Association between severe sarcopenic obesity and respiratory incidence and mortality: an obesity paradox.

IntroductionObesity remains one of the biggest health challenges worldwide. Sarcopenia, a progressive loss of muscle strength, is associated with a higher risk of disability and lower quality of life. Both conditions can occur independently of each other; however, share a common inflammatory pathway, leading to serious health problems. Previous studies have shown a positive association between severe sarcopenia and respiratory disease incidence/mortality, however, it is unclear if this association is modified by obesity. The aim of this work, therefore, was to investigate the association of severe sarcopenia and severe sarcopenic-obesity with respiratory incidence and mortality in the UK Biobank cohort.Material and methods242,572 white participants from the UK biobank study were included. Severe sarcopenia was defined as the combination of low muscle mass, low grip strength and slow gait speed. Severe sarcopenic-obesity was defined, using 3 different criteria. The combination of severe sarcopenia plus at least one of the following criteria: BMI ≥ 30 kg/m2, waist circumference (WC) > 88 cm in women and > 102 cm in men, or the two highest quintiles of body fat (60%). Associations between severe sarcopenic and severe sarcopenic-obesity and respiratory incidence and mortality were investigated using Cox-proportional hazard models.ResultsIn people without sarcopenia, high BMI, WC and body fat were associated with a reduced risk of respiratory disease mortality (HR: 0.70 [0.52; 0.85], HR: 0.74 [95%CI: 062: 088] and HR: 0.74 [95%CI: 0.63; 0.88], respectively). In comparison to people without sarcopenia or obesity, those with severe sarcopenia had three times higher risk of respiratory disease incidence (HR: 3.13 [95%CI: 2.25; 4.35]) and five times higher risk of mortality (HR: 5.37 [95%CI: 2.96: 9.74]). However, sarcopenic-obesity, based on WC and body fat, was only associated with a moderately increased respiratory disease incidence (HR 1.60 [95%CI: 1.04; 2.46] and HR: 1.52 [1.04: 2.22], respectively). There were no associations between respiratory mortality and sarcopenic-obesity.DiscussionHigher levels of adiposity may be a protective factor against respiratory mortality and could reduce the effect of severe sarcopenia over this disease. However, the mechanism behind this association needs to elucidate.

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Letter to the Editor: Comment on “Sarcopenic obesity and its association with respiratory disease incidence and mortality”

Clinical Nutrition ◽

10.1016/j.clnu.2021.03.025 ◽

2021 ◽

Author(s):

Priscila Berti Zanella

Keyword(s):

Respiratory Disease ◽

Disease Incidence ◽

Sarcopenic Obesity ◽

Editor Comment ◽

Letter To The Editor ◽

Incidence And Mortality

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Sarcopenic obesity and its association with respiratory disease incidence and mortality – Authors’ reply

Clinical Nutrition ◽

10.1016/j.clnu.2021.03.030 ◽

2021 ◽

Vol 40 (5) ◽

pp. 2520

Author(s):

Fanny Petermann-Rocha ◽

Shuai Yang ◽

Stuart R. Gray ◽

Jill P. Pell ◽

Carlos Celis-Morales ◽

...

Keyword(s):

Respiratory Disease ◽

Disease Incidence ◽

Sarcopenic Obesity ◽

Incidence And Mortality

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Associations of six adiposity-related markers with incidence and mortality from 24 cancers—findings from the UK Biobank prospective cohort study

BMC Medicine ◽

10.1186/s12916-020-01848-8 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Solange Parra-Soto ◽

Emma S. Cowley ◽

Leandro F. M. Rezende ◽

Catterina Ferreccio ◽

John C. Mathers ◽

...

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Body Fat ◽

Cancer Incidence ◽

Body Fat Percentage ◽

Uk Biobank ◽

Fat Percentage ◽

Incidence And Mortality ◽

The Uk

Abstract Background Adiposity is a strong risk factor for cancer incidence and mortality. However, most of the evidence available has focused on body mass index (BMI) as a marker of adiposity. There is limited evidence on relationships of cancer with other adiposity markers, and if these associations are linear or not. The aim of this study was to investigate the associations of six adiposity markers with incidence and mortality from 24 cancers by accounting for potential non-linear associations. Methods A total of 437,393 participants (53.8% women; mean age 56.3 years) from the UK Biobank prospective cohort study were included in this study. The median follow-up was 8.8 years (interquartile range 7.9 to 9.6) for mortality and 9.3 years (IQR 8.6 to 9.9) for cancer incidence. Adiposity-related exposures were BMI, body fat percentage, waist-hip ratio, waist-height ratio, and waist and hip circumference. Incidence and mortality of 24 cancers sites were the outcomes. Cox proportional hazard models were used with each of the exposure variables fitted separately on penalised cubic splines. Results During follow-up, 47,882 individuals developed cancer and 11,265 died due to cancer during the follow-up period. All adiposity markers had similar associations with overall cancer incidence. BMI was associated with a higher incidence of 10 cancers (stomach cardia (hazard ratio per 1 SD increment 1.35, (95% CI 1.23; 1.47)), gallbladder (1.33 (1.12; 1.58)), liver (1.27 (1.19; 1.36)), kidney (1.26 (1.20; 1.33)), pancreas (1.12 (1.06; 1.19)), bladder (1.09 (1.04; 1.14)), colorectal (1.10 (1.06; 1.13)), endometrial (1.73 (1.65; 1.82)), uterine (1.68 (1.60; 1.75)), and breast cancer (1.08 (1.05; 1.11))) and overall cancer (1.03 (1.02; 1.04)). All these associations were linear except for breast cancer in postmenopausal women. Similar results were observed when other markers of central and overall adiposity were used. For mortality, nine cancer sites were linearly associated with BMI and eight with waist circumference and body fat percentage. Conclusion Adiposity, regardless of the marker used, was associated with an increased risk in 10 cancer sites.

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Sarcopenic obesity and its association with respiratory disease incidence and mortality

Clinical Nutrition ◽

10.1016/j.clnu.2020.03.006 ◽

2020 ◽

Vol 39 (11) ◽

pp. 3461-3466 ◽

Cited By ~ 1

Author(s):

Fanny Petermann-Rocha ◽

Shuai Yang ◽

Stuart R. Gray ◽

Jill P. Pell ◽

Carlos Celis-Morales ◽

...

Keyword(s):

Respiratory Disease ◽

Disease Incidence ◽

Sarcopenic Obesity ◽

Incidence And Mortality

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A Prospective Investigation of Body Size, Body Fat Composition and Colorectal Cancer Risk in the UK Biobank

Scientific Reports ◽

10.1038/s41598-017-17997-5 ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 8

Author(s):

Luisa Saldana Ortega ◽

Kathryn E. Bradbury ◽

Amanda J. Cross ◽

Jessica S. Morris ◽

Marc J. Gunter ◽

...

Keyword(s):

Colorectal Cancer ◽

Body Size ◽

Cancer Risk ◽

Body Fat ◽

Colorectal Cancer Risk ◽

Uk Biobank ◽

Fat Composition ◽

The Uk ◽

Prospective Investigation

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The Association of Serum Lipid and Lipoprotein Levels with Total and Differential Leukocyte Counts: Results of a Cross-sectional and Longitudinal Analysis of the UK Biobank

10.1101/2020.07.11.20149310 ◽

2020 ◽

Author(s):

Bradley Tucker ◽

Sonia Sawant ◽

Hannah McDonald ◽

Kerry-Anne Rye ◽

Sanjay Patel ◽

...

Keyword(s):

Longitudinal Analysis ◽

Positive Association ◽

Hdl Cholesterol ◽

Uk Biobank ◽

Cross Sectional ◽

Lipoprotein A ◽

Valid Data ◽

Leukocyte Counts ◽

The Uk ◽

Relationship Of

Background and aims: There is some evidence of a cross-sectional, and possibly causal, relationship of lipid levels with leukocyte counts in mice and humans. This study investigates the cross-sectional and longitudinal relationship of blood lipid and lipoprotein levels with leukocyte counts in the UK Biobank cohort. Methods: The primary cross-sectional analysis included 417,132 participants with valid data on lipid measures and leukocyte counts. A subgroup analysis was performed in 333,668 participants with valid data on lipoprotein(a). The longitudinal analysis included 9,058 participants with valid baseline and follow-up data on lipid and lipoprotein levels and leukocyte counts. The association of lipid and lipoprotein levels with leukocyte counts was analysed by multivariable linear regression. Results: Several relationships were significant in both cross-sectional and longitudinal analysis. After adjustment for demographic, socioeconomic and other confounding factors a higher eosinophil count was associated with lower HDL cholesterol and apolipoproteinA-I concentration (p<0.001). Higher triglycerides levels were associated with higher total leukocyte, basophil, eosinophil, monocyte and neutrophil counts (all p<0.01). A higher lymphocyte count was associated with a higher apolipoprotein B level (p<0.001). In the longitudinal analysis lipoprotein(a) was inversely associated with basophil count in men but not women (p<0.001). Conclusion: Triglyceride levels demonstrate a robust positive association with total and differential leukocyte counts suggesting they may be directly involved in leuokogenesis. However, unlike in murine models, the remainder of these relationships are modest which suggests that cholesterol and lipoproteins are minimally involved in leukogenesis in humans.

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Association of Antioxidants Use with All-Cause and Cause-Specific Mortality: A Prospective Study of the UK Biobank

Antioxidants ◽

10.3390/antiox9121287 ◽

2020 ◽

Vol 9 (12) ◽

pp. 1287

Author(s):

Inken Behrendt ◽

Gerrit Eichner ◽

Mathias Fasshauer

Keyword(s):

Respiratory Disease ◽

Mortality Risk ◽

Cancer Mortality ◽

Primary Objective ◽

Inverse Association ◽

Uk Biobank ◽

Cancer Subtypes ◽

Specific Mortality ◽

The Uk ◽

The Impact

Prospective studies and randomized controlled trials elucidating the impact of antioxidants supplementation on mortality risk are inconclusive. The present analysis determined association between regular antioxidants use and all-cause (primary objective), as well as cause-specific, mortality in 345,626 participants of the UK Biobank cohort using Cox proportional hazard models. All models were adjusted for confounders and multiple testing. Antioxidants users were defined as participants who indicated to regularly use at least one of the following: multivitamins, vitamin C, vitamin E, selenium, and zinc. Median age of antioxidants users (n = 101,159) and non-users (n = 244,467) at baseline was 57 years. During 3.9 million person-years and a median follow-up of 11.5 years, 19,491 deaths occurred. Antioxidants use was not significantly associated with all-cause, cancer, and non-cancer mortality including several cancer and non-cancer subtypes. Interestingly, mortality risk from respiratory disease was significantly 21% lower among antioxidants users as compared to non-users (hazard ratio: 0.79; 95% confidence interval: 0.67, 0.92). In conclusion, the present study findings do not support recommendations for antioxidants supplementation to prevent all-cause, cancer, or non-cancer mortality on a population level. The significant inverse association between antioxidants use and respiratory disease mortality needs further study.

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