title: Obesity, Muscular Strength, Muscle Composition and Physical Performance in an Elderly Population.
abstract: OBJECTIVE
  To evaluate the association between BMI levels, muscular strength, muscle composition and physical performance in the elderly.
  
  
  METHODS
  Italians subjects from the Progetto Veneto Anziani (ProVA) study were analyzed.
  
  
  METHODS
  The ProVa was a population study focused on chronic diseases and functional limitations in Italian subjects aged ≥65 years living in two Northeast Italian cities.
  
  
  METHODS
  The ProVa study included 3099 subjects. ProVa participants with unknown information on BMI or disability status were excluded. The final sample was thus represented by 1.188 men, and 1.723 women.
  
  
  METHODS
  Physical performance was measured with the Short Physical Performance Battery (SPPB) and leg muscular strength with dynamometry. Fat distribution and skeletal muscle composition were measured in an abdominal single-scan magnetic resonance (MRI) in a randomly selected sample of 348 subjects. Study population was stratified by BMI classes.
  
  
  RESULTS
  An association between BMI levels and SPPB was observed. Normal weight subjects showed the best SPPB scores (8.29±0.03), with significant differences compared to underweight (7.50±0.15; p<0.001), overweight (8.12±0.02; p<0.001), class I (7.72±0.04; p<0.001), class II (6.67±0.09; p<0.001) and class III obesity (5.88±0.24; p<0.001). This pattern was not modified by adjustment for possible confounders. Compared to normal weight subjects (22.9±0.1 kg), leg muscular strength was higher in overweight (23.8±0.1; p<0.001) and in class I obesity (24.5±0.1; p<0.001), but it was reduced in class II (21.4±0.3; p<0.001) and class III (19.8±0.9; p<0.001). The association between BMI and impaired physical performance was not affected by adjustment for muscular strength. An inverse association between SPPB scores and fat infiltration in skeletal muscle was observed in patients with abdominal MRI.
  
  
  CONCLUSIONS
  A poor physical performance was observed in overweight and obese elderly subjects. Leg strength was reduced only in subjects with severe obesity. Physical performance was negatively influenced by the degree of fat infiltration in skeletal muscle.
authors.affiliation: Fabio De Stefano Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi di Padova, Clinica Medica I, Policlinico Universitario, Via Giustiniani 2, 35128 Padova, Italy,: Tel (+39) 049 821 2171, Fax (+39) 049 821 2149 E-mail: fabiods80@libero.it.
authors.forename: F
authors.initials: F
authors.lastname: De Stefano
authors.forename: S
authors.initials: S
authors.lastname: Zambon
authors.forename: L
authors.initials: L
authors.lastname: Giacometti
authors.forename: G
authors.initials: G
authors.lastname: Sergi
authors.forename: M C
authors.initials: MC
authors.lastname: Corti
authors.forename: E
authors.initials: E
authors.lastname: Manzato
authors.forename: L
authors.initials: L
authors.lastname: Busetto
mesh_terms: D050153:Abdominal Fat / Q000502:physiology; D050154:Adiposity / Q000502:physiology*; D000368:Aged; D000375:Aging / Q000502:physiology*; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007558:Italy; D007866:Leg / Q000502:physiology; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000033:anatomy & histology* / Q000502:physiology*; D009765:Obesity / Q000503:physiopathology*; D050177:Overweight / Q000503:physiopathology; D013851:Thinness / Q000503:physiopathology