"Obese Patients with Low Muscle Mass Have a 4x Higher Risk of 'Muscle Quality Decline'"

Seoul Asan Hospital Research Team

Due to aging and decreased physical activity, the number of patients with 'sarcopenic obesity,' characterized by decreased muscle mass and function and increased fat mass, is rising. A recent study revealed that patients with sarcopenic obesity may also experience a decline in muscle quality.

Professors Changhee Jeong and Yoonkyung Cho from the Department of Endocrinology, Asan Medical Center, Seoul, and Hongkyu Kim from the Department of Health Medicine (from left).

Professors Jung Changhee and Cho Yoonkyung from the Department of Endocrinology, and Professor Kim Honggyu from the Department of Health Medicine at Seoul Asan Medical Center recently announced on the 17th that their research found that the risk of myosteatosis is nearly four times higher in the sarcopenic obesity group.

Myosteatosis refers to a condition where fat accumulates in muscles, similar to fatty liver where fat builds up in the liver, leading to a deterioration in muscle quality. The research team analyzed abdominal computed tomography (CT) images of 13,612 adults aged 20 and over who underwent health checkups at the Seoul Asan Medical Center Health Promotion Center between 2012 and 2013, excluding those with a history of liver, cardiovascular, or other diseases.

Using an automated image analysis program, the entire abdominal muscle was subdivided into healthy and unhealthy muscle groups, and a 'good muscle mass index,' representing the proportion of healthy muscle in the total abdominal muscle, was calculated for each individual. Individuals in the lowest quartile of the good muscle mass index (73.56% or less for men, 66.97% or less for women) were considered to have myosteatosis. Sarcopenia was determined based on the skeletal muscle mass adjusted by body mass index (BMI) (less than 0.789 for men, less than 0.512 for women), and obesity was defined as a BMI of 25 kg/m² or higher. Patients with obesity accompanied by sarcopenia were classified as having sarcopenic obesity.

As a result of the analysis, the proportion of individuals with myosteatosis was 17.9% in the normal group (310 people) without sarcopenia or obesity, whereas it was 54.2% in the sarcopenic obesity group (9,353 people). When the risk of developing myosteatosis in the normal group was set as 1, the risk in the sarcopenic obesity group was 3.7, showing about a fourfold difference between the two groups.

Sarcopenic obesity can induce lipotoxicity, chronic inflammation, and insulin resistance, which may lead to a reduction in both the quantity and function of normal muscle. The research team hypothesized that myosteatosis could be a factor influencing the progression of sarcopenic obesity.

Professor Jung Changhee explained, "Because myosteatosis and sarcopenic obesity produce a negative synergistic effect, it is necessary to not only reduce visceral fat but also improve both the quantity and quality of muscle for metabolic health." Professor Kim Honggyu added, "To increase high-quality muscle, it is important to combine aerobic exercise with resistance training. If possible, we recommend exercising under the guidance of a professional to maintain an appropriate balance and intensity of exercise tailored to individual physical conditions."

The results of this study were published in the recent issue of 'Obesity (IF 9.298),' an international journal published by The Obesity Society.

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