Muscle quality, abdominal adiposity and functional performance in older women with DXA-defined obesity
DOI:
https://doi.org/10.47197/retos.v82.119557Keywords:
Dual-Energy X-Ray Ab-sorptiometry, functional performance, muscle quality, obesity, older womenAbstract
Introduction: female aging is associated with adipose redistribution, muscle deterioration, and decreased functionality. Integrating body composition and functionality could improve the clinical characterization of obesity.
Objective: to analyze the relationship between muscle quality, abdominal adiposity, hemodynamic parameters, and functional performance in older women with obesity.
Methodology: an observational, cross-sectional, and analytical study was conducted in 131 community-dwelling older women. Body composition was assessed using dual-energy X-ray absorptiometry, obtaining body fat percentage, appendicular lean mass, visceral adipose tissue, and subcutaneous adipose tissue. Muscle quality was estimated using the muscle quality index. Functional performance was evaluated through gait speed, Timed Up and Go, five-times sit-to-stand test, single-leg balance, and the 2-minute step test. Analysis of variance, Welch robust tests, and multiple linear regression were performed.
Results: 23.7% showed impaired muscle quality and 54.2% clinical obesity. Participants with lower muscle quality showed poorer balance, functional mobility, and resistance. Visceral adipose tissue was associated with diastolic blood pressure, whereas age was related to higher systolic blood pressure and poorer functional performance. Additionally, the ratio between visceral and subcutaneous adipose tissue progressively increased with age.
Discussion: the findings are consistent with studies describing associations between muscle deterioration, abdominal adipose redistribution, and functional decline.
Conclusions: lower muscle quality was associated with poorer physical functionality in older women with obesity. Furthermore, advanced aging was related to abdominal adipose redistribution and progressive deterioration in functional performance.
References
Álvarez, L., Arteaga-Pazmiño, C., Rivero-Mendoza, D., Giller-Párraga, N., & Frías-Toral, E. (2025). Preva-lencia y factores asociados de dinapenia en mujeres postmenopáusicas de zonas comunitarias urbano-marginales de Guayaquil. Retos, 65, 1008-1017. https://doi.org/10.47197/retos.v65.112778
Baltes, P. B., & Smith, J. (2003). New frontiers in the future of aging: from successful aging of the young old to the dilemmas of the fourth age. Gerontology, 49(2), 123–135. https://doi.org/10.1159/000067946
Barbat-Artigas, S., Rolland, Y., Zamboni, M., & Aubertin-Leheudre, M. (2012). How to assess functional status: a new muscle quality index. The journal of nutrition, health & aging, 16(1), 67–77. https://doi.org/10.1007/s12603-012-0004-5
Batsis, J. A., & Villareal, D. T. (2018). Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nature reviews. Endocrinology, 14(9), 513–537. https://doi.org/10.1038/s41574-018-0062-9
Benton, M. J., Spicher, J. M., & Silva-Smith, A. L. (2022). Validity and reliability of handgrip dynamome-try in older adults: A comparison of two widely used dynamometers. PLOS ONE, 17(6), e0270132. https://doi.org/10.1371/journal.pone.0270132
Bohannon R. W. (2006). Reference values for the five-repetition sit-to-stand test: a descriptive meta-analysis of data from elders. Perceptual and motor skills, 103(1), 215–222. https://doi.org/10.2466/pms.103.1.215-222
Buatois, S., Miljkovic, D., Manckoundia, P., Gueguen, R., Miget, P., Vançon, G., Perrin, P., & Benetos, A. (2008). Five times sit to stand test is a predictor of recurrent falls in healthy community-living subjects aged 65 and older. Journal of the American Geriatrics Society, 56(8), 1575–1577. https://doi.org/10.1111/j.1532-5415.2008.01777.x
Coronado-Zarco, R., & de León, A. O. (2023). Muscle quality an evolving concept. Journal of frailty, sar-copenia and falls, 8(4), 254–260. https://doi.org/10.22540/JFSF-08-254
Correa-de-Araujo, R., & Hadley, E. (2014). Skeletal muscle function deficit: a new terminology to em-brace the evolving concepts of sarcopenia and age-related muscle dysfunction. The journals of gerontology. Series A, Biological sciences and medical sciences, 69(5), 591–594. https://doi.org/10.1093/gerona/glt208
Cruz-Jentoft, A. J., & Sayer, A. A. (2019). Sarcopenia. Lancet (London, England), 393(10191), 2636–2646. https://doi.org/10.1016/S0140-6736(19)31138-9
Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., Cooper, C., Landi, F., Rolland, Y., Sayer, A. A., Schneider, S. M., Sieber, C. C., Topinkova, E., Vandewoude, M., Visser, M., & Writ-ing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). (2019). Sarcopenia: Revised European consensus on definition and diagnosis. Age and Ageing, 48(1), 16–31. https://doi.org/10.1093/ageing/afy169
Donini, L. M., Busetto, L., Bischoff, S. C., Cederholm, T., Ballesteros-Pomar, M. D., Batsis, J. A., Bauer, J. M., Boirie, Y., Cruz-Jentoft, A. J., Dicker, D., Frara, S., Frühbeck, G., Genton, L., Gepner, Y., Giustina, A., Gonzalez, M. C., Han, H. S., Heymsfield, S. B., Higashiguchi, T., Laviano, A., … Barazzoni, R. (2022). Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus State-ment. Obesity facts, 15(3), 321–335. https://doi.org/10.1159/000521241
Ferrucci, L., Cooper, R., Shardell, M., Simonsick, E. M., Schrack, J. A., & Kuh, D. (2016). Age-Related Change in Mobility: Perspectives From Life Course Epidemiology and Geroscience. The journals of gerontology. Series A, Biological sciences and medical sciences, 71(9), 1184–1194. https://doi.org/10.1093/gerona/glw043
Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., Seeman, T., Tracy, R., Kop, W. J., Burke, G., McBurnie, M. A., & Cardiovascular Health Study Collaborative Research Group (2001). Frailty in older adults: evidence for a phenotype. The journals of gerontology. Series A, Biological sciences and medical sciences, 56(3), M146–M156. https://doi.org/10.1093/gerona/56.3.m146
Fox, C. S., Massaro, J. M., Hoffmann, U., Pou, K. M., Maurovich-Horvat, P., Liu, C. Y., Vasan, R. S., Murabito, J. M., Meigs, J. B., Cupples, L. A., D'Agostino, R. B., Sr, & O'Donnell, C. J. (2007). Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation, 116(1), 39–48. https://doi.org/10.1161/CIRCULATIONAHA.106.675355
Gallagher, D., Heymsfield, S. B., Heo, M., Jebb, S. A., Murgatroyd, P. R., & Sakamoto, Y. (2000). Healthy percentage body fat ranges: an approach for developing guidelines based on body mass in-dex. The American journal of clinical nutrition, 72(3), 694–701. https://doi.org/10.1093/ajcn/72.3.694
Hunter, G. R., Gower, B. A., & Kane, B. L. (2010). Age Related Shift in Visceral Fat. International journal of body composition research, 8(3), 103–108.
Jones, D. W., Carey, R. M., Whelton, P. K., et al. (2025). 2025 guideline for the prevention, detection, evaluation and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Cir-culation. Advance online publication. https://doi.org/10.1161/CIR.0000000000001356
Lee, K., Lee, S., Kim, Y. J., & Kim, Y. J. (2008). Waist circumference, dual-energy X-ray absortiometrically measured abdominal adiposity, and computed tomographically derived intra-abdominal fat ar-ea on detecting metabolic risk factors in obese women. Nutrition (Burbank, Los Angeles County, Calif.), 24(7-8), 625–631. https://doi.org/10.1016/j.nut.2008.03.004
McGregor, R. A., Cameron-Smith, D., & Poppitt, S. D. (2014). It is not just muscle mass: a review of mus-cle quality, composition and metabolism during ageing as determinants of muscle function and mobility in later life. Longevity & healthspan, 3(1), 9. https://doi.org/10.1186/2046-2395-3-9
Maurovich-Horvat, P., Massaro, J., Fox, C. S., Moselewski, F., O'Donnell, C. J., & Hoffmann, U. (2007). Comparison of anthropometric, area- and volume-based assessment of abdominal subcutane-ous and visceral adipose tissue volumes using multi-detector computed tomogra-phy. International journal of obesity (2005), 31(3), 500–506. https://doi.org/10.1038/sj.ijo.0803454
Podsiadlo, D., & Richardson, S. (1991). The timed “Up & Go”: A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142–148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
Rikli, R. E., & Jones, C. J. (2013). Senior fitness test manual (2nd ed.). Human Kinetics.
Rothney, M. P., Brychta, R. J., Schaefer, E. V., Chen, K. Y., & Skarulis, M. C. (2009). Body composition measured by dual-energy X-ray absorptiometry half-body scans in obese adults. Obesity (Silver Spring, Md.), 17(6), 1281–1286. https://doi.org/10.1038/oby.2009.14
Rubino, F., Cummings, D. E., Eckel, R. H., Cohen, R. V., Wilding, J. P. H., Brown, W. A., Stanford, F. C., Bat-terham, R. L., Farooqi, I. S., Farpour-Lambert, N. J., le Roux, C. W., Sattar, N., Baur, L. A., Morrison, K. M., Misra, A., Kadowaki, T., Tham, K. W., Sumithran, P., Garvey, W. T., Kirwan, J. P., … Mingrone, G. (2025). Definition and diagnostic criteria of clinical obesity. The lancet. Diabetes & endocrinology, 13(3), 221–262. https://doi.org/10.1016/S2213-8587(24)00316-4
Shah NR, Braverman ER (2012) Measuring Adiposity in Patients: The Utility of Body Mass Index (BMI), Percent Body Fat, and Leptin. PLoS ONE 7(4): e33308. https://doi.org/10.1371/journal.pone.0033308
Shepherd, J. A., Ng, B. K., Sommer, M. J., & Heymsfield, S. B. (2017). Body composition by DXA. Bone, 104, 101–105. https://doi.org/10.1016/j.bone.2017.06.010
Shuhart, C. R., Yeap, S. S., Anderson, P. A., Jankowski, L. G., Lewiecki, E. M., Morse, L. R., Rosen, H. N., We-ber, D. R., Zemel, B. S., & Shepherd, J. A. (2019). Executive summary of the 2019 ISCD position development conference on monitoring treatment, DXA cross-calibration and least significant change, spinal cord injury, peri-prosthetic and orthopedic bone health, transgender medicine, and pediatrics. Journal of Clinical Densitometry, 22(4), 453–471. https://doi.org/10.1016/j.jocd.2019.07.001
Springer, B. A., Marin, R., Cyhan, T., Roberts, H., & Gill, N. W. (2007). Normative values for the unipedal stance test with eyes open and closed. Journal of geriatric physical therapy (2001), 30(1), 8–15. https://doi.org/10.1519/00139143-200704000-00003
Studenski, S., Perera, S., Patel, K., Rosano, C., Faulkner, K., Inzitari, M., Brach, J., Chandler, J., Cawthon, P., Connor, E. B., Nevitt, M., Visser, M., Kritchevsky, S., Badinelli, S., Harris, T., Newman, A. B., Cauley, J., Ferrucci, L., & Guralnik, J. (2011). Gait speed and survival in older adults. JAMA, 305(1), 50–58. https://doi.org/10.1001/jama.2010.1923
Vellas, B. J., Wayne, S. J., Romero, L., Baumgartner, R. N., Rubenstein, L. Z., & Garry, P. J. (1997). One-leg balance is an important predictor of injurious falls in older persons. Journal of the American Geriatrics Society, 45(6), 735–738. https://doi.org/10.1111/j.1532-5415.1997.tb01479.x
Wang, C.-Y., & Chen, L.-Y. (2010). Grip strength in older adults: Test-retest reliability and cutoff for sub-jective weakness of using the hands in heavy tasks. Archives of Physical Medicine and Rehabili-tation, 91(11), 1747–1751. https://doi.org/10.1016/j.apmr.2010.07.225
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