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Sarcopenia, obesity, and inflammation—results from the Trial of Angiotensin Converting Enzyme Inhibition and Novel Cardiovascular Risk Factors study^1,2,3

¹ From the Department of Aging and Geriatric Research, College of Medicine, Institute on Aging, University of Florida, Gainesville, FL (MC and MP); the Sticht Center on Aging (SBK, HHA, and LL) and the Department of Public Health Sciences (SLP and WTA), Wake Forest University School of Medicine, Winston-Salem, NC; the Division of Epidemiology and Preventive Medicine, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM (RNB); the Department of Psychiatry, Vrije Universiteit, Amsterdam, Netherlands (BWHJP); and the Department of Pathology, University of Vermont, Colchester, VT (RPT)

Background: Age-related body-composition changes are associated with health-related outcomes in elders. This relation may be explained by inflammation and hemostatic abnormalities.

Objectives: Our objectives were to evaluate the relation between body-composition measures [body mass index (BMI), total fat mass, and appendicular lean mass (aLM)] and C-reactive protein (CRP), interleukin 6 (IL-6), and plasminogen activator inhibitor 1 (PAI-1) and to explore the effect of obesity and sarcopenia on CRP, IL-6, and PAI-1 concentrations.

Design: The data are from the Trial of Angiotensin Converting Enzyme Inhibition and Novel Cardiovascular Risk Factors (TRAIN) study baseline visit (n = 286; mean age = 66.0 y). Total fat mass and aLM were assessed with a dual-energy X-ray absorptiometry scan. Linear regressions were performed between body-composition measures and CRP, IL-6, or PAI-1 concentrations. The effect of sarcopenia and obesity (defined as the percentage of fat mass) on CRP, IL-6, and PAI-1 concentrations was evaluated with the use of analyses of covariance.

Results: CRP and IL-6 were positively associated with both BMI [ß = 0.027 (P = 0.03) and ß = 0.048 (P < 0.001), respectively] and total fat mass [ß = 0.049 (P < 0.001) and ß = 0.055 (P < 0.001), respectively] and were inversely associated with fat-adjusted aLM [ß = –0.629 (P = 0.002) and ß = –0.467 (P = 0.02), respectively]. PAI-1 was positively associated with both BMI (ß = 0.038, P = 0.005) and total fat mass (ß = 0.032, P = 0.007). No significant interaction was found between either obesity or sarcopenia and CRP, IL-6, and PAI-1 concentrations. Obesity remained significantly associated with high CRP and IL-6 concentrations after adjustments for sarcopenia.

Conclusions: CRP and IL-6 are positively associated with total fat mass and negatively associated with aLM. Obesity-associated inflammation may play an important role in the age-related process that leads to sarcopenia. The relation of inflammation with sarcopenia was not independent of any of the considered obesity indexes.

Key Words: Sarcopenia • obesity • inflammation • fibrinolysis • skeletal muscle • aging

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