Sarcopenia prevalence between obese and morbid obese patients in an obesity center

Prevalence of sarcopenia in obese middle-aged women



sarcopenia, sarcopenic obesity, middle aged women, EWGSOP


Background/Aim: Sarcopenia and obesity are independent diseases that result in decreased muscle strength and function. Few studies have been conducted on the association of sarcopenia and obesity, especially in women. This study aims to measure the possibility of sarcopenic obesity in women with obesity.

Methods: Our study was organized using a prospective cross-sectional study in Turkey. A total of 135 volunteer were included in the study. Inclusion criteria required the patients to have a BMI >35 kg/m2 or BMI >40 kg/m2 and no current comorbid disease. The exclusion criteria included: age (<18 and >70 years were excluded), history of muscle disease, malignancy, psychiatric disorders such as bipolar disease and psychosis, malnutrition, and recent corticosteroid (CS) use (within the last three months). Probable sarcopenia is determined by low skeletal muscle strength, and confirmed sarcopenia is defined if there is both low skeletal muscle mass and low skeletal muscle quality. Muscle strength was measured with isometric dynamometry using the handgrip method. A six-minute walk test (6MWT), in which we measured walking speed, was performed to determine the physical performance of the patients. We adjusted appendicular skeletal muscle (ASM) using height squared (ASM/height2) bioelectrical impedance analysis (BIA) to measure the muscle mass.

Results: Patients’ mean age was 43 (11.4) (20-69) years. Of the total participants, 64.6% were in the age range of 40-59; 19.2% of patients were defined as possible sarcopenia; and 2.2% had confirmed sarcopenia. A total of 78.5% of patients did not meet any of the sarcopenia criteria. We determined that there was no difference in anthropometric measurements between sarcopenic and non-sarcopenic patients (P>0.05), except for waist and hip circumferences. However, we did observe a noteworthy distinction in waist and hip circumference measurements between the two groups, with sarcopenic patients exhibiting larger circumferences (P=0.05 and P=0.032, respectively). Our study revealed a significant disparity in the results of the six-minute walk test and handgrip strength values between sarcopenic and non-sarcopenic patients (P<0.001). Specifically, non-sarcopenic patients demonstrated higher values in both tests..

Conclusion: Obesity and sarcopenic obesity will continue to be a public health problem in the future among middle-aged women. It should be considered that the prevalence of decreased muscle strength was high in our study group, and physical performance decreased due to muscle strength. We concluded that as success in the six-minute walk test and handgrip values increased, the diagnosis of sarcopenia decreased, and each increase in platelet count increased the risk of sarcopenia in obese female patients.


Download data is not yet available.


Baumgartner RN. Body composition in healthy aging. Ann N Y Acad Sci. 2000 May;904:437-48. doi: 10.1111/j.1749-6632.2000.tb06498.x. DOI:

Rolland Y, Lauwers-Cances V, Cristini C, Abellan van Kan G, Janssen I, Morley JE, et al. Difficulties with physical function associated with obesity, sarcopenia, and sarcopenic-obesity in community-dwelling elderly women: the EPIDOS (EPIDemiologie de l'OSteoporose) Study. Am J Clin Nutr. 2009 Jun;89(6):1895-900. doi: 10.3945/ajcn.2008.26950 DOI:

Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International Working Group on Sarcopenia. J Am Med Dir Assoc. 2011 May;12(4):249-56. doi: 10.1016/j.jamda.2011.01.003. Epub 2011 Mar 4. PMID: 21527165; PMCID: PMC3377163. DOI:

Addison O, Marcus RL, Lastayo PC, Ryan AS. Intermuscular fat: a review of the consequences and causes. Int J Endocrinol. 2014;2014:309570. doi: 10.1155/2014/309570 DOI:

Newman AB, Kupelian V, Visser M, Simonsick EM, Goodpaster BH, Kritchevsky SB, et al. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol A Biol Sci Med Sci. 2006 Jan;61(1):72-7. doi: 10.1093/gerona/61.1.72. DOI:

Fukushima Y, Kurose S, Shinno H, Cao Thu H, Takao N, Tsutsumi H, Kimura Y. Importance of Lean Muscle Maintenance to Improve Insulin Resistance by Body Weight Reduction in Female Patients with Obesity. Diabetes Metab J. 2016 Apr;40(2):147-53. doi: 10.4093/dmj.2016.40.2.147. DOI:

Badin PM, Langin D, Moro C. Dynamics of skeletal muscle lipid pools. Trends Endocrinol Metab. 2013 Dec;24(12):607-15. doi: 10.1016/j.tem.2013.08.001. DOI:

Kase ET, Feng YZ, Badin PM, Bakke SS, Laurens C, Coue M, et al. Primary defects in lipolysis and insulin action in skeletal muscle cells from type 2 diabetic individuals. Biochim Biophys Acta. 2015 Sep;1851(9):1194-201. doi: 10.1016/j.bbalip.2015.03.005. DOI:

O'Neill S, O'Driscoll L. Metabolic syndrome: a closer look at the growing epidemic and its associated pathologies. Obes Rev. 2015 Jan;16(1):1-12. doi: 10.1111/obr.12229. DOI:

Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010 Jul;39(4):412-23. doi: 10.1093/ageing/afq034 DOI:

Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jul 1;48(4):601. doi: 10.1093/ageing/afz046. DOI:

Kim KM, Jang HC, Lim S. Differences among skeletal muscle mass indices derived from height-, weight-, and body mass index-adjusted models in assessing sarcopenia. Korean J Intern Med. 2016 Jul;31(4):643-50. doi: 10.3904/kjim.2016.015. DOI:

Bahat G, Tufan A, Tufan F, Kilic C, Akpinar TS, Kose M, et al. Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition. Clin Nutr. 2016 Dec;35(6):1557-63. doi: 10.1016/j.clnu.2016.02.002. DOI:

Lynch DH, Spangler HB, Franz JR, Krupenevich RL, Kim H, Nissman D, et al. Multimodal Diagnostic Approaches to Advance Precision Medicine in Sarcopenia and Frailty. Nutrients. 2022 Mar 26;14(7):1384. doi: 10.3390/nu14071384 DOI:

Studenski S, Perera S, Patel K, Rosano C, Faulkner K, Inzitari M, et al. Gait speed and survival in older adults. JAMA. 2011 Jan 5;305(1):50-8. doi: 10.1001/jama.2010.1923. DOI:

Morley JE, Abbatecola AM, Argiles JM, Baracos V, Bauer J, Bhasin S, et al. Society on Sarcopenia, Cachexia and Wasting Disorders Trialist Workshop. Sarcopenia with limited mobility: an international consensus. J Am Med Dir Assoc. 2011 Jul;12(6):403-9. doi: 10.1016/j.jamda.2011.04.014 DOI:

Kemmler W, von Stengel S, Engelke K, Sieber C, Freiberger E. Prevalence of sarcopenic obesity in Germany using established definitions: Baseline data of the FORMOsA study. Osteoporos Int. 2016 Jan;27(1):275-81. doi: 10.1007/s00198-015-3303-y. DOI:

Beaudart C, Reginster JY, Slomian J, Buckinx F, Locquet M, Bruyère O. Prevalence of sarcopenia: the impact of different diagnostic cut-off limits. J Musculoskelet Neuronal Interact. 2014 Dec;14(4):425-3.

Kim TN, Yang SJ, Yoo HJ, Lim KI, Kang HJ, Song W, et al. Prevalence of sarcopenia and sarcopenic obesity in Korean adults: the Korean sarcopenic obesity study. Int J Obes (Lond). 2009 Aug;33(8):885-92. doi: 10.1038/ijo.2009.130. DOI:

Janssen F, Bardoutsos A, Vidra N. Obesity Prevalence in the Long-Term Future in 18 European Countries and in the USA. Obes Facts. 2020;13(5):514-27. doi: 10.1159/000511023. DOI:

Peralta M, Ramos M, Lipert A, Martins J, Marques A. Prevalence and trends of overweight and obesity in older adults from 10 European countries from 2005 to 2013. Scand J Public Health. 2018 Jul;46(5):522-9. doi: 10.1177/1403494818764810. DOI:

Nair KS. Aging muscle. Am J Clin Nutr. 2005 May;81(5):953-63. doi: 10.1093/ajcn/81.5.953. DOI:

Newman AB, Haggerty CL, Goodpaster B, Harris T, Kritchevsky S, Nevitt M, et al. Health Aging And Body Composition Research Group. Strength and muscle quality in a well-functioning cohort of older adults: the Health, Aging and Body Composition Study. J Am Geriatr Soc. 2003 Mar;51(3):323-30. doi: 10.1046/j.1532-5415.2003.51105.x. DOI:

Altinkaynak M, Ozturk CK, Goksoy Y, Eryigit OY, Akpinar TS, Erten SN, et al. The prevalence of sarcopenic obesity and its relationship with type 2 diabetes in a nursing home. Eur Rev Med Pharmacol Sci. 2023 Apr;27(7):2858-64. doi: 10.26355/eurrev_202304_31916.

Silva TLD, Mulder AP. Sarcopenia and poor muscle quality associated with severe obesity in young adults and middle-aged adults. ClinNutr ESPEN. 2021 Oct;45:299-305. doi: 10.1016/j.clnesp.2021.07.031. DOI:

Rasaei N, Kashavarz SA, Yekaninejad MS, Mirzaei K. The association between sarcopenic obesity (SO) and major dietary patterns in overweight and obese adult women. Diabetes Metab Syndr. 2019 Jul-Aug;13(4):2519-24. doi: 10.1016/j.dsx.2019.06.023. DOI:






Research Article

How to Cite

Tuna M, Işık AC, Hürmeydan O. Sarcopenia prevalence between obese and morbid obese patients in an obesity center: Prevalence of sarcopenia in obese middle-aged women. J Surg Med [Internet]. 2024 Mar. 27 [cited 2024 May 18];8(4):73-7. Available from: