Objective: In Japan, obesity is defined as a body mass index (BMI) ≥25 kg/m2. Sarcopenic obesity (low BMI with visceral fat accumulation) has high mortality and is common in elderly people. We evaluated the value of visceral fat area (VFA) measurement in elderly type 2 diabetes (T2D) patients for determining sarcopenic obesity.

Methods: We analyzed 124 T2D patients who were hospitalized for glycemic control. They were divided into elderly people (aged ≥65 years) (n=74) and non-elderly people (aged <65 years) (n=50). They were further divided according to BMI (<25 kg/m2 and ≥25 kg/m2) and VFA (<100 cm2 and ≥100 cm2). We compared the number and percentages of significantly different metabolism related items by BMI or VFA grouping between the elderly and non-elderly groups. The correlation between BMI and VFA was also analyzed.

Results: We observed the following patient characteristics: the elderly group; 55 men (74.3%), average age 73.2 years, BMI 24.7 kg/m2, and VFA 137.7 cm2; and the non-elderly group; 25 men (50%), average age 49.8 years, BMI 31.8 kg/m2, and VFA 180.7 cm2. Only 6/43 (14.0%) metabolism related items differed significantly between patients with BMI ≥25 kg/m2 and those with BMI <25 kg/m2 in the elderly group, whereas 18/43 (41.9%) items differed significantly between patients with BMI ≥25 kg/m2 and those with BMI <25 kg/m2 in the non-elderly group. In the elderly group, 15/43 (34.9%) metabolism related items differed significantly between patients with VFA ≥100 cm2 and those with VFA <100 cm2, whereas in the non-elderly group, 18/43 (41.9%) items differed significantly between patients with VFA ≥100 cm2 and those with VFA <100 cm2. The correlation between BMI and VFA was stronger in the non-elderly group than in the elderly group.

Conclusion: Although BMI is a simple and useful index of obesity evaluation, sarcopenic obesity may be overlooked. In elderly patients who tend to have sarcopenic obesity, VFA measurement might be a more useful index of obesity.

Disclosure

T. Minamizuka: None. Y. Maeda: None. M. Koshizaka: Research Support; Self; Astellas Pharma Inc., Pfizer Health Research Foundation, Taisho Pharmaceutical Co., Ltd. T. Ishikawa: None. Y. Maezawa: None. K. Yokote: None.

© 2019 by the American Diabetes Association.
2019
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