title: Impact of visceral fat on skeletal muscle mass and vice versa in a prospective cohort study: the Korean Sarcopenic Obesity Study (KSOS).
abstract: OBJECTIVE
  Sarcopenia and visceral obesity have been suggested to aggravate each other, resulting in a vicious cycle. However, evidence based on prospective study is very limited. Our purpose was to investigate whether visceral fat promotes a decrease in skeletal muscle mass and vice versa.
  
  
  METHODS
  We observed changes in anthropometric and body composition data during a follow-up period of 27.6 ± 2.8 months in 379 Korean men and women (mean age 51.9 ± 14.6 years) from the Korean Sarcopenic Obesity Study (KSOS). Appendicular lean soft tissue (ALST) mass was calculated using dual-energy X-ray absorptiometry, and visceral fat area (VFA) was measured using computed tomography at baseline and follow-up examination.
  
  
  RESULTS
  ALST mass significantly decreased, whereas trunk and total fat mass increased in both men and women despite no significant change in weight and body mass index. In particular, women with visceral obesity at baseline had a greater decrease in ALST mass than those without visceral obesity (P = 0.001). In multiple linear regression analysis, baseline VFA was an independent negative predictor of the changes in ALST after adjusting for confounding factors including age, gender, life style and body composition parameters, insulin resistance, high sensitivity C-reactive protein and vitamin D levels (P = 0.001), whereas the association between baseline ALST mass and changes in VFA was not statistically significant (P = 0.555).
  
  
  CONCLUSIONS
  This longitudinal study showed that visceral obesity was associated with future loss of skeletal muscle mass in Korean adults. These results may provide novel insight into sarcopenic obesity in an aging society.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea; Department of Internal Medicine, Cardiovascular and Metabolic Disease Center, College of Medicine, Inje University, Busan, Korea.
authors.forename: Tae Nyun
authors.initials: TN
authors.lastname: Kim
authors.affiliation: Department of Statistics, College of Natural Sciences, Sungshin Women's University, Seoul, Korea.
authors.forename: Man Sik
authors.initials: MS
authors.lastname: Park
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Ja Young
authors.initials: JY
authors.lastname: Ryu
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Hae Yoon
authors.initials: HY
authors.lastname: Choi
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Ho Cheol
authors.initials: HC
authors.lastname: Hong
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Yoo
authors.affiliation: Sports Medicine, Division of Physical Education, Soonchunhyang University, A-San, Korea.
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Kang
authors.affiliation: Health and Exercise Science Laboratory, Institute of Sports Science, Department of Physical Education, Seoul National University, Seoul, Korea.
authors.forename: Wook
authors.initials: W
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Pochon CHA University, Pochon, Korea.
authors.forename: Seok Won
authors.initials: SW
authors.lastname: Park
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Sei Hyun
authors.initials: SH
authors.lastname: Baik
authors.affiliation: Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Kyung Mook
authors.initials: KM
authors.lastname: Choi
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications*; D011379:Prognosis; D011446:Prospective Studies; D056910:Republic of Korea; D012307:Risk Factors; D055948:Sarcopenia / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein