscular dystrophy, and neurological disorders.

    “Then the frequency decreased below 10% (diabetes, osteoporosis, cardiovascular diseases, postmenopausal status, arthritis, chronic kidney diseases, non-alcoholic fatty liver disease, respiratory diseases) and below 2% (endocrine disorders, cancer, cirrhosis, hormone-dependent cancer, chronic diseases, colorectal cancer, human immunodeficiency virus, intestinal disorders, liver diseases, muscular D”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    History of weight cycling, Cushing's syndrome, aging, bariatric surgery, orthopedic surgery, poor oral health, antidepressive therapies, health literacy and gut microbiota were factors suggested during the first round of evaluation and were evaluated during the second round.

    “In the final list, history of weight cycling, Cushing's syndrome, aging, bariatric surgery, orthopedic surgery, poor oral health, antidepressive therapies, health literacy and gut microbiota were factors suggested during the first round of evaluation and were evaluated during the second round.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Discrepancies were also found for the association of sex, social status and quality of life with SO development, with some articles detecting higher risk in males or females and in the presence of poor social status, urban area, married individuals, or white collar subgroup.

    “Discrepancies were also found for the association of sex, social status and quality of life with SO development as some articles detected a higher risk in males [23,24] or females [25,26] and in the presence of poor social status [18e20,26e29], in people living in urban area [30], married individuals [20] or in white collar subgroup [31].”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [23] Baker, 2015, Are men at greater risk of lean mass deficits in rheumatoid arthritis?, Arthritis Care Res Hoboken source

      Not checked in the free run.

    • cites [24] Ran, 2020, Replication of FTO gene associated with lean mass in a meta-analysis of genome-wide association studies, Sci Rep source

      Not checked in the free run.

    • cites [25] Papadopoulou, 2020, Gender and exercise in relation to obesity in Greek elderly population, Int J Environ Res Publ Health source

      Not checked in the free run.

    • cites [26] Sousa-Santos, 2020, Sarcopenia, physical frailty, undernutrition and obesity cooccurrence among Portuguese community-dwelling older adults: results from Nutrition UP 65 cross-sectional study, BMJ Open source

      Not checked in the free run.

    • cites [18e20,26e29]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The analyses depicted a high variability of factors' types: some are negatively correlated to SO and could be considered as protective factors, meaning they could be risk factors if there is a lack of practice or if a poorer level is observed in the targeted population.

    “The analyses depicted a high variability of factors' types: some are negatively correlated to SO and could be considered as protective factors (i.e.exercise training in intervention studies), meaning they could be risk factors if there is a lack of practice or if a poorer level is observed in the targeted population (i.e.quality of life).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Even if a majority of articles depicted protective effect of protein and derivates on SO development, two studies found higher intakes in SO group compared to sarcopenia group and compared to people without sarcopenia, expressed as % of energy.

    “Even if a majority of articles depicted protective effect of protein and derivates on SO development, two studies found higher intakes in SO group compared to sarcopenia group [49] and compared to people without sarcopenia, expressed as % of energy [50].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [49] Lim, 2018, Association between sarcopenia, sarcopenic obesity, and chronic disease in Korean elderly, J Bone Metab

      Not checked in the free run.

    • cites [50] Lee, 2018, Relationships between 25(OH)D concentration, sarcopenia and HOMA-IR in postmenopausal Korean women, Climacteric source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    The factors gathered together are sometimes too heterogeneous like the secreted muscle biomarkers or the hormones and growth factors analyzed.

    “The factors gathered together are sometimes too heterogeneous like the secreted muscle biomarkers or the hormones and growth factors analyzed.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Very few articles were focused on psychosocial evaluation.

    “Very few articles were focused on psychosocial evaluation.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Even considering the same cohort, some studies found different results mainly because of inclusion/exclusion criteria or cut-offs applied.

    “However, even considering the same cohort, some studies found different results mainly because of inclusion/exclusion criteria or cut-offs applied.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    Other factors can be closely related to treatment strategies or comorbidity that lead to difficulties to summarize the global findings.

    “Furthermore, other factors can be closely related to treatment strategies (i.e.exercise training, protein, essential fatty acid intakes) or comorbidity (i.e.insulin resistance) that lead to difficulties to summarize the global findings.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    For dyslipidemia and insulin resistance, the majority of the articles reported a positive link but some found negative association.

    “For dyslipidemia and insulin resistance, the majority of the articles reported a positive link but some found negative association [9e13].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9e13]

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The top 5 factors identified from 20 years of scientific literature on factors related to SO development are insulin resistance, dyslipidemia, exercise training, inflammation and hypertension, and they are positively or negatively related to obesity.

    “With this review based on 20 years scientific literature, focusing on identifying all the potential factors already reported as related to SO development, top 5 factors (insulin resistance, dyslipidemia, exercise training, inflammation and hypertension) are positively or negatively related to obesity.”
    Quote in the paperSubstantial claim

  • May combine two claims. The quote only partly states this claim.

    Interpretationreasoning

    The low frequency (less than 3%) of other factors could be explained by difficulties to be assessed, difficulties to be exhaustively/precisely estimated, and not generally considered related to SO due to lack of evidence and/or low statistical power.

    “The low frequency (less than 3%) of other factors could be explained by the following reasons: (i) more difficulties to be assessed (e.g.myosteatosis, secreted muscle Factors found in the literature were classified from the more frequent to the rarest (number of times or in percent of total number of factors -i.e.447 -).In the last column, positive association with sarcopenic obesity (as found in”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Some of these factors are commonly included in routine measurements when obese patients are included in research protocols and can be easily evaluated in blood samples.

    “This could be notably explained by the fact that some of these factors are commonly included in routine measurements when obese patients are included in research protocols and can be easily evaluated in blood samples (e.g.quantification of total cholesterol, high-or low-density lipoproteins for dyslipidemia).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Insulin resistance and plasma ghrelin profile were found to be predictive SO risk factors independent of age, sex and BMI in the MoMa epidemiological study.

    “They found insulin resistance and plasma ghrelin profile to be predictive SO risk factors independent of age, sex and BMI [59].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59] Gortan, 2023, Sarcopenic obesity in free-living older adults detected by the ESPEN-EASO consensus diagnostic algorithm: Validation in an Italian cohort and predictive value of insulin resistance and altered plasma ghrelin profile, Metabolism

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Even if depression is known to be associated with obesity, evidences are lacking in SO.

    “Even if depression is known to be associated with obesity [56,57], evidences are lacking in SO.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [56] Jokela, 2023, Obesity as a causal risk factor for depression: systematic review and meta-analysis of Mendelian Randomization studies and implications for population mental health, J Psychiatr Res source

      Not checked in the free run.

    • cites [57] Fulton, 2022, The menace of obesity to depression and anxiety prevalence, Trends Endocrinol Metab TEM source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Higher triglyceride levels were associated with SO in males but not in females.

    “More recently, higher triglyceride levels were associated with SO in males but not in females [14].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] Hwang, 2023, Gender-specific prevalence and risk factors of sarcopenic obesity in the Korean elderly population: a nationwide cross-sectional study, Int J Environ Res Publ Health source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationcitation

    In all clinical situations linked to SO, it might be of particular importance to address the role of myosteatosis and low muscle density in the development of SO as literature is scarce.

    “In all the various clinical situations linked to SO, it might be of particular importance to address the role of myosteatosis and low muscle density in the development of SO as literature is scarce on this [36].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] Zamboni, 2019, Myosteatosis: a relevant, yet poorly explored element of sarcopenia, Eur Geriatr Med source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Da Boit et al. described an increased muscle function in older women but not in men after receiving fish oil supplements.

    “Da Boit et al. described an increased muscle function in older women but not in men [52] after receiving fish oil supplements.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [52] Da Boit, 2017, Sex differences in the effect of fish-oil supplementation on the adaptive response to resistance exercise training in older people: a randomized controlled trial, Am J Clin Nutr source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Alcohol consumption was positively related to SO in some studies and negatively in others.

    “Indeed, alcohol consumption was positively related to SO [15e17] or negatively [18e21].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [15e17]

      Not checked in the free run.

    • cites [18e21]

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Factors found in literature were classified by the experts, but it was not possible to propose a restrictive number of key factors because the authors were not able to perform statistical analyses to decipher which factors are relevant or not.

    “Factors found in literature were classified by the experts but it was not possible to propose a restrictive number of key factors as we were not able to perform statistical analyses and decipher which factors are relevant or not.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    It might have a weak effect on our results as we focused on other factors than body composition and muscle strength and function.

    “However, it might have a weak effect on our results as we focused on other factors than body composition and muscle strength and function.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing). May combine two claims.

    Premisecitation

    Park et al. suggested that adequate energy intake that meets requirements is more likely to be effective as a major prevention and treatment goal for sarcopenia, whereas physical activity guidelines should be prioritized in the case of SO.

    “More recently, Park et al. suggested that adequate energy intake that meets requirements is more likely to be effective as a major prevention and treatment goal for sarcopenia, whereas physical activity guidelines should be prioritized in the case of SO [55].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [55] Park, 2023, The effect of combining nutrient intake and physical activity levels on central obesity, sarcopenia, and sarcopenic obesity: a population-based cross-sectional study in South Korea, BMC Geriatr source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    Such discrepancies might be partially explained by sex-specific factors.

    “Such discrepancies might be partially explained by sex-specific factors [22].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Ryu, 2013, Association of physical activity with sarcopenia and sarcopenic obesity in community-dwelling older adults: the Fourth Korea National Health and Nutrition Examination Survey, Age Ageing source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    We did not consider the variability in cut-off values used between the studies for the definition of SO.

    “We did not consider the variability in cut-off values used between the studies for the definition of SO.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Taken individually, the articles identified in the review gave interesting results helpful for profiling individuals at risk of SO and targeting them for SO development prevention, but their frequency is too low to definitely conclude on their role.

    “Taken individually, these articles gave interesting results which will be helpful for profiling individuals at risk of SO and targeting them for SO development prevention but their frequency is too low to definitely conclude on their role.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The analysis was performed only with articles written in English and before the publication of the SO definition consensus.

    “The analysis was performed only with articles written in English and before the publication of the SO definition consensus [3].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] Donini, 2022, Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement, Clin Nutr source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Many diseases could lead to reduced physical activity and/or unbalanced diet, increasing significantly the loss of muscle mass also in patients who are overweight or obese, and might be considered as a SO risk factor.

    “Globally, many diseases could lead to a reduced physical activity and/or an unbalanced diet increasing significantly the loss of muscle mass also in patients who are overweight or obese and might be considered as a SO risk factor.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In chronic kidney disease, even if the SO prevalence is lower than that of sarcopenia, patients are also at risk of SO.

    “In chronic kidney disease, even if the SO prevalence is lower than that of sarcopenia, patients are also at risk of SO.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33] Barreto Silva, 2022, Sarcopenia and sarcopenic obesity in chronic kidney disease: update on prevalence, outcomes, risk factors and nutrition treatment, Curr Opin Clin Nutr Metab Care source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    All of the factors identified can thus be considered in clinical practice either as deleterious or as protective regarding patient's conditions.

    “All of the factors identified can thus be considered in clinical practice either as deleterious or as protective regarding patient's conditions.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    High total and central body adiposity contribute to sarcopenia through a bi-directional relationship with reduced physical activity and unbalanced diet in chronic kidney disease patients.

    “As mentioned by Barreto Silva et al., high total and central body adiposity contribute to sarcopenia through a bi-directional relationship with reduced physical activity and unbalanced diet in these patients [33].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33] Barreto Silva, 2022, Sarcopenia and sarcopenic obesity in chronic kidney disease: update on prevalence, outcomes, risk factors and nutrition treatment, Curr Opin Clin Nutr Metab Care source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    One article mentioned a larger muscle mass but a reduced muscle quality associated with SO.

    “In our research, one article mentioned a larger muscle mass but a reduced muscle quality associated with SO [37].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37] Mesinovic, 2019, Metabolic syndrome and its associations with components of sarcopenia in overweight and obese older adults, J Clin Med

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    As dyslipidemia and insulin resistance could be related to lower muscle response to insulin, the positive link should be the most plausible, but further studies are necessary to clearly conclude.

    “As these two dysregulations could be related to lower muscle response to insulin, it might be stated that the positive link should be the most plausible but further studies should be necessary to clearly conclude.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Evidence on nutrition and muscle aspects has only been developed very recently and may participate to the low number of studies investigating their role in the timeline of our analysis (2000-2021).

    “Additionally, evidence on nutrition and muscle aspects has only been developed very recently (i.e.sarcopenia definition) and may participate to the low number of studies investigating their role in the timeline of our analysis (2000e2021).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Eicosapentaenoic acid was found to be associated with higher intramuscular adipose tissue and arachidonic acid associated to smaller muscles.

    “Conversely, eicosapentaenoic acid (a very long chain omega-3 polyunsaturated fatty acid) was found to be associated with higher intramuscular adipose tissue and arachidonic acid (omega-6 polyunsaturated fatty acid) associated to smaller muscles [53].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [53] Reinders, 2015, Plasma phospholipid PUFAs are associated with greater muscle and knee extension strength but not with changes in muscle parameters in older adults, J Nutr

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The panel of experts likely did not consider gut dysbiosis important because of the lack of literature in the SO research field or because of the difficulty to include it in clinical assessment.

    “likely because of the lack of literature in the research field of SO or because of the difficulty to include it in clinical assessment, as could be the case for myosteatosis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    The variety of clinical situations may affect the pathological process and may explain the variability of factors found associated with SO.

    “The variety of clinical situations may affect the pathological process and may explain the variability of factors found associated with SO.”
    Quote in the paperNot a substantial claim
46 of 46

  • The paper relies on this without support.

    Little is known about the related factors of sarcopenic obese patients and the potential risk factors leading to the development of SO.

    “However, little is known about the related factors of the sarcopenic obese patients and the potential risk factors leading to the development of SO.”

  • The paper relies on this without support.

    The relevance of factors related to SO has not yet been investigated.

    “An increasing number of scientific articles on SO has been published but the relevance of the factors related to SO has not yet been investigated.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A recent literature review described five main factors associated with SO (i.e., insulin resistance, dyslipidaemia, exercise training, inflammation and hypertension) from a total of 39.

    “A recent literature review described five main factors associated with SO (i.e., insulin resistance, dyslipidaemia, exercise training, inflammation and hypertension) from a total of 39 [28].”

    From Sarcopenic Obesity Phenotype Index (SOP <i>i</i> ): A Population‐Based Study (2025) · cites this paper as [28]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Text and Figure 4 caption draw opposite conclusions about frequency and expert scores

    Major

    The comparison section says higher literature frequency was not related to more positive expert evaluations. The Figure 4 caption says the most frequent factors generally received better scores.

  • Micronutrients row reports 100% for zero positive associations

    Minor

    Table 1 reports zero positive associations among five micronutrient entries, which is 0%, not 100%.

    Reported 100 · recomputed 0

  • Diabetes contradicts the claim that all remaining factors are below 4%

    Minor

    After naming the more frequent factors, the text says every other factor accounts for less than 4%. Table 1 lists diabetes at exactly 4.0%.

3 of 3

Cites

Flagged first, then by citations

6 of the 66 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Pinel, A., Guillet, C., Capel, F., Pouget, M., De Antonio, M., Pereira, B., Topinkova, E., Eglseer, D., Barazzoni, R., Cruz-Jentoft, A. J., Schoufour, J. D., Weijs, P. J. M., & Boirie, Y.
Affiliations
  • Université Clermont Auvergne (FR)
  • Centre Hospitalier Universitaire de Clermont-Ferrand (FR)
  • Medical University of Graz (AT)
  • University of Trieste (IT)
  • Instituto Ramón y Cajal de Investigación Sanitaria (ES)
  • Amsterdam University of Applied Sciences (NL)
  • Amsterdam Public Health (NL)
Corresponding author
  • Pinel, A.
  • Guillet, C.
  • Pouget, M.
  • Pereira, B.
  • Eglseer, D.
  • Barazzoni, R.
  • Cruz-Jentoft, A.J.
  • Schoufour, J.D.
  • Weijs, P.J.M.
ORCID
Venue
Clinical Nutrition
Publisher
Elsevier BV
Published
2024-06
Volume
43
Issue
6
Pages
1414-1424
ISSN
0261-5614 (ISSN-L)
DOI
10.1016/j.clnu.2024.04.033
OpenAlex
W4395071748
Semantic Scholar
7712dc678de4f7cedd2b006518a9cc4e9b346b7f
Cited by
24
References
66
Citations by year
2026: 4 · 2025: 9 · 2024: 11
FWCI
1.36
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Nutrition (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
  • HAL (submittedVersion, other-oa)
  • HAL (submittedVersion, cc-by)
  • ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion, cc-by-nc-nd)
Funders
  • JPI HDHL
  • Horizon 2020
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
Keywords
sarcopenic obesity, risk factors, sarcopenia, obesity, skeletal muscle mass, insulin resistance, dyslipidemia, physical inactivity, exercise training, inflammation, hypertension, protein intake, energy intake, aging, risk stratification
MeSH terms
Voting, Aging, Humans, Insulin Resistance, Obesity, Risk Factors, Exercise, Muscle, Skeletal, Sarcopenia

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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