Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Oct 1;72(10):1445-1451.
doi: 10.1093/gerona/glx002.

Low Lean Mass With and Without Obesity, and Mortality: Results From the 1999-2004 National Health and Nutrition Examination Survey

John A Batsis  1   2   3 , Todd A Mackenzie  2   3   4 , Rebecca T Emeny  2   3 , Francisco Lopez-Jimenez  5 , Stephen J Bartels  2   3
Affiliations

Low Lean Mass With and Without Obesity, and Mortality: Results From the 1999-2004 National Health and Nutrition Examination Survey

John A Batsis et al. J Gerontol A Biol Sci Med Sci. .

Abstract

Background: The Foundation for the NIH Sarcopenia Project validated cutpoints for appendicular lean mass. We ascertained the relationship between low lean mass (LLM), obesity, and mortality and identified predictors in this subgroup.

Methods: A total of 4,984 subjects aged 60 years and older were identified from the National Health and Nutrition Examination Survey 1999-2004 linked to the National Death Index. LLM was defined using reduced appendicular lean mass (men < 19.75 kg; females < 15.02 kg). Obesity was defined using dual-energy x-ray absorptiometry body fat (males ≥ 25%; females ≥ 35%). LLM with obesity was defined using criteria for both LLM and obesity. Proportional hazard models determined mortality risk for LLM and LLM with obesity, separately (referent = no LLM and no LLM with obesity, respectively).

Results: Mean age was 71.1 ± 0.19 years (56.5% female). Median follow-up was 102 months (interquartile range: 78, 124) with 1,901 deaths (35.0%). Prevalence of LLM with obesity was 33.5% in females and 12.6% in males. In those with LLM, overall mortality risk was 1.49 (1.27, 1.73) in males and 1.19 (1.02, 1.40) in females. Mortality risk in LLM with obesity was 1.31 (1.11, 1.55) and 0.99 (0.85, 1.16) in males and females, respectively. Age, diabetes, history of stroke, congestive heart failure, cancer, and kidney disease were predictive of death.

Conclusions: Risk of death is higher in subjects with LLM than with LLM and obesity. Having advanced age, diabetes, stroke, heart failure, cancer, and renal disease predict a worse prognosis in both classifications.

Keywords: Epidemiology; Low lean mass; Survival.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
(a,b) Sex-specific prevalence of low lean mass with obesity, by obesity definition, 1999–2004. Rates of low lean mass obesity using the ALM definitions of sarcopenia from the Foundation for the National Institutes of Health and three definitions of obesity (body fat percent, waist circumference, and body mass index). Obesity defined using body fat cutpoints were ≥25% in men and ≥35% in females; waist circumference ≥88/102 cm in men/women and body mass index ≥30 kg/m2. Sarcopenia is defined as ALM <19.75 kg and <15.02 kg in men and women. ALM = appendicular lean mass.
See this image and copyright information in PMC

References

    1. Studenski SA, Peters KW, Alley DE, et al. The FNIH Sarcopenia Project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci. 2014;69:547–558. doi:10.1093/gerona/glu010 - PMC - PubMed
    1. Sayer AA, Syddall H, Martin H, Patel H, Baylis D, Cooper C. The developmental origins of sarcopenia. J Nutr Health Aging. 2008;12:427–432. - PMC - PubMed
    1. Batsis JA, Barre LK, Mackenzie TA, Pratt SI, Lopez-Jimenez F, Bartels SJ. Variation in the prevalence of sarcopenia and sarcopenic obesity in older adults associated with different research definitions: dual-energy X-ray absorptiometry data from the National Health and Nutrition Examination Survey 1999–2004. J Am Geriatr Soc. 2013;61:974–980. doi:10.1111/jgs.12260 - PubMed
    1. McLean RR, Shardell MD, Alley DE, et al. Criteria for clinically relevant weakness and low lean mass and their longitudinal association with incident mobility impairment and mortality: the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project. J Gerontol A Biol Sci Med Sci. 2014;69:576–583. doi:10.1093/gerona/glu012 - PMC - PubMed
    1. Woo J, Leung J. Anthropometric cut points for definition of sarcopenia based on incident mobility and physical limitation in older Chinese people. J Gerontol A Biol Sci Med Sci. 2016;71:935–940. doi:10.1093/gerona/glv197 - PubMed