Osteosarcopenic Visceral Obesity and Osteosarcopenic Subcutaneous Obesity, Two New Phenotypes of Sarcopenia: Prevalence, Metabolic Profile, and Risk Factors
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Background . The main criticism of the definition of “osteosarcopenic obesity” (OSO) is the lack of division between subcutaneous and visceral fat. This study describes the prevalence, metabolic profile, and risk factors of two new phenotypes of sarcopenia: osteosarcopenic visceral obesity (OSVAT) and osteosarcopenic subcutaneous obesity (OSSAT). Methods . A standardized geriatric assessment was performed by anthropometric and biochemical measures. Dual-energy X-ray absorptiometry (DXA) was used to assess body composition, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), osteoporosis, and sarcopenia. Results . A sample of 801 subjects were assessed (247 men; 554 women). The prevalence of osteosarcopenic obesity (OSO) was 6.79%; OSSAT and OSOVAT were, respectively, 2.22% and 4.56%. OSVAT (versus the others) showed a higher level of inflammation (CRP and ESR, p < 0.05 ), bilirubin ( p < 0.05 ), and risk of fractures (FRAX index over 15%, p < 0.001 ). Subjects with OSSAT did not show any significant risk factors associated to obesity. Conclusions . The osteosarcopenic visceral obesity phenotype (OSVAT) seems to be associated with a higher risk of fractures, inflammation, and a worse metabolic profile. These conditions in OSVAT cohort are associated with an increase of visceral adipose tissue, while patients with OSSAT seem to benefit related to the “obesity paradox.”
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Visceral obesity was closely linked to a higher risk of fractures and inflammation.
“Visceral obesity was closely linked to a higher risk of fractures and inflammation [77].”
From Is There Enough Evidence for Osteosarcopenic Obesity as a Distinct Entity? A Critical Literature Review (2019) · cites this paper as [77]
Among a sample population of older people (N=801), the prevalence of osteosarcopenic obesity was 6.8%; subjects with a visceral/subcutaneous adipose tissue ratio greater than 1 were classified as having visceral obesity, and subjects with values under 1 were classified as having subcutaneous obesity.
“Among a sample population of older people (N = 801), the prevalence of osteosarcopenic obesity was determined as 6.8%; subjects with a visceral/subcutaneous adipose tissue ratio > 1 were classified as having visceral obesity, and subjects with values under 1 were classified as having subcutaneous obesity [77].”
From Is There Enough Evidence for Osteosarcopenic Obesity as a Distinct Entity? A Critical Literature Review (2019) · cites this paper as [77]
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Perna, S., Hammad, L., Mohamed, M. W., Alromaihi, D., Alhammadi, M., Al-Khater, N., Alchuban, A. R., Aledrisy, M. A., Ilyas, Z., Alalwan, T. A., et al. (2022) · Geriatrics · doi:10.3390/geriatrics7040075 · Cited by 2 · see citing works
“4% had elevated TGs, all of which contribute to MetS development [25].”
BackgroundSelf-citationPapadopoulou‐Marketou, N., Papageorgiou, A., & Chrousos, G. P. (2023) · Endocrines · doi:10.3390/endocrines4020029 · Cited by 2 · see citing works
“…results in the coexistence of bone loss (osteoporosis); sarcopenia/dynapenia (decreased muscle performance); and increased adiposity, either as overt, BMI-defined overweight/obesity or because of tissue accumulation and organ infiltration with fat (liver, skeletal muscle, and bone) [1,2].”
BackgroundPerna, S., & Rondanelli, M. (2023) · Nutrients · doi:10.3390/nu15092188 · Cited by 2 · see citing works
“This obesity paradox is based on the subcutaneous adipose tissue that appears to be protective against an adverse prognosis; whereas, in contrast, visceral adipose tissue (VAT) is associated with the progression of sarcopenia [3,4].”
BackgroundSelf-citationCvijetić, S., Keser, I., & Ilich, J. Z. (2024) · Archives of Industrial Hygiene and Toxicology · doi:10.2478/aiht-2024-75-3886 · Cited by 1 · see citing works
Sarcopenia: clinic, diagnosis, treatment, prevention (literature review)
Bykov, Y. N., & Nurulina, T. F. (2025) · Vestnik of North-Eastern Federal University Medical Sciences · doi:10.25587/2587-5590-2025-2-12-22 · Cited by 1 · see citing works
Obesidade osteosarcopênica sob o olhar da nutrição funcional
de Souza, M. L. R. (2019) · Revista Brasileira de Nutrição Funcional · doi:10.32809/2176-4522.42.77.05 · Cited by 1 · see citing works
Araújo, M. M., Lima, R. M., de Carvalho, K. M. B., & Botelho, P. B. (2024) · Nutrients · doi:10.3390/nu16223965 · Cited by 1 · see citing works
Modeling the Risk of Decrease in Bone Mineral Density in Men with Type 2 Diabetes
Fazullina, O. N., & Klimontov, V. V. (2019) · International Multi-Conference on Engineering, Computer and Information Sciences (SIBIRCON) · doi:10.1109/sibircon48586.2019.8958320
“These relationships could be explained by molecular interactions between adipose tissue, muscles, and bones [4].”
BackgroundПОСТМЕНОПАУЗАЛЬНАЯ ОСТЕОСАРКОПЕНИЯ
Іgnatiev, О. М., Turchin, M. I., & Yermolenko, T. О. (2021) · Актуальні питання педіатрії акушерства та гінекології · doi:10.11603/24116-4944.2020.2.11845
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Osteosarcopenia as a lifetime syndrome: Could it be prevented?
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Sarcopenia: modern views of the problem
Pasiyeshvili, L. M., & Zhelezniakova, N. M. (2023) · Shidnoevropejskij zurnal vnutrisnoi ta simejnoi medicini · doi:10.15407/internalmed2023.02b.121
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Imaging methods for assessing fat depot status in osteosarcopenic obesity
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“Prior work has established visceral and subcutaneous fat as distinct metabolic and inflammatory phenotypes [21,22].”
Elkasabi, H. G., Hegazi, Y., Abdelaziz, M., Moussa, M. M., ElShishiny, M. A., Salman, K., Shalaby, M. M., Achkar, M. E. G., El-Deeb, K. Y., Eladl, M. E., et al. (2026) · Annals of Anatomy - Anatomischer Anzeiger · doi:10.1016/j.aanat.2026.153390
- Authors
- Perna, S., Spadaccini, D., Nichetti, M., Avanzato, I., Faliva, M. A., & Rondanelli, M.
- Affiliations
- University of Pavia (IT)
- Corresponding author
- Perna, Simone
- Venue
- Journal of Aging Research
- Publisher
- Wiley
- Published
- 2018
- Volume
- 2018
- Pages
- 1-8
- ISSN
- 2090-2204 (ISSN-L)
- 2090-2212
- PMC
- PMC5976921
- OpenAlex
- W2804966739
- Cited by
- 65
- References
- 34
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 5 · 2023: 13 · 2022: 11 · 2021: 6 · 2020: 11 · 2019: 6 · 2018: 2
- FWCI
- 4.30
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Aging Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- osteosarcopenic obesity, visceral adipose tissue, subcutaneous adipose tissue, fracture risk, inflammation, C-reactive protein, erythrocyte sedimentation rate, obesity paradox, metabolic profile, prevalence, risk factors, body composition, osteoporosis
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