Cited by 247Nutrition and Health in AgingBody Composition Measurement TechniquesFrailty in Older Adults

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Deciphering the “obesity paradox” in the elderly: A systematic review and meta‐analysis of sarcopenic obesity

Liu, Chaoran, Wong, Pui Yan, Chung, Yik Lok, Chow, Simon Kwoon‐Ho, Cheung, Wing Hoi, Law, Sheung Wai, Chan, Juliana Chung Ngor, Wong, Ronald Man Yeung·2023·Obesity Reviews

DOI 10.1111/obr.13534

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Abstract

Summary: Aging and obesity are two global concerns in public health. Sarcopenic obesity (SO), defined as the combination of age‐related sarcopenia and obesity, has become a pressing issue. This systematic review and meta‐analysis summarize the current clinical evidence relevant to SO. PubMed, Embase, and Web of Science were searched, and 106 clinical studies with 167,151 elderlies were included. The estimated prevalence of SO was 9% in both men and women. Obesity was associated with 34% reduced risk of sarcopenia (odds ratio [OR] 0.66, 95% CI 0.48–0.91; p < 0.001). The pooled hazard ratio (HR) of all‐cause mortality was 1.51 (95% CI 1.14–2.02; p < 0.001) for people with SO compared with healthy individuals. SO was associated with increased risk of cardiovascular disease and related mortality, metabolic disorders, cognitive impairment, arthritis, functional limitation, and lung diseases (all ORs > 1.0, p < 0.05). The attenuated risk of sarcopenia in elderlies with obesity (“obesity paradox”) was dependent on higher muscle mass and strength. Apart from unifying the diagnosis of SO, more research is needed to subphenotype people with obesity and sarcopenia for individualized treatment. Meanwhile, the maintenance of proper body composition of muscle and fat may delay or attenuate the adverse outcomes of aging.

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Authors: Liu, C., Wong, P. Y., Chung, Y. L., Chow, S. K., Cheung, W. H., Law, S. W., Chan, J. C. N., & Wong, R. M. Y.
Affiliations: Chinese University of Hong Kong (HK)
Corresponding author: Wong, Ronald Man Yeung
ORCID: Liu, Chaoran
Wong, Pui Yan
Chung, Yik Lok
Chow, Simon Kwoon‐Ho
Cheung, Wing Hoi
Law, Sheung Wai
Chan, Juliana Chung Ngor
Wong, Ronald Man Yeung
Venue: Obesity Reviews
Publisher: Wiley
Published: 2022-11-28
Volume: 24
Issue: 2
Pages: e13534-e13534
ISSN: 1467-7881 (ISSN-L)
1467-789X
DOI: 10.1111/obr.13534
OpenAlex: W4310209091
Cited by: 247
References: 133
Citations by year: 2026: 61 · 2025: 92 · 2024: 70 · 2023: 24
FWCI: 6.40
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Obesity Reviews (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Keywords: sarcopenic obesity, obesity paradox, sarcopenia, aging, older adults, all-cause mortality, cardiovascular disease, cognitive impairment, functional limitations, muscle mass, muscle strength, body composition, prevalence
MeSH terms: Aged, Aging, Body Composition, Cardiovascular Diseases, Female, Humans, Male, Obesity, Sarcopenia

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Deciphering the “obesity paradox” in the elderly: A systematic review and meta‐analysis of sarcopenic obesity

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