Body composition in long-living patients: sarcopenia, obesity and osteoporosis

BACKGROUND. Studies on body composition in long-living patients, especially using dual-energy absorptiometry, are almost unknown. AIM. To investigate body composition in patients over 90 years old (long-living patients) with coronary artery disease (CAD).

MATERIALS AND METHODS. This work was a cross-sectional study that enrolled 200 patients (140 women and 60 men, mean age 92.4 ± 2.3 years) with CAD. Body composition was analyzed using dual-energy X-ray absorptiometry.

RESULTS. Overweight or obesity were diagnosed in 69.5% of patients. Obesity was reported in 29.0% of patients: 77.6% of them had class I obesity, while class III obesity was not observed at all. Mean values of the body mass index (BMI) were 27.6 ± 4.5 kg/m2 (18.2–38.8 kg/m2). Women had a higher proportion of fat in all areas of the body. The adipose tissue content in the upper limbs was 1.6 kg in men and 2.2 kg in women (p < 0.0001); in the lower limbs, these values were 5.7 kg and 8.1 kg, respectively (p < 0.0001). The ratio of the adipose tissue in the lower limbs to the total fat content reached 0.40 in women and 0.27 in men (p < 0.0001). The ratio of trunk fat to total fat was 0.53 in women and 0.62 in men (p < 0.0001). Mean values of bone mineral density (BMD) as a whole were 1,008 ± 140 mg/cm3; the T-score reached -1.7SD. The lowest BMD values were registered in the ribs (626 mg/cm3). In women, all BMD values were significantly lower than in men; the greatest differences were noted for BMD of the lower and upper extremities (p < 0.0001). The total lean tissue content was 38.4 kg in women and 48.8 kg in men (p < 0.0001). The musculoskeletal index remained within normal in 72.1% of patients. A decrease in this index was reported in 25% of women and 33% of men. A direct correlation was established between BMI and BMD in all areas of the skeleton (r = 0.5; p < 0.0001). A highly significant direct correlation was found between the adipose tissue content in all areas of the body and BMD; the most significant values were registered for the correlation between BMD of the ribs and the fat mass in the trunk (r = 0.85; p < 0.0001). A significant correlation was observed between the lean tissue and BMD; the most significant relationship was registered for BMD of the upper limbs and the lean tissue in the upper limbs (r = 0.69; p < 0.0001). An inverse correlation was recorded between the adipose tissue and lean tissue; the most significant relationship was found in the lower limbs (r = -0.46; p < 0.0001). Sarcopenic obesity was observed in 5% of patients, osteosarcopenic obesity in 2%, and a combination of osteoporosis with obesity in 8.7%. Normal BMD values in combination with the absence of sarcopenia and obesity were registered in 16.5% of patients.

CONCLUSIONS. The study results indicate the specific features of body composition in long-living patients A high proportion of patients with excess body weight, but with normal BMD and lean tissue mass was found.