Endocrine Abstracts

Sarcopenic obesity is a clinical condition characterized by the coexistence of excess fat mass and sarcopenia, i.e. a decrease in muscle mass or function. This coincidence leads to an increased risk of complications. Sarcopenia induces increased insulin resistance and worsens the metabolic status of obesity, while impairing functional capacity. Obesity itself can induce changes in muscle mass and function, as a consequence of changes in diet and physical activity and alterations in different hormonal axes (GH/IGF-1, hypogonadism, decreased adrenal androgens, etc.). Insulin resistance itself as well as the secretion of hormones and inflammatory mediators by adipose tissue may promote protein catabolism. There is no unanimous agreement on the diagnostic criteria for sarcopenic obesity or the most appropriate method of assessing body composition or muscle function. For this reason, the prevalence of this clinical condition is not well known, although it is more frequent in the elderly or in patients with a chronic disease that induce inflammation or increased catabolism (heart failure, pulmonary, renal or chronic liver disease). The clinical approach to the sarcopenic obese patient should be multifactorial, and treatment includes correction of predisposing factors, increased physical activity and adjustment of the dietary pattern. There is an urgent need to increase our knowledge of the factors influencing the genesis and progression of sarcopenic obesity and to define uniform diagnostic criteria accepted in the scientific community.