BMC Geriatrics (Jul 2022)

Sarcopenic obesity is associated with impaired physical function and mortality in older patients with heart failure: insight from FRAGILE-HF

  • Hiroshi Saito,
  • Yuya Matsue,
  • Kentaro Kamiya,
  • Nobuyuki Kagiyama,
  • Daichi Maeda,
  • Yoshiko Endo,
  • Hidenao Ueno,
  • Kenji Yoshioka,
  • Akira Mizukami,
  • Kazuya Saito,
  • Yuki Ogasahara,
  • Emi Maekawa,
  • Masaaki Konishi,
  • Takeshi Kitai,
  • Kentaro Iwata,
  • Kentaro Jujo,
  • Hiroshi Wada,
  • Masaru Hiki,
  • Taishi Dotare,
  • Tsutomu Sunayama,
  • Takatoshi Kasai,
  • Hirofumi Nagamatsu,
  • Tetsuya Ozawa,
  • Katsuya Izawa,
  • Shuhei Yamamoto,
  • Naoki Aizawa,
  • Kazuki Wakaume,
  • Kazuhiro Oka,
  • Shin-ichi Momomura,
  • Tohru Minamino

DOI
https://doi.org/10.1186/s12877-022-03168-3
Journal volume & issue
Vol. 22, no. 1
pp. 1 – 11

Abstract

Read online

Abstract Background The purpose of this study was to clarify the prevalence, association with frailty and exercise capacity, and prognostic implication of sarcopenic obesity in patients with heart failure. Methods The present study included 779 older adults hospitalized with heart failure (median age: 81 years; 57.4% men). Sarcopenia was diagnosed based on the guidelines by the Asian Working Group for Sarcopenia. Obesity was defined as the percentage of body fat mass (FM) obtained by bioelectrical impedance analysis. The FM cut-off points for obesity were 38% for women and 27% for men. The primary endpoint was 1-year all-cause death. We assessed the associations of sarcopenic obesity occurrence with the short physical performance battery (SPPB) score and 6-minute walk distance (6MWD). Results The rates of sarcopenia and obesity were 19.3 and 26.2%, respectively. The patients were classified into the following groups: non-sarcopenia/non-obesity (58.5%), non-sarcopenia/obesity (22.2%), sarcopenia/non-obesity (15.3%), and sarcopenia/obesity (4.0%). The sarcopenia/obesity group had a lower SPPB score and shorter 6MWD, which was independent of age and sex (coefficient, − 0.120; t-value, − 3.74; P < 0.001 and coefficient, − 77.42; t-value, − 3.61; P < 0.001; respectively). Ninety-six patients died during the 1-year follow-up period. In a Cox proportional hazard analysis, sarcopenia and obesity together were an independent prognostic factor even after adjusting for a coexisting prognostic factor (non-sarcopenia/non-obesity vs. sarcopenia/obesity: hazard ratio, 2.48; 95% confidence interval, 1.22–5.04; P = 0.012). Conclusion Sarcopenic obesity is a risk factor for all-cause death and low physical function in older adults with heart failure. Trial registration University Hospital Information Network (UMIN-CTR: UMIN000023929 ).

Keywords