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Is there enough evidence for osteosarcopenic obesity as a distinct entity? A critical literature review

Is there enough evidence for osteosarcopenic obesity as a distinct entity? A critical literature review
Is there enough evidence for osteosarcopenic obesity as a distinct entity? A critical literature review

The co-existence of impaired bone health (osteopenia/osteoporosis), reduced muscle mass and strength (sarcopenia), and increased adiposity (obesity) in middle-aged and older people has been identified in recent studies, leading to a proposal for the existence of “osteosarcopenic obesity” as a distinct entity. Evidence for the pathophysiological overlap of these conditions is mounting, although a causal relationship is yet to be established. Each component condition occurs frequently with increasing age, and with shared risk factors in many instances, thus, an overlap of these three conditions is not surprising. However, whether the concurrent existence of sarcopenia, osteoporosis and obesity leads to an increased risk of adverse musculoskeletal outcomes and mortality above and beyond the risks associated with the sum of the component parts remains to be proven and is a question of research interest. In this article, we review evidence for the existence of osteosarcopenic obesity including the current operational definition of osteosarcopenic obesity, prevalence, pathophysiology, outcomes and exploratory approaches to the management of components. We conclude that, there is insufficient evidence to support a discrete clinical entity of osteosarcopenic obesity at this time. To expand knowledge and understanding in this area, there is a need for consensus on a definition of osteosarcopenic obesity which will allow for identification, further epidemiological studies and comparisons between studies. Additionally, studies should assess whether the clinical outcomes associated with osteosarcopenic obesity are worse than the mere addition of those linked with its components. This will help to determine whether defining a person as having this triad will eventually result in a more effective treatment than addressing each of the three conditions separately.

Obesity, Osteoporosis, Osteosarcopenia, Sarcopenia, Sarcopenic obesity
0171-967X
Bauer, Jürgen M.
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Cruz-Jentoft, Alfonso J.
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Fielding, Roger A.
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Kanis, John A.
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Reginster, Jean Yves
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Bruyère, Olivier
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Cesari, Matteo
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Chapurlat, Roland
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Al-Daghri, Nasser
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Dennison, Elaine
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Kaufman, Jean Marc
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Landi, Francesco
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Laslop, Andrea
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Locquet, Médéa
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Maggi, Stefania
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McCloskey, Eugene
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Perna, Simone
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Rizzoli, René
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Rolland, Yves
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Rondanelli, Mariangela
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Szulc, Pawel
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Vellas, Bruno
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Vlaskovska, Mila
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Cooper, Cyrus
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Bauer, Jürgen M.
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Cruz-Jentoft, Alfonso J.
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Fielding, Roger A.
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Kanis, John A.
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Reginster, Jean Yves
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Bruyère, Olivier
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Cesari, Matteo
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Chapurlat, Roland
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Al-Daghri, Nasser
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Dennison, Elaine
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Kaufman, Jean Marc
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Landi, Francesco
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Laslop, Andrea
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Locquet, Médéa
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Maggi, Stefania
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McCloskey, Eugene
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Perna, Simone
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Rizzoli, René
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Rolland, Yves
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Rondanelli, Mariangela
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Szulc, Pawel
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Vellas, Bruno
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Vlaskovska, Mila
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Cooper, Cyrus
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Bauer, Jürgen M., Cruz-Jentoft, Alfonso J., Fielding, Roger A., Kanis, John A., Reginster, Jean Yves, Bruyère, Olivier, Cesari, Matteo, Chapurlat, Roland, Al-Daghri, Nasser, Dennison, Elaine, Kaufman, Jean Marc, Landi, Francesco, Laslop, Andrea, Locquet, Médéa, Maggi, Stefania, McCloskey, Eugene, Perna, Simone, Rizzoli, René, Rolland, Yves, Rondanelli, Mariangela, Szulc, Pawel, Vellas, Bruno, Vlaskovska, Mila and Cooper, Cyrus (2019) Is there enough evidence for osteosarcopenic obesity as a distinct entity? A critical literature review. Calcified Tissue International. (doi:10.1007/s00223-019-00561-w).

Record type: Review

Abstract

The co-existence of impaired bone health (osteopenia/osteoporosis), reduced muscle mass and strength (sarcopenia), and increased adiposity (obesity) in middle-aged and older people has been identified in recent studies, leading to a proposal for the existence of “osteosarcopenic obesity” as a distinct entity. Evidence for the pathophysiological overlap of these conditions is mounting, although a causal relationship is yet to be established. Each component condition occurs frequently with increasing age, and with shared risk factors in many instances, thus, an overlap of these three conditions is not surprising. However, whether the concurrent existence of sarcopenia, osteoporosis and obesity leads to an increased risk of adverse musculoskeletal outcomes and mortality above and beyond the risks associated with the sum of the component parts remains to be proven and is a question of research interest. In this article, we review evidence for the existence of osteosarcopenic obesity including the current operational definition of osteosarcopenic obesity, prevalence, pathophysiology, outcomes and exploratory approaches to the management of components. We conclude that, there is insufficient evidence to support a discrete clinical entity of osteosarcopenic obesity at this time. To expand knowledge and understanding in this area, there is a need for consensus on a definition of osteosarcopenic obesity which will allow for identification, further epidemiological studies and comparisons between studies. Additionally, studies should assess whether the clinical outcomes associated with osteosarcopenic obesity are worse than the mere addition of those linked with its components. This will help to determine whether defining a person as having this triad will eventually result in a more effective treatment than addressing each of the three conditions separately.

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Accepted/In Press date: 2 May 2019
e-pub ahead of print date: 16 May 2019
Keywords: Obesity, Osteoporosis, Osteosarcopenia, Sarcopenia, Sarcopenic obesity

Identifiers

Local EPrints ID: 431871
URI: http://eprints.soton.ac.uk/id/eprint/431871
ISSN: 0171-967X
PURE UUID: f5526712-6fe6-4326-a27a-66a971cef6f1
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 20 Jun 2019 16:30
Last modified: 26 Nov 2021 02:39

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Contributors

Author: Jürgen M. Bauer
Author: Alfonso J. Cruz-Jentoft
Author: Roger A. Fielding
Author: John A. Kanis
Author: Jean Yves Reginster
Author: Olivier Bruyère
Author: Matteo Cesari
Author: Roland Chapurlat
Author: Nasser Al-Daghri
Author: Elaine Dennison ORCID iD
Author: Jean Marc Kaufman
Author: Francesco Landi
Author: Andrea Laslop
Author: Médéa Locquet
Author: Stefania Maggi
Author: Eugene McCloskey
Author: Simone Perna
Author: René Rizzoli
Author: Yves Rolland
Author: Mariangela Rondanelli
Author: Pawel Szulc
Author: Bruno Vellas
Author: Mila Vlaskovska
Author: Cyrus Cooper ORCID iD

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