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Another Impairment in Older Age: What Does Osteosarcopenic Obesity Syndrome Mean for Middle-Aged and Older Women?

      Osteosarcopenic obesity (OSO) syndrome is a newly identified condition characterized by concurrent occurrence of impaired bone health (osteopenia/osteoporosis), reduced muscle mass or strength (sarcopenia or dynapenia), and increased adiposity (Figure 1). Important point to note in this definition is that increased adiposity can be present either as an overt overweight/obesity or redistributed fat into visceral organs and/or infiltrated fat into bone and muscle, occurring with age and some other chronic diseases.
      • Ilich J.Z.
      • Kelly O.J.
      • Inglis J.E.
      • et al.
      Interrelationship among muscle, fat, and bone: Connecting the dots on cellular, hormonal, and whole body levels.
      The initial concept was proposed based on scientific evidence and theoretical presumptions incorporating some preliminary data collected in midlife and older Caucasian women.
      • Ilich J.Z.
      • Kelly O.J.
      • Inglis J.E.
      • et al.
      Interrelationship among muscle, fat, and bone: Connecting the dots on cellular, hormonal, and whole body levels.
      Further investigation enabled development of some diagnostic criteria to better identify the syndrome
      • Ilich J.Z.
      • Kelly O.J.
      • Inglis J.E.
      Osteosarcopenic obesity syndrome: What is it and how can it be diagnosed?.
      • JafariNasabian P.
      • Inglis J.E.
      • Kelly O.J.
      • Ilich J.Z.
      Osteosarcopenic obesity in women: Impact, prevalence, and management challenges.
      • Ilich J.Z.
      • Inglis J.E.
      • Kelly O.J.
      • McGee D.L.
      Osteosarcopenic obesity is associated with reduced handgrip strength, walking abilities and balance in postmenopausal women.
      and prompted additional studies and classifications by other researchers; the latest one published in this issue.
      • Szlejf C.
      • Parra-Rodríguez L.
      • Rosas-Carrasco O.
      Osteosarcopenic obesity: Prevalence and its relation with frailty and physical performance in middle-aged and older women.
      Currently, the OSO phenotype has been recognized in various populations, including middle-aged and older Caucasian
      • Ilich J.Z.
      • Inglis J.E.
      • Kelly O.J.
      • McGee D.L.
      Osteosarcopenic obesity is associated with reduced handgrip strength, walking abilities and balance in postmenopausal women.
      and Mexican women,
      • Szlejf C.
      • Parra-Rodríguez L.
      • Rosas-Carrasco O.
      Osteosarcopenic obesity: Prevalence and its relation with frailty and physical performance in middle-aged and older women.
      where it was associated with diminished functionality and/or greater frailty; Korean National representative sample of women and men older than 50 years
      • Kim J.
      • Lee Y.
      • Kye S.
      • et al.
      Association of serum vitamin D with osteosarcopenic obesity: Korea National Health and Nutrition Examination Survey 2008-2010.
      ; and even in young, overweight/obese, adults living in Greece.
      • Stefanaki C.
      • Peppa M.
      • Boschiero D.
      • Chrousos G.P.
      Healthy overweight/obese youth: Early osteosarcopenic obesity features.
      Figure thumbnail gr1
      Fig. 1Osteopenia/osteoporosis, sarcopenia and obesity overlap, creating combination of other tissue derangements, with osteosarcopenic obesity being the most multifaceted.
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