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Case Report

A case report of semaglutide induced sarcopenia: causes of fatigue in older adults
Azwan Aziz Mohamad
Received January 9, 2025  Accepted February 6, 2025  Published online April 14, 2025  
DOI: https://doi.org/10.4082/kjfm.25.0008    [Epub ahead of print]
Semaglutide, a medication used for type 2 diabetes and weight loss, may have unexpected side effects such as sarcopenia and age-related loss of muscle mass and strength. A 74-year-old male patient with type 2 diabetes and dyslipidemia presented with progressive fatigue over 2 years. He experienced a significant decline in walking endurance and speed despite the absence of joint pain or other obvious causes. He had a history of ocular myasthenia gravis and localized prostate cancer, both of which were well-managed. Further investigation revealed a weight loss of 8 kg after starting semaglutide treatment for diabetes. Physical examinations revealed reduced muscle bulk and strength. Extensive investigations, including blood tests, imaging, and cardiopulmonary exercise testing, have ruled out other potential causes of fatigue. The patient’s fatigue improved after reducing the semaglutide dose and implementing a tailored exercise program that focused on muscle strengthening. This case highlights the potential contribution of semaglutide to muscle mass loss and subsequent fatigue, particularly among older adults.
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  • 18 Download

Original Articles

Low Muscle Strength as Risk Factor for Non-Alcoholic Fatty Liver Disease in Different Metabolic Conditions
Hye-Sun Rho, Whan-Seok Choi
Korean J Fam Med 2024;45(2):89-95.   Published online November 28, 2023
DOI: https://doi.org/10.4082/kjfm.23.0118
Background
Non-alcoholic fatty liver disease (NAFLD) recently became a leading liver disease that threatens health worldwide. Low muscle strength, obesity, insulin resistance, and metabolic syndrome are recognized key factors for NAFLD. However, the impact of low muscle strength itself in different metabolic conditions has not been widely studied.
Methods
A cross-sectional analysis was performed of a sample of 5,427 participants from the 2019 Korea National Health and Nutrition Examination Survey. Relative handgrip strength (rHGS, defined as handgrip strength/body mass index) was used to assess muscle strength. The cut-off values for a low rHGS were 1.405 for men and 0.850 for women. NAFLD was diagnosed if the Hepatic Steatosis Index was >36. Participants were stratified according to insulin resistance, metabolic syndrome, and central obesity for the subgroup analyses.
Results
Complex sample multivariate logistic regression analysis revealed a significant association between low muscle strength and NAFLD after the adjustment for other confounders (odds ratio [OR], 1.92; P<0.001). In the insulin resistance, metabolic syndrome, and central obesity subgroups, a significant association between low muscle strength and NAFLD remained (OR, 1.66–4.19 depending on subgroup; all P<0.05), whereas it did not in the no central obesity group.
Conclusion
This study demonstrated that low muscle strength is correlated with a risk of NAFLD. This relationship was independent of insulin resistance and metabolic syndrome but was dependent on the presence of central obesity.

Citations

Citations to this article as recorded by  
  • Possible association between metabolic dysfunction-associated steatotic liver disease predictors and hand grip strength
    Suyeon Lee, Jong-Koo Kim, Taesic Lee
    Scientific Reports.2025;[Epub]     CrossRef
  • Association Between Relative Grip Strength, Insulin Resistance, and Nonalcoholic Fatty Liver Disease Among Middle-Aged and Older Adults: A Prospective Cohort Study
    DooYong Park, Byungul Lim, On Lee
    Metabolic Syndrome and Related Disorders.2024;[Epub]     CrossRef
  • The impact of appendicular skeletal muscle index and trunk muscle index on stress urinary incontinence risk in female adults: a retrospective study
    Junwei Wang, Cunming Zhang, Aiwei Zhang
    Frontiers in Nutrition.2024;[Epub]     CrossRef
  • Joint Association of Relative Grip Strength and Regular Exercise Participation with Nonalcoholic Fatty Liver Disease: A Prospective Cohort Study
    Sujung Yoo, Dooyong Park
    The Korean Journal of Sports Medicine.2024; 42(4): 262.     CrossRef
  • 3,572 View
  • 76 Download
  • 2 Web of Science
  • 4 Crossref
Background
Despite increased clinical and research interest in sarcopenia, even in Asia, not much is known about the association between sarcopenia and depressive symptoms. Sarcopenia and depressive symptoms are associated with several health problems in older adults; therefore, we investigated the association between sarcopenia and depression in Korean older adults.
Methods
The study sample included 1,929 participants aged over 60 years (44.6% men; mean age, 69.7 years) from nationally representative data of the 2018 Korea National Health and Nutrition Examination survey. Possible sarcopenia was defined according to the diagnostic algorithm of the Asian Working Group for Sarcopenia 2019; however, we measured only hand-grip strength (kg) in this study. Patient Health Questionnaire-9 was used for screening for symptoms of depression. A cross-sectional analysis was used to examine the relationship between possible sarcopenia and depressive symptoms.
Results
Possible sarcopenia and depressive symptoms were identified in 538 (27.9%) and 97 (5.0%) participants, respectively. After adjusting for age, sex, and other potential covariates, possible sarcopenia was positively associated with higher odds of depressive symptoms (odds ratio, 2.06; 95% confidence interval, 1.36–3.11; P<0.001).
Conclusion
Possible sarcopenia was significantly associated with depressive symptoms in Korean older adults. Early interventions for possible sarcopenia and depressive symptoms in routine clinical practice could help Korean older adults to have healthy aging. Future studies are required to explore any causal relationship between possible sarcopenia and depressive symptoms in Korean older adults.

Citations

Citations to this article as recorded by  
  • Social media-based Health Education plus Exercise Program (SHEEP) to improve muscle function among young-old adults with possible sarcopenia in the community: A feasibility study protocol
    Ya Shi, Emma Stanmore, Lisa McGarrigle, Chris Todd, Marina De Rui
    PLOS ONE.2025; 20(1): e0303481.     CrossRef
  • Association between sarcopenia components and depressed mood varies by sex among community-dwelling older adults from the Korean Frailty and Aging Cohort Study
    Yong Soon Park, Keunjoong Yoo, Hye Jin Kim, Miji Kim, Chang Won Won
    Scientific Reports.2025;[Epub]     CrossRef
  • Bidirectional association between sarcopenia and depression: A systematic review and meta-analysis
    Xiangpeng Meng, Ze Wang, Linyu Lyu
    Archives of Gerontology and Geriatrics.2025; 132: 105787.     CrossRef
  • Association between handgrip strength, handgrip strength asymmetry, and anxiety in Korean older adults: The Korean National Health and Nutrition Examination Survey 2022
    Sang-Youn Choi, Su-Min Park, Eun-Cheol Park, Marina De Rui
    PLOS ONE.2025; 20(4): e0315256.     CrossRef
  • Relationship between dietary protein and amino acid intake and handgrip strength in Korean adults: data from the 2014–2019 Korea National Health and Nutrition Examination Survey
    Hyunji Ham, Sumin Kim, Kyungho Ha
    Nutrition Journal.2025;[Epub]     CrossRef
  • Análisis de la relación entre sarcopenia y síntomas depresivos en adultos mayores: una revisión de alcance
    Miguel Ángel Hernández Real, Uriel Nahum Hernández Puebla
    RESPYN Revista Salud Pública y Nutrición.2024; 23(2): 23.     CrossRef
  • 3,024 View
  • 170 Download
  • 3 Web of Science
  • 6 Crossref

Review Article

Management of Sarcopenia in Primary Care Settings
Chang Won Won
Korean J Fam Med 2023;44(2):71-75.   Published online March 20, 2023
DOI: https://doi.org/10.4082/kjfm.22.0224
With aging, loss of skeletal muscle mass and muscle function increases, resulting in an increased risk of falls, fractures, long-term institutional care, cardiovascular and metabolic diseases, and even death. Sarcopenia, which is derived from the Greek words “sarx” or flesh+“penia” or loss, is defined as a condition characterized by low muscle mass and low muscle strength and performance. In 2019, the Asian Working Group for Sarcopenia (AWGS) published a consensus paper on the diagnosis and treatment of sarcopenia. The AWGS 2019 guideline, specifically, presented strategies for case-finding and assessment to help diagnose “possible sarcopenia” in primary care settings. For case finding, the AWGS 2019 guideline proposed an algorithm that recommends calf circumference measurement (cut-off <34 cm in men, <33 cm in women) or the SARC-F (strength, assistance with walking, rising from a chair, climbing stairs, and falls) questionnaire (cut-off ≥4). If this case finding is confirmed, handgrip strength (cutoff <28 kg in men, <18 kg in women) or the 5-time chair stand test (≥12 seconds) should be performed to diagnose “possible sarcopenia.” If an individual is diagnosed as “possible sarcopenia,” AWGS 2019 recommends that the individual should start lifestyle interventions and related health education for primary healthcare users. Because no medication is available to treat sarcopenia, exercise and nutrition is essential for sarcopenia management. Many guidelines, recommend physical activity, with a focus on progressive resistance (strength) training, as a first-line therapy for the management of sarcopenia. It is essential to educate older adults with sarcopenia on the need to increase protein intake. Many guidelines recommended that older people should consume at least 1.2 g of proteins/kg/d. This minimum threshold can be increased in the presence of catabolic or muscle wasting. Previous studies reported that leucine, a branched-chain amino acid, is essential for protein synthesis in muscle, and a stimulator for skeletal muscle synthesis. A guideline conditionally recommends that diet or nutritional supplements should be combined with exercise intervention for older adults with sarcopenia.

Citations

Citations to this article as recorded by  
  • Evaluating sarcopenia and nutritional status in outpatients with liver cirrhosis: concordance of diagnostic methods
    Marina Demas Rezende Gischewski, Fernanda Lívia Cavalcante Araujo, Aryana Isabelle De Almeida Neves Siqueira, Alina Joana da Silva Wallraf, João Araújo Barros Neto, Nassib Bezerra Bueno Nassib, Juliana Célia de Farias Santos, Fabiana Andréa Moura
    Nutrición Hospitalaria.2025;[Epub]     CrossRef
  • Update on the Complications and Management of Liver Cirrhosis
    Hiba Fadlallah, Diala El Masri, Hisham F. Bahmad, Wassim Abou-Kheir, Jad El Masri
    Medical Sciences.2025; 13(1): 13.     CrossRef
  • Diabetes and Sarcopenia: Intersection of Co Morbid Conditions
    Byron J. Hoogwerf
    OBM Geriatrics.2025; 09(01): 1.     CrossRef
  • Prevalence and Associated Factors of Dynapenia, Pre-Sarcopenia, and Sarcopenia in Korean Adults: A Cross-Sectional Epidemiological Study
    Do-Youn Lee
    Medicina.2025; 61(4): 575.     CrossRef
  • The Prognostic Significance of Handgrip Strength in Cirrhosis: Simplicity Is the Ultimate Sophistication
    Binxin Cui, Ziyi Yang, Chao Sun
    Portal Hypertension & Cirrhosis.2025;[Epub]     CrossRef
  • Guidelines for obesity clinic consultations in primary healthcare clinics
    Jee-Hyun Kang, Kyoung-Kon Kim
    Journal of the Korean Medical Association.2024; 67(4): 240.     CrossRef
  • Guidelines for physical activity counseling in primary healthcare clinics
    Yun Jun Yang
    Journal of the Korean Medical Association.2024; 67(4): 265.     CrossRef
  • Whole Genome Linkage and Association Analyses Identify DLG Associated Protein-1 as a Novel Positional and Biological Candidate Gene for Muscle Strength: The Long Life Family Study
    Adam J Santanasto, Sandeep Acharya, Mary K Wojczynski, Ryan K Cvejkus, Shiow Lin, Michael R Brent, Jason A Anema, Lihua Wang, Bharat Thyagarajan, Kaare Christensen, E Warwick Daw, Joseph M Zmuda, Lewis A Lipsitz
    The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences.2024;[Epub]     CrossRef
  • Predictors of hip fracture in 15 European countries: a longitudinal study of 48,533 geriatric adults using SHARE dataset
    M. Azhar Hussain, Rizwan Qaisar, Asima Karim, Firdos Ahmad, Fabio Franzese, Atif Awad, Abeer A. Al-Masri, Mohammed Alsaeed, Shaea A. Alkahtani
    Archives of Osteoporosis.2024;[Epub]     CrossRef
  • Open, Active-Controlled Clinical Study to Evaluate the Correlation between Whole Body DEXA and BIA Muscle Measurements
    Yong-Chan Ha, Shinjune Kim, Jun-Il Yoo
    Journal of Bone Metabolism.2024; 31(3): 219.     CrossRef
  • Doctor and patient perceptions of sarcopenia in community-based primary care clinics: a questionnaire survey
    Jungha Park, Daehyun Lee, Jae Young Jang, Jung-Ha Kim, Jae Uk Baek, Myungkwan Jeong, Sungwouk Kim, Moonbae Kyoung, Miji Kim, Chang Won Won
    European Geriatric Medicine.2024; 15(6): 1827.     CrossRef
  • Frequency of clinical signs in patients with Cushing's syndrome and mild autonomous cortisol secretion: overlap is common
    Leah T Braun, Frederick Vogel, Elisabeth Nowak, German Rubinstein, Stephanie Zopp, Katrin Ritzel, Felix Beuschlein, Martin Reincke
    European Journal of Endocrinology.2024; 191(4): 473.     CrossRef
  • Efficacy of a combined exercise and nutrition intervention study for outpatients with possible sarcopenia in community-based primary care clinics (ENdSarC): study protocol for a multicenter single-blinded randomized controlled trial
    Woohyuk Ji, Daehyun Lee, Minjin Kim, Nahyun Lim, Jae-Young Lim, Jae Uk Baek, Sungwouk Kim, Choong Hyung Lee, Miji Kim, Chang Won Won
    BMC Geriatrics.2024;[Epub]     CrossRef
  • Age-related increase in the excitability of mouse layer V pyramidal neurons in the primary motor cortex is accompanied by an increased persistent inward current
    Jose A. Viteri, Nikolaus Bueschke, Joseph M. Santin, W. David Arnold
    GeroScience.2024; 47(2): 2199.     CrossRef
  • The Effect of Long Chain n-3 Fatty Acid Supplementation on Muscle Strength in Older Adults: A Systematic Review and Meta-Analysis
    Maha Timraz, Ahmad Binmahfoz, Terry J. Quinn, Emilie Combet, Stuart R. Gray
    Nutrients.2023; 15(16): 3579.     CrossRef
  • 4,301 View
  • 187 Download
  • 13 Web of Science
  • 15 Crossref
Original Articles
Background
Cancer survivors experience decreased physical function and reduced muscle strength, which leads to lower quality of life (QOL). The hand grip strength (HGS) can be a predictor of poor health-related QOL as a parameter of sarcopenia. The purpose of this study was to investigate the relationship between low HGS and QOL in cancer survivors and healthy controls.
Methods
We analyzed 392 cancer survivors and 1,176 healthy controls from the Korea National Health and Nutrition Examination Survey, 2014–2017. We defined low HGS as 2 standard deviation values for healthy young Korean adults from a previous study. QOL was evaluated using the European Quality of Life Scale-Five Dimensions. A complex sample logistic regression model was used to assess the relationship between each dimension of low HGS and QOL.
Results
The odds ratios (ORs) for decreased QOL were significantly higher in male cancer survivors with low HGS on self-care (OR, 8.51; 95% confidence interval [CI], 1.69–42.83) and usual activities (OR, 6.63; 95% CI, 1.22–36.03). The ORs for problems in mobility (OR, 5.87; 95% CI, 2.04–16.91), usual activities (OR, 14.46; 95% CI, 3.84–54.44), pain/discomfort (OR, 4.90; 95% CI, 2.00–12.01), and anxiety/depression (OR, 6.43; 95% CI, 2.16–19.12) were significantly high in female cancer survivors with low HGS. However, healthy controls showed no significant relationship between low HGS and QOL.
Conclusion
For cancer survivors, low HGS was associated with poor QOL in some domains. Strategies to increase muscle strength must be considered to improve the QOL of cancer survivors.

Citations

Citations to this article as recorded by  
  • The quality of life impacting factors in malnourished patients with gastric cancer
    Hong Zhao, Chenan Liu, Guotian Ruan, Xin Zheng, Yue Chen, Shiqi Lin, Xiaoyue Liu, Jinyu Shi, Xiangrui Li, Shuqun Li, Hanping Shi
    Frontiers in Oncology.2024;[Epub]     CrossRef
  • Cardiovascular and metabolic determinants of quality of life in patients with cancer
    Ruben Evertz, Katharina Gödde, Christine Diehl, Miroslava Valentova, Tania Garfias‐Veitl, Friederike Braulke, Gerald G. Wulf, Tobias R. Overbeck, Annalen Bleckmann, Alexander O. König, Pia Weinländer, Sophia Potthoff, Sara Hadzibegovic, Alessia Lena, Ulri
    ESC Heart Failure.2023; 10(1): 167.     CrossRef
  • Understanding Heterogeneity in the Relationship Between Cancer and Hand Grip Strength: A Longitudinal Analysis
    Jinho Kim, Gum-Ryeong Park
    Research on Aging.2023; 45(7-8): 586.     CrossRef
  • Better Handgrip Strength Is Related to the Lower Prevalence of Pain and Anxiety in Community-Dwelling Older Adults
    Natalia Sosowska, Agnieszka Guligowska, Bartłomiej Sołtysik, Ewa Borowiak, Tomasz Kostka, Joanna Kostka
    Journal of Clinical Medicine.2023; 12(11): 3846.     CrossRef
  • Predictors of lower exercise capacity in patients with cancer
    Ruben Evertz, Christine Diehl, Katharina Gödde, Miroslava Valentova, Tania Garfias-Veitl, Tobias R. Overbeck, Friederike Braulke, Alessia Lena, Sara Hadzibegovic, Annalen Bleckmann, Ulrich Keller, Ulf Landmesser, Alexander O. König, Gerd Hasenfuss, Andrea
    Scientific Reports.2023;[Epub]     CrossRef
  • NEUROCANTRIAL: study protocol for a randomised controlled trial of a pain neuroscience education programme in adults with cancer pain
    Leidy Tatiana Ordoñez-Mora, Ilem D Rosero, Marco Antonio Morales-Osorio, Rocío Guil, Giancarlo Quintero Jordan, Julian Alberto Agudelo Jimenez, Katherine Gonzalez-Ruiz, Juan Carlos Avila-Valencia
    BMJ Open.2023; 13(9): e071493.     CrossRef
  • Differences in Health-Related Quality of Life in Older People with and without Sarcopenia Covered by Long-Term Care Insurance
    Masahiro Kitamura, Kazuhiro P. Izawa, Kodai Ishihara, Peter H. Brubaker, Hiroaki Matsuda, Soichiro Okamura, Koji Fujioka
    European Journal of Investigation in Health, Psychology and Education.2022; 12(6): 536.     CrossRef
  • Associations of Physical Activity and Handgrip Strength with Health-Related Quality of Life in Older Korean Cancer Survivors
    Jeonghyeon Kim, Seamon Kang, Donghyun Kim, Hyunsik Kang
    Cancers.2022; 14(24): 6067.     CrossRef
  • Differences in the Relationships Between Muscle Strength, Muscle Mass, Balance Function, and Quality of Life for Middle-Aged and Older Breast Cancer Survivors
    Shinichiro Morishita, Ryuichi Kasahara, Yuichi Yamamoto, Ryohei Jinbo, Aya Takano, Mitsuhiko Yasuda, Atsuhiro Tsubaki, Osamu Aoki, Jack B. Fu, Tetsuya Tsuji
    Integrative Cancer Therapies.2022;[Epub]     CrossRef
  • 4,382 View
  • 89 Download
  • 10 Web of Science
  • 9 Crossref
Relationship between Decreased Estimated Glomerular Filtration Rate and Sarcopenic Obesity among Postmenopausal Women: Korea National Health and Nutrition Examination Survey (2008–2011)
Changbin Hong, Jae Yong Baek, Ji Won Lee, Ji Hoon Lee, Kayoung Lee, Tae-jin Park, Jinseung Kim
Korean J Fam Med 2020;41(5):332-338.   Published online May 21, 2020
DOI: https://doi.org/10.4082/kjfm.19.0032
Background
Previous studies have shown that body composition is associated with chronic kidney disease (CKD), and perimenopause is associated with increased fat mass and decreased lean body mass. Muscle wasting is common among patients with CKD. Sarcopenic obesity (SO) refers to excess adiposity with decreased muscle mass. However, little is known about the relationship between SO and renal function decline. Here, we identified the relationship between SO and decreased estimated glomerular filtration rate (eGFR) in postmenopausal women.
Methods
We conducted a cross-sectional study based on the data from the Korea National Health and Nutrition Examination Survey (2008–2011). We analyzed 4,560 postmenopausal women who underwent dual energy X-ray absorptiometry. Sarcopenia was defined based on weight-adjusted appendicular skeletal muscle mass. Obesity was defined based on body mass index. The eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Subjects were classified into four groups: normal, obese, sarcopenic, and sarcopenic obese. Logistic regression analysis was performed to examine the association between SO and decreased eGFR. The results were adjusted for variable confounders.
Results
In the unadjusted model, the odds ratio (OR) of decreased eGFR for SO was 1.67 (95% confidence interval [CI], 1.23–2.26). The obese and sarcopenic groups had ORs of 0.67 (95% CI, 0.44–1.03) and 0.70 (95% CI, 0.44–1.10), respectively. After controlling for confounding variables, there was also a significant association between SO and decreased eGFR (adjusted OR, 1.48; 95% Cl, 1.05–2.07).
Conclusion
SO was independently associated with decreased eGFR in postmenopausal Korean women.

Citations

Citations to this article as recorded by  
  • Sarcopenic obesity in predialysis chronic kidney disease: Muscle strength is a predictor of mortlity and disease progression in a six-year prospective cohort
    Dílmerson Oliveira, Viviane Angelina de Souza, Guilherme Cardenaz Souza, Lucas Fernandes Suassuna, Marcus Gomes Bastos, Maycon Moura Reboredo, Natália Maria da Silva Fernandes, Jeremy P Loenneke,
    PLOS ONE.2025; 20(3): e0318773.     CrossRef
  • Obesity paradox in older sarcopenic adults ― a delay in aging: A systematic review and meta-analysis
    Szimonetta Eitmann, Peter Matrai, Peter Hegyi, Marta Balasko, Balint Eross, Kira Dorogi, Erika Petervari
    Ageing Research Reviews.2024; 93: 102164.     CrossRef
  • Association of skeletal muscle index with postoperative acute kidney injury in living donor hepatectomy: A retrospective single‐centre cohort study
    Ji‐Hoon Sim, Hye‐Mee Kwon, In‐Gu Jun, Sung‐Hoon Kim, Kyoung‐Sun Kim, Young‐Jin Moon, Jun‐Gol Song, Gyu‐Sam Hwang, YouSun Ko, Kyung‐Won Kim
    Liver International.2022; 42(2): 425.     CrossRef
  • Dynapenic-abdominal obesity as an independent risk factor for chronic kidney disease in postmenopausal women: a population-based cohort study
    Youngju Choi, Jinkyung Cho, Jiyeon Kim, Jun Hyun Bae, Eun-Jeong Cho, Eunwook Chang, Kyung-Lim Joa, Junghoon Kim, Dong-Ho Park, Ju-Hee Kang, Hyo-Bum Kwak
    Menopause.2022; 29(9): 1040.     CrossRef
  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • Global prevalence of sarcopenic obesity in older adults: A systematic review and meta-analysis
    Qianqian Gao, Fan Mei, Yi Shang, Kaiyan Hu, Fei Chen, Li Zhao, Bin Ma
    Clinical Nutrition.2021; 40(7): 4633.     CrossRef
  • 4,694 View
  • 104 Download
  • 6 Web of Science
  • 6 Crossref
Background
Sarcopenia is an important health problem, the risk factors of which a few studies have reported on. The purpose of this study was to evaluate the correlation between sarcopenia and the ratio of total energy intake to basal metabolic rate (BMR) as well as physical activity, and determine whether the relationship was different between younger and older age groups using data from the 2008–2011 Korea National Health and Nutrition Examination Survey.
Methods
We analyzed 16,313 subjects older than 19 years who had dual energy X-ray absorptiometry data. Sarcopenia was defined as an appendicular lean mass/weight (%) ratio of 1 standard deviation below the sex-specific mean value for a younger reference group, and BMR was calculated using the Harris–Benedict equation. A chi-squared test and logistic regression analyses were performed to evaluate the factors associated with sarcopenia.
Results
In this study, 15.2% of males and 15.4% of females had sarcopenia. Energy intake/BMR as well as physical activity was negatively related to sarcopenia risk. In stratified analysis by age and sex, strength exercises showed an inverse association with sarcopenia only in males under the age of 50 years (odds ratio, 0.577; P<0.0001), whereas higher energy intake/BMR was negatively associated with sarcopenia in each age and sex group.
Conclusion
Our findings suggest that adequate energy intake is important to prevent sarcopenia regardless of whether one exercises.

Citations

Citations to this article as recorded by  
  • Association of dietary inflammatory index with sarcopenia in patients with Metabolic dysfunction-associated fatty liver disease: a cross-sectional study
    Xianyao Wang, Rongjie Shi, Ying Zi, Jun Long
    Frontiers in Nutrition.2024;[Epub]     CrossRef
  • Metabolically Healthy Obesity: Are Interventions Useful?
    Bryan J. Mathis, Kiyoji Tanaka, Yuji Hiramatsu
    Current Obesity Reports.2023; 12(1): 36.     CrossRef
  • Gene polymorphisms associated with heterogeneity and senescence characteristics of sarcopenia in chronic obstructive pulmonary disease
    Amy H. Attaway, Annette Bellar, Nicole Welch, Jinendiran Sekar, Avinash Kumar, Saurabh Mishra, Umur Hatipoğlu, Merry‐Lynn McDonald, Elizabeth A. Regan, Jonathan D. Smith, George Washko, Raúl San José Estépar, Peter Bazeley, Joe Zein, Srinivasan Dasarathy
    Journal of Cachexia, Sarcopenia and Muscle.2023; 14(2): 1083.     CrossRef
  • Dietary inflammatory potential is associated with sarcopenia in patients with hypertension: national health and nutrition examination study
    Jiabin Tu, Shanshan Shi, Yuchen Liu, Jiaming Xiu, Yanbin Zhang, Bo Wu, Ying Liao, Kaihong Chen, Ganyang Li, Llling Chen
    Frontiers in Nutrition.2023;[Epub]     CrossRef
  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • 4,333 View
  • 103 Download
  • 5 Web of Science
  • 5 Crossref
Association between Cigarette Smoking and Sarcopenia according to Obesity in the Middle-Aged and Elderly Korean Population: The Korea National Health and Nutrition Examination Survey (2008–2011)
Yoonjoo Jo, John Alderman Linton, Junho Choi, Junghae Moon, Jungeun Kim, Jiyoung Lee, Sinae Oh
Korean J Fam Med 2019;40(2):87-92.   Published online March 20, 2019
DOI: https://doi.org/10.4082/kjfm.17.0078
Background
The definition of sarcopenia focuses on muscle mass and function. Sarcopenic obesity is the relative excess of fat tissue with decreased muscle mass. We examined the association between cigarette smoking and sarcopenia according to obesity in middle-aged and elderly Koreans.
Methods
We conducted a cross-sectional study of 9,385 subjects (age ≥50 years) based on data from the fourth and fifth Korea National Health and Nutrition Examination Surveys (2008–2011). Smoking groups were categorized by smoking status and the number of cigarettes smoked daily. Sarcopenia was defined as weight-adjusted appendicular skeletal muscle mass of 2 standard deviations below the sex-specific mean for young adults. Obesity was defined as fat mass ≥30% for men and ≥40% for women. Subjects were categorized into three groups: sarcopenic obese (SO), sarcopenic non-obese (SNO), and normal. Multiple logistic regression analysis was performed to assess the association between smoking and SNO and SO.
Results
Among men, current smokers were more associated with SNO than never-smokers (adjusted odds ratio [OR], 3.34; 95% confidence interval [CI], 1.09–10.26). However, there was no significant association between smoking status and SNO in women or SO in either sex. Among current smokers, moderate smokers (11–20 cigarettes/d) were more likely to be SNO (adjusted OR, 5.81; 95% CI, 1.12–30.31) and heavy smokers (>20 cigarettes/d) were more likely to be SO (adjusted OR, 9.53; 95% CI, 1.65–55.01) than light smokers (<11 cigarettes/d).
Conclusion
In men, smoking was positively associated with SNO, and heavy smokers were more likely to be SO than light smokers.

Citations

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  • Prevalence of and risk factors for sarcopenia in patients with epilepsy
    Yu-Shiue Chen, Hung-Ling Huang, Huai-Hsien Huang, Tzu-Hsin Huang, Ming-Chi Lai, Chin-Wei Huang
    Seizure: European Journal of Epilepsy.2025; 125: 162.     CrossRef
  • Reliability and Clinical Validity of the SARC-Global Questionnaire for Sarcopenia and Sarcopenic Obesity in Spanish Older Adults
    Juan Manuel Guardia-Baena, María del Carmen Carcelén-Fraile, Fidel Hita-Contreras, Agustín Aibar-Almazán, María de los Ángeles Arévalo-Ruíz, María Aurora Mesas-Aróstegui, Raquel Fábrega-Cuadros
    Nutrients.2025; 17(7): 1206.     CrossRef
  • Association between triglyceride-glucose index and sarcopenic obesity in adults: a population-based study
    Zhengmei Zhao, Ruiting Cai, Lili Tao, Yuxiao Sun, Keping Sun
    Frontiers in Nutrition.2025;[Epub]     CrossRef
  • The Theoretical and Practical Research of Traditional Chinese Medicine in the Prevention and Treatment of Sarcopenia
    Chunlin Hu, Xin Bao
    Journal of Contemporary Medical Practice.2024; 6(10): 42.     CrossRef
  • Gene polymorphisms associated with heterogeneity and senescence characteristics of sarcopenia in chronic obstructive pulmonary disease
    Amy H. Attaway, Annette Bellar, Nicole Welch, Jinendiran Sekar, Avinash Kumar, Saurabh Mishra, Umur Hatipoğlu, Merry‐Lynn McDonald, Elizabeth A. Regan, Jonathan D. Smith, George Washko, Raúl San José Estépar, Peter Bazeley, Joe Zein, Srinivasan Dasarathy
    Journal of Cachexia, Sarcopenia and Muscle.2023; 14(2): 1083.     CrossRef
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  • Breastfeeding and Sarcopenia in Later Life
    Jungun Lee
    Korean Journal of Family Medicine.2019; 40(3): 133.     CrossRef
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Background
Several studies have suggested that breastfeeding has a positive effect on long-term obesity, diabetes, hypertension, and hyperlipidemia. This study aimed to examine maternal bone health, muscle mass, and obesity based on breastfeeding duration.
Methods
This study was based on the Korea National Health and Nutrition Examination Survey 2010–2011. We selected 2,027 elderly women by screening survey participants with a history of delivery. Multivariate logistic regression analyses were performed to estimate the odds ratios (ORs) of sarcopenia, osteoporosis, and obesity among four breastfeeding groups.
Results
The OR of sarcopenia significantly decreased with increasing breastfeeding duration (OR, 0.27; 95% confidence interval [CI], 0.11–0.65; P for trend <0.001), whereas the OR of obesity significantly increased with increasing breastfeeding duration (OR, 2.56; 95% CI, 1.43–4.60; P for trend=0.009) after adjusting for potential confounding variables. We also found a positive correlation between the duration since last delivery and sarcopenia.
Conclusion
Our results suggest a negative correlation between prolonged breastfeeding and the prevalence of sarcopenia, and a positive correlation between prolonged breastfeeding and the prevalence of obesity. Further studies are needed to clarify the relationship between breastfeeding and sarcopenia in the future.

Citations

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    Basil H. Aboul-Enein, Elizabeth Dodge, Nada Benajiba, Ruth M. Mabry
    Maternal and Child Health Journal.2023; 27(5): 774.     CrossRef
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    Ye Rang Jo, Yoo Kyoung Park, Hee-Sook Lim
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    Irasema C. Paster, Pi-i D. Lin, Sheryl L. Rifas-Shiman, Wei Perng, Jorge E. Chavarro, Emily Oken
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    Jungun Lee
    Korean Journal of Family Medicine.2019; 40(3): 133.     CrossRef
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  • 121 Download
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  • 4 Crossref
Association between Sleep Duration and Body Composition Measures in Korean Adults: The Korea National Health and Nutrition Examination Survey 2010
Ryoung Hee Kim, Kyong In Kim, Jeong Hyeon Kim, Yong Soon Park
Korean J Fam Med 2018;39(4):219-224.   Published online July 4, 2018
DOI: https://doi.org/10.4082/kjfm.17.0030
Background
The association between sleep duration and body composition measures in Korean adults remains unclear.
Methods
This cross-sectional study included 3,532 subjects aged ≥40 years (1,542 men and 1,990 women) who participated in the 2010 Korea National Health and Nutrition Examination Survey V-1. Self-reported sleep duration and anthropometric data were collected. Appendicular skeletal muscle mass (ASM) was quantified via dual-energy X-ray absorptiometry. Obesity was defined according to the body mass index and waist circumference. Sarcopenia was defined as the muscle mass percentage (ASM/weight) below the lowest quintile computed for the study population. Multivariate logistic regressions with or without adjustment for sociodemographic and lifestyle factors were used to evaluate the association of sleep duration with obesity and sarcopenia for participants who slept ≤5, 6–8, and ≥9 h/d. The results were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs).
Results
In women, the association between sleep duration and sarcopenia was stronger for individuals who slept ≥9 h/d than for those who slept 6–8 h/d (unadjusted OR, 1.99; 95% CI, 1.19–3.34; adjusted OR, 1.77; 95% CI, 1.06– 2.96).
Conclusion
Longer sleep duration is associated with a significantly higher incidence of sarcopenia in Korean women aged ≥40 years.

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    I. de Frutos-Galindo, D. Catalina-Palomares, P. Yubero-García, L. Botella-Juan, D. Vargas-Caraballo-Lockwood, A. Marcos-Delgado, T. Fernández-Villa
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    Xilin Peng, Ruihao Zhou, Congqi Liu, Xudong Chen, Tao Zhu, Guo Chen
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    Gang Zhang, Dong Wang, Jie Chen, Mingyue Tong, Jing Wang, Jun Chang, Xiaoping Gao
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    Kepeng Liu, Jinhui Luo, Yong Chen, Binfei Li, Ye Tian, Xianxue Wang, Xiaozu Liao
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    Xiaoyan Li, Jie He, Qiuhua Sun
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    Peipei Han, Lin Hou, Zhenwen Liang, Wuxiong Chen, Junxue Li, Yazhou Cheng, Wenjing Zhou, Siya Zeng, Jiangtao Pan, Lanshan Xu, Yi Wang, Yangyi Chen, Qi Guo
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Association between Sarcopenia and Dipstick Proteinuria in the Elderly Population: The Korea National Health and Nutrition Examination Surveys 2009–2011
Duna Hwang, Mi-Ryung Cho, Minyong Choi, Sang Hyun Lee, Youngmin Park
Korean J Fam Med 2017;38(6):372-379.   Published online November 14, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.6.372
Background

Sarcopenia and proteinuria are significant health difficulties in the elderly; however, few studies have investigated their relationship. In this study, we investigated the association between sarcopenia and proteinuria in Korean subjects over 60 years old.

Methods

We included data from the Korean National Health and Nutrition Examination Survey, a cross-sectional, nationally representative survey conducted from 2009 to 2011 (n=4,008). Sarcopenia was defined using appendicular skeletal muscle mass as a percentage of body weight. Proteinuria was defined by a urine dipstick test result above trace levels.

Results

The overall proteinuria prevalence was 7.2%. The incidence of sarcopenia was significantly higher in subjects with proteinuria. The prevalence of proteinuria was significantly higher in the sarcopenic group (5.5% vs. 14.5% in the non-chronic kidney disease (CKD) group; 17.2% vs. 23.2% in the CKD group) than in the non-sarcopenic group. Furthermore, sarcopenic participants had worse metabolic parameters, such as higher body mass indexes, waist circumferences, and fasting glucose levels, and lower high-density lipoprotein cholesterol levels than those in the non-CKD group. After adjustment for confounders, the odds ratios (95% confidence interval) for proteinuria were 2.84 (1.92–4.18) in the sarcopenic non-CKD group, 3.70 (2.59–5.30) in the non-sarcopenic CKD group, and 5.19 (2.64–10.18) in the sarcopenic CKD group, compared to the non-sarcopenic, non-CKD group. Sarcopenia increased the proteinuria risk in elderly participants without CKD, even after adjustment for obesity, hypertension, diabetes, and metabolic syndrome.

Conclusion

These findings showed that sarcopenia was associated with dipstick proteinuria, especially in elderly participants without CKD, regardless of comorbidities.

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    Laisha Yan, Xiaoyan Hu, Shanshan Wu, Lina Chen, Shunying Zhao
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    Ozkan Gungor, Sena Ulu, Ayca Inci, Kenan Topal, Kamyar Kalantar-Zadeh
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    Brazilian Journal of Nephrology.2023; 45(2): 162.     CrossRef
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    Júlio César Chaves Nunes Filho, David Silva Camurça, Gabriel Alves Rocha, Ana Beatriz Timbó de Oliveira, Gabriela Correia Pequeno Marinho, Sérgio Gabriel Monteiro Santos, Dyego Castelo Branco Holanda Gadelha Pereira, Gdayllon Cavalcante Meneses, Elizabeth
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    Hae Hyeong Kang, Yohwan Yeo, Jung Jin Cho, Jong Lull Yoon, Mee Young Kim, Bo Mi Chun, Su Jin Lee
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    Changbin Hong, Jae Yong Baek, Ji Won Lee, Ji Hoon Lee, Kayoung Lee, Tae-jin Park, Jinseung Kim
    Korean Journal of Family Medicine.2020; 41(5): 332.     CrossRef
  • Breastfeeding and Sarcopenia in Later Life
    Jungun Lee
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  • Association between Sarcopenia and Renal Function in Patients with Diabetes: A Systematic Review and Meta-Analysis
    Satoshi Ida, Ryutaro Kaneko, Kanako Imataka, Kazuya Murata
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Association of Coffee Consumption with Sarcopenia in Korean Elderly Men: Analysis Using the Korea National Health and Nutrition Examination Survey, 2008–2011
Hyewon Chung, Ji Hyun Moon, Ju Il Kim, Mi Hee Kong, Jung Sik Huh, Hyeon Ju Kim
Korean J Fam Med 2017;38(3):141-147.   Published online May 23, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.3.141
Background

Sarcopenia is an age-related loss of muscle mass and strength. Coffee has antioxidant and anti-inflammatory properties that have been shown to be inversely related to the mechanism of sarcopenia. While there have been some studies on the effect of coffee on sarcopenia in animals, studies on the topic in humans are rare. Therefore, we investigated this relationship in elderly Korean men.

Methods

The cross-sectional data were derived from the 2008–2011 Korea National Health and Nutrition Examination Survey. After applying the exclusion criteria, the study sample consisted of 1,781 men who were at least 60 years of age. Study participants were identified as having sarcopenia if their appendicular skeletal muscle mass divided by height squared was less than two standard deviations below the gender-specific mean of this value for young adults. Daily coffee consumption amounts were categorized as <1 cup, 1 cup, 2 cups, and ≥3 cups.

Results

Compared to the group of individuals who drank less than one cup of coffee a day, people who consumed at least 3 cups (adjusted odds ratio, 0.43; 95% confidence interval, 0.20 to 0.94) showed significantly decreased sarcopenia; however, the decrease was not significant when the daily coffee consumption was 1 or 2 cups. In multivariate logistic regression models, significant associations were observed between sarcopenia and coffee consumption (P for trend=0.039).

Conclusion

The results of this study suggest that consuming at least 3 cups of coffee per day was associated with a lower prevalence of sarcopenia in elderly Korean elderly men.

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  • Trigonelline is an NAD+ precursor that improves muscle function during ageing and is reduced in human sarcopenia
    Mathieu Membrez, Eugenia Migliavacca, Stefan Christen, Keisuke Yaku, Jennifer Trieu, Alaina K. Lee, Francesco Morandini, Maria Pilar Giner, Jade Stiner, Mikhail V. Makarov, Emma S. Garratt, Maria F. Vasiloglou, Lucie Chanvillard, Emilie Dalbram, Amy M. Eh
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    D. P. Kurmaev, S. V. Bulgakova, E. V. Treneva
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    Huangyi Yin, Wei Zhu, Liuqing Guo, Weishan Li, Min Liang
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    Cátia R. Lopes, Rodrigo A. Cunha
    Ageing Research Reviews.2024; 102: 102581.     CrossRef
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    Ryoko Kawakami, Kumpei Tanisawa, Tomoko Ito, Chiyoko Usui, Kaori Ishii, Isao Muraoka, Katsuhiko Suzuki, Shizuo Sakamoto, Mitsuru Higuchi, Koichiro Oka
    British Journal of Nutrition.2023; 130(1): 127.     CrossRef
  • The association between healthy beverage index and sarcopenic obesity among women with overweight and obesity: a cross-sectional study
    Niloufar Rasaei, Rasool Ghaffarian-Ensaf, Fatemeh Gholami, Farideh Shiraseb, Alireza Khadem, Seyedeh Fatemeh Fatemi, Khadijeh Mirzaei
    BMC Endocrine Disorders.2023;[Epub]     CrossRef
  • Association of habitual coffee consumption with obesity, sarcopenia, bone mineral density and cardiovascular risk factors: A two-year follow-up study in kidney transplant recipients
    Mariana Silva da Costa, Karine Scanci da Silva Pontes, Marcella Rodrigues Guedes, Maria Inês Barreto Silva, Márcia Regina Simas Torres Klein
    Clinical Nutrition.2023; 42(10): 1889.     CrossRef
  • Focus on Nutritional Aspects of Sarcopenia in Diabetes: Current Evidence and Remarks for Future Research
    Christian Göbl, Andrea Tura
    Nutrients.2022; 14(2): 312.     CrossRef
  • Coffee Drinking and Adverse Physical Outcomes in the Aging Adult Population: A Systematic Review
    Simon Mazeaud, Fabio Castellana, Hélio Coelho-Junior, Francesco Panza, Mariangela Rondanelli, Federico Fassio, Giovanni De Pergola, Roberta Zupo, Rodolfo Sardone
    Metabolites.2022; 12(7): 654.     CrossRef
  • A Narrative Review on Sarcopenia in Type 2 Diabetes Mellitus: Prevalence and Associated Factors
    Anna Izzo, Elena Massimino, Gabriele Riccardi, Giuseppe Della Pepa
    Nutrients.2021; 13(1): 183.     CrossRef
  • Dietary total antioxidant capacity is positively associated with muscular strength in cirrhotic outpatients: a cross‐sectional study
    L. de Freitas Lima, F. de Faria Ghetti, H. H. M. Hermsdorff, D. G. de Oliveira, G. Teixeira, L. E. V. V. de Castro Ferreira, A. P. B. Moreira
    Journal of Human Nutrition and Dietetics.2020; 33(1): 78.     CrossRef
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    Jungun Lee
    Korean Journal of Family Medicine.2019; 40(3): 133.     CrossRef
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Sarcopenia Is Not Associated with Depression in Korean Adults: Results from the 2010–2011 Korean National Health and Nutrition Examination Survey
Chae-Hwa Byeon, Kee-Young Kang, Se-Hun Kang, Han-Kyul Kim, Eun-Jin Bae
Korean J Fam Med 2016;37(1):37-43.   Published online January 27, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.1.37
Background

Sarcopenia is associated with metabolic disorders, cardiovascular disease, and mortality; however, its association with depression in the general population remains unknown. Therefore, we investigated this association in Korea.

Methods

This study included 8,958 and 8,518 subjects from the 2010–2011 Korean National Health and Nutrition Examination Survey V-1, 2. The study was restricted to participants ≥20 years of age who had completed the survey, including whole-body dual-energy X-ray absorptiometry scans. After exclusion, 7,364 subjects were included in our final analysis. Age was categorized into three groups (20–39, 40–59, and ≥60 years), and subjects were categorized according to their sarcopenic and obesity status. Depression was categorized into three groups (not depressed, depressed, and depression).

Results

The sarcopenia group did not have a higher prevalence of depression or depressive symptoms compared to the nonsarcopenia group; the same was true even when obesity was considered. All age groups showed non-significant associations between sarcopenia and depression. In multivariate logistic regression models, no significant associations were observed between sarcopenia and prevalence of depression or depressed symptoms in men and women.

Conclusion

We found no associations between sarcopenia and the prevalence of depression or depressed symptoms in Korean adults. Future large prospective studies and randomized controlled trials are needed to further assess this relationship.

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    Yong Soon Park, Keunjoong Yoo, Hye Jin Kim, Miji Kim, Chang Won Won
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    Xiangpeng Meng, Ze Wang, Linyu Lyu
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Association between Sarcopenia, Bone Density, and Health-Related Quality of Life in Korean Men
Seon Won Go, Young Hwa Cha, Jung A Lee, Hye Soon Park
Korean J Fam Med 2013;34(4):281-288.   Published online July 24, 2013
DOI: https://doi.org/10.4082/kjfm.2013.34.4.281
Background

Sarcopenia is the loss of muscle mass leading to decreased muscle strength, physical disability, and increased mortality. The genesis of both sarcopenia and osteoporosis is multifactorial, and several factors that play a role in osteoporosis are thought to contribute to sarcopenia. This study evaluated the association between sarcopenia and bone density and health-related quality of life in Korean men.

Methods

We used the data of 1,397 men over 50 years of age from the 2009 Korean National Health and Nutrition Examination Survey. Sarcopenia was defined as the appendicular skeletal muscle mass divided by height2 (kg/m2) < 2 standard deviations below the sex-specific mean for young adults. Health-related quality of life was measured by the EuroQol-5 dimension (EQ-5D) instrument. Logistic regression analysis was performed to evaluate the relationship between sarcopenia, bone density, and health-related quality of life.

Results

The T-score of the lumbar spine, total femur, and femur neck in bone mineral density in subjects with sarcopenia were lower than those in subjects without sarcopenia. The score of the EQ-5D index was significantly lower and the rate of having problems with individual components of health-related quality of life was higher in the sarcopenic group. After adjustment for age and body mass index, the odds ratios (ORs) (95% confidence interval [CI]) for sarcopenia were 2.06 (1.07-3.96) in osteopenic subjects and 3.49 (1.52-8.02) in osteoporotic subjects, respectively. After adjustment, the total score of the EQ-5D index was significantly lower in the sarcopenic subjects. The ORs (95% CI) for having problems of mobility and usual activity of the EQ-5D descriptive system were 1.70 (1.02-2.84) and 1.90 (1.09-3.31), respectively.

Conclusion

Sarcopenia was associated with decreased bone mineral density in Korean men. In addition, sarcopenia was related to poor quality of life, especially with regard to mobility and usual activity. Greater attention to and evaluation for sarcopenia are needed in subjects showing low bone mineral density to prevent and manage poor quality of life.

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