Caspian Journal of Internal Medicine
Babol University of Medical Sciences
چهارشنبه 1 مهر 1405
[Archive]
دوره 17، شماره 4 - ( 7-1405 )
جلد 17 شماره 4 صفحات 3-0 |
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Afshar F, Afshar M A, Sepidarkish M. Sarcopenic Obesity in Clinical Practice: A Narrative Review of Diagnostic Challenges, Biochemical Pathways, and Therapeutic Strategies. Caspian J Intern Med 2026; 17 (4)
URL: http://caspjim.com/article-1-5134-fa.html
URL: http://caspjim.com/article-1-5134-fa.html
Sarcopenic Obesity in Clinical Practice: A Narrative Review of Diagnostic Challenges, Biochemical Pathways, and Therapeutic Strategies. . 1405; 17 (4)
چکیده: (71 مشاهده)
Background: Sarcopenic obesity (SO), the coexistence of age-related muscle loss and excess adiposity, creates a synergistic interaction that increases disability, metabolic complications, and mortality. Obesity may mask underlying muscle wasting, contributing to underdiagnosis. This review provides a focused synthesis of diagnostic, mechanistic, and therapeutic aspects of SO.
Methods: This focused narrative review searched MEDLINE (PubMed), Scopus, and the Cochrane Library through April 2026 for relevant guidelines, meta-analyses, systematic reviews, and representative randomized trials. Evidence selection was purposive rather than protocol-driven; no PRISMA flow diagram, duplicate screening, formal risk-of-bias assessment, or GRADE evaluation was performed.
Results: Diagnosis requires assessment of impaired skeletal muscle status and excess adiposity. We propose a pragmatic two-step case-finding approach using simple clinical measures, including calf circumference and handgrip strength, followed, when indicated, by confirmatory body-composition assessment. This author-derived synthesis of consensus recommendations has not been externally validated. Chronic low-grade inflammation, insulin resistance, mitochondrial dysfunction, and disrupted myokine-adipokine crosstalk contribute to disease progression. Progressive resistance training combined with protein intake has the strongest clinical support. Caloric restriction without sufficient protein and muscle-preserving exercise may increase lean-mass loss. GLP-1-based anti-obesity therapies can reduce both fat and lean mass and therefore warrant individualized monitoring in patients at risk of sarcopenia.
Conclusions: SO is underrecognized because excess adiposity can conceal low muscle reserves. The proposed two-step approach is a pragmatic, unvalidated case-finding framework rather than a replacement for consensus criteria. Resistance exercise and adequate protein intake remain central to management, while muscle-preserving strategies and functional monitoring should accompany weight-loss interventions.
Methods: This focused narrative review searched MEDLINE (PubMed), Scopus, and the Cochrane Library through April 2026 for relevant guidelines, meta-analyses, systematic reviews, and representative randomized trials. Evidence selection was purposive rather than protocol-driven; no PRISMA flow diagram, duplicate screening, formal risk-of-bias assessment, or GRADE evaluation was performed.
Results: Diagnosis requires assessment of impaired skeletal muscle status and excess adiposity. We propose a pragmatic two-step case-finding approach using simple clinical measures, including calf circumference and handgrip strength, followed, when indicated, by confirmatory body-composition assessment. This author-derived synthesis of consensus recommendations has not been externally validated. Chronic low-grade inflammation, insulin resistance, mitochondrial dysfunction, and disrupted myokine-adipokine crosstalk contribute to disease progression. Progressive resistance training combined with protein intake has the strongest clinical support. Caloric restriction without sufficient protein and muscle-preserving exercise may increase lean-mass loss. GLP-1-based anti-obesity therapies can reduce both fat and lean mass and therefore warrant individualized monitoring in patients at risk of sarcopenia.
Conclusions: SO is underrecognized because excess adiposity can conceal low muscle reserves. The proposed two-step approach is a pragmatic, unvalidated case-finding framework rather than a replacement for consensus criteria. Resistance exercise and adequate protein intake remain central to management, while muscle-preserving strategies and functional monitoring should accompany weight-loss interventions.
نوع مطالعه: Review Article |
موضوع مقاله:
Internal
دریافت: 1405/2/19 | پذیرش: 1405/4/30 | انتشار: 1405/6/18
دریافت: 1405/2/19 | پذیرش: 1405/4/30 | انتشار: 1405/6/18
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