Association of sarcopenic obesity with the risk of all-cause mortality among adults over a broad range of different settings: A updated meta-analysis

Xiaoming Zhang, Xiaohua Xie, Qingli Dou, Chenyun Liu, Wenwu Zhang, Yunzhi Yang, Renli Deng, Andy S.K. Cheng

Research output: Journal article publicationJournal articleAcademic researchpeer-review

91 Citations (Scopus)


Background: Previous cohort studies investigating the association between sarcopenic obesity (SO) and all-cause mortality among adult people have been inconsistent. We performed a meta-analysis to determine if SO is a predictor of all-cause mortality. Methods: Prospective cohort studies that evaluated the association between SO and mortality in older people were identified via a systematic search of three electronic databases (PubMed, EMBASE, and the Cochrane Library). A random-effects model was applied to combine the results. We considered the methods recommeded by consensuses (dual X-ray absorptiometry,bio-impedancemetry, anthropometric measures or CT scan) to assess sarcopenic obesity. Results: Of the 603 studies identified through the systematic review, 23 (Participants: 50866) were included in the meta-analysis. The mean age ranged from 50 to 82.5 years.SO was significantly associated with a higher risk of all-cause mortality among adult people (pooled HR = 1.21, 95% confidence interval [95% CI] = 1.10-1.32, p < 0.001, I 2 = 64.3%). Furthermore, the subgroup analysis of participants showed that SO was associated with all-cause mortality (pooled HR = 1.14, 95% CI: 1.06-1.23) among community-dwelling adult people; similarly, this association was found in hospitalized patients (pooled HR = 1.65, 95% CI: 1.17-2.33). Moreover, the subgroup analysis demonstrated that SO was associated with all-cause mortality when using skeletal muscle mass (SMM) criteria, muscle strength criteria, and skeletal muscle index (SMI) criteria (HR = 1.12, 95% CI: 1.01-1.23; HR = 1.18, 95% CI: 1.05-1.33; and HR = 1.53, 95% CI: 1.13-2.07, respectively). In addition, we analyzed SO on the basis of obesity definition and demonstrated that participants with a SO diagnosis based on waist circumference (WC) (HR = 1.24, 95% CI: 1.09-1.40), body mass index (BMI) (HR = 1.29, 95% CI: 1.04-1.59), or visceral fat area (HR = 2.54, 95% CI: 1.83-3.53) have a significantly increase mortality risk compared with those without SO. Conclusion: Based on our update of existing scientific researches, SO is a significant predictor of all-cause mortality among older people, particularly hospitalized patients. Therefore, it is important to diagnose SO and to treat the condition to reduce mortality rates among older people.

Original languageEnglish
Article number183
JournalBMC Geriatrics
Issue number1
Publication statusPublished - 3 Jul 2019


  • All-cause mortality
  • Meta-analysis
  • Older adults
  • Sarcopenic obesity

ASJC Scopus subject areas

  • Geriatrics and Gerontology


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