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

Authors: BAUER, JURGEN - University Of Heidelberg; CRUZ-JENTOFT, ALFONSO - Hospital Ramon Y Cajal; FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; KANIS, JOHN - University Of Sheffield; REGINSTER, JEAN-YVES - University Of Liege; BRUYERE, OLIVIER - University Of Liege; CESARI, MATTEO - University Of Milan; CHAPURLAT, ROLAND - University Of Lyon; AL-DAGHRI, NASSER - King Saud University; DENNISON, ELAINE - University Of Southampton; KAUFMAN, JEAN-MARC - Ghent University; LANDI, FRANCESCO - Catholic University Of The Sacred Heart Italy; LASLOP, ANDREA - Austrian Agency For Health And Food Safety Ltd (AGES); LOCQUET, MEDEA - University Of Liege; MAGGI, STEFANIA - National Research Council - Italy; MCCLOSKEY, EUGENE - University Of Sheffield; PERNA, SIMONE - University Of Bahrain; RIZZOLI, RENE - Geneva University Hospital; ROLLAND, YVES - Gerontopole De Toulouse Center Hospital University; RONDANELLI, MARIANGELA - University Of Pavia; SZULC, PAWEL - University Of Lyon; VELLAS, BRUNO - Gerontopole De Toulouse Center Hospital University; VLASKOVSKA, MILA - Sofia University St "kliment Ohridski"; COOPER, CYRUS - University Of Oxford

Submitted to: Calcified Tissue International
Publication Type: Review Article
Publication Acceptance Date: 5/2/2019
Publication Date: 5/16/2019
Citation: Bauer, J.M., Cruz-Jentoft, A.J., Fielding, R.A., Kanis, J.A., Reginster, J., Bruyere, O., Cesari, M., Chapurlat, R., Al-Daghri, N., Dennison, E., Kaufman, J., Landi, F., Laslop, A., Locquet, M., Maggi, S., Mccloskey, E., Perna, S., Rizzoli, R., Rolland, Y., Rondanelli, M., Szulc, P., Vellas, B., Vlaskovska, M., Cooper, C. 2019. Is there enough evidence for osteosarcopenic obesity as a distinct entity? A critical literature review. Calcified Tissue International. 105(2):109-124. https://doi.org/10.1007/s00223-019-00561-w.
DOI: https://doi.org/10.1007/s00223-019-00561-w

Interpretive Summary:

Technical 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.