Relationships between sarcopenic obesity and insulin resistance, inflammation, and vitamin D status: the Korean Sarcopenic Obesity Study

Tae Nyun Kim, Man Sik Park, Kang Il Lim, Hae Yoon Choi, Sae Jeong Yang, Hye Jin Yoo, Hyun Joo Kang, Wook Song, Hyuk Choi, Sei Hyun Baik, Dong Seop Choi, Kyung Mook Choi
Clinical Endocrinology 2013, 78 (4): 525-32

OBJECTIVE: It has been suggested that insulin resistance, low-grade inflammation and vitamin D deficiency are associated with obesity and sarcopenia. However, their relationships with sarcopenic obesity (SO) are unclear. We evaluated the impact of homoeostasis model assessment of insulin resistance (HOMA-IR), high-sensitivity C-reactive protein (hsCRP) and 25-hydroxyvitamin D (25[OH]D) levels on SO in Korean adults. STUDY SUBJECT/MEASUREMENTS: This study included 493 apparently healthy adults (180 men and 313 women) enrolled in the Korean Sarcopenic Obesity Study. Sarcopenia was defined as a skeletal muscle mass index (SMI) of 1 SD below the sex-specific mean value for a young reference group. Obesity was defined as a visceral fat area (VFA) ≥100 cm(2) . We classified the participants into four sarcopenia/obesity groups based on both SMI and VFA.

RESULTS: The prevalence of SO was 17·8% in men and 24·9% in women. In women, the SO group had higher HOMA-IR and hsCRP levels compared with the non-SO group. In men, the 25[OH]D levels were significantly lower in the SO group than the non-SO group. Both hsCRP and HOMA-IR levels were negatively correlated with SMI and positively correlated with VFA in both men and women, whereas 25[OH]D levels were positively correlated with SMI in both men and women. Multiple binary logistic regression analysis showed that HOMA-IR and 25[OH]D levels were independently associated with SO in men, while HOMA-IR and hsCRP were significant factors predicting SO in women.

CONCLUSION: Insulin resistance, inflammation and vitamin D deficiency were associated with SO in a Korean adult population.

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