The Impact of Insulin Resistance and Inflammation on the Association Between Sarcopenic Obesity and Physical Functioning
Open Access
- 17 October 2012
- Vol. 20 (10), 2101-2106
- https://doi.org/10.1038/oby.2012.20
Abstract
Age associated increases in visceral adiposity and decreases in muscle mass (sarcopenia) have been shown to contribute to disability in late life. Furthermore, there is evidence that obesity‐related physiological states, such as insulin resistance and systemic inflammation, may exacerbate physical functioning problems. Both conditions have been shown to prompt hypercatabolism and impair the anabolic effect of muscles, ultimately stimulating protein breakdown and suppressing muscle synthesis. This cross‐sectional study investigates whether insulin resistance and inflammation partially account for the associations between decreased physical functioning and sarcopenic obesity. Subjects include 2,287 males and females aged 60 and older without diagnosed diabetes from the National Health and Nutrition Examination Survey (NHANES 1999–2004). Body composition measurements indicating waist circumference and appendicular skeletal muscle mass, measured by dual‐energy X‐ray absorptiometry (DXA), were used to construct four body composition categories—healthy, sarcopenic nonobese, nonsarcopenic obese, and sarcopenic obese. Physical functioning was measured using self‐reports of difficulty performing six activities. The homeostasis model assessment (IRHOMA) was used to measure insulin resistance, while inflammatory state was assessed through measurement of serum C‐reactive protein (CRP). Modified Poisson regression models were used to examine the association between physical functioning and body composition, and to evaluate whether differences in insulin resistance or inflammation partially explained this relationship. In the analysis, we controlled for possible confounders such as age, education, sex, height, and race/ethnicity. Findings suggest that physical functioning problems are increased in those with sarcopenic obesity, sarcopenic nonobesity and nonsarcopenic obesity. Furthermore, these associations may be influenced by differences in insulin resistance among different body composition phenotypes.Keywords
This publication has 33 references indexed in Scilit:
- What explains the American disadvantage in health compared with the English? The case of diabetesJournal of Epidemiology and Community Health, 2010
- Sarcopenic Obesity: Prevalence and Association With Metabolic Syndrome in the Korean Longitudinal Study on Health and Aging (KLoSHA)Diabetes Care, 2010
- Inflammation: Roles in Aging and SarcopeniaJournal of Parenteral and Enteral Nutrition, 2008
- Hypercatabolic Syndrome: Molecular Basis and Effects of Nutritional Supplements with Amino AcidsThe American Journal of Cardiology, 2008
- Sarcopenic obesity and inflammation in the InCHIANTI studyJournal of Applied Physiology, 2007
- The molecular basis of skeletal muscle atrophyAmerican Journal of Physiology-Cell Physiology, 2004
- Disability as a Public Health Outcome in the Aging PopulationAnnual Review of Public Health, 1996
- Regression analyses of counts and rates: Poisson, overdispersed Poisson, and negative binomial models.Psychological Bulletin, 1995
- Body mass index, weight change, and risk of mobility disability in middle-aged and older women. The epidemiologic follow-up study of NHANES IJAMA, 1994
- Human Aging: Usual and SuccessfulScience, 1987