{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:36:54Z","timestamp":1792175814618,"version":"4.4.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sarcopenic obesity (SO) is characterized by the coexistence of sarcopenia and excess adipose tissue, increasing the risk of falls and related adverse outcomes in older adults. However, diagnostic criteria for SO remain inconsistent, warranting further investigation. This study aimed to examine the association between SO, defined according to the criteria proposed by the 2022 European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO), and the history of falls among hospitalized older Italian adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross-sectional study included 90 older Italian adults (\u2265 60 years) with severe obesity (body mass index \u2265 35 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). The exposure variable, SO, was defined by the concomitant presence of reduced muscle function, high fat mass, and low muscle mass adjusted for body weight. Muscle function was assessed using the Five-Times Sit-to-Stand (5\u00d7STS) test and handgrip strength (HGS). Fat mass percentage (FM%) was measured using dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA). Appendicular muscle mass (AMM\/W) and skeletal muscle mass (SMM\/W), both adjusted for body weight, were assessed using DXA and BIA, respectively. Four diagnostic definitions of SO were analyzed according to the following combinations of tests and instruments: 1) 5\u00d7STS + FM% DXA + AMM\/W, 2) 5\u00d7STS + FM% BIA + SMM\/W, 3) HGS + FM% DXA + AMM\/W, and 4) HGS + FM% BIA + SMM\/W. The outcome was self-reported falls in the past year. Multivariable logistic regression models were adjusted for sex, age, education, marital status, fall-related multimorbidity, alcohol consumption, and regular physical activity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant associations between SO and falls were found only when muscle function was assessed using HGS, regardless of the method used to estimate FM% and muscle mass. In adjusted analyses, participants classified as having SO according to combinations HGS + FM% BIA + SMM\/W and HGS + FM% DXA + AMM\/W had approximately almost fourfold (OR=3.61; 95% CI: 1.28\u201310.19) and sixfold (OR=6.03; 95% CI: 1.80\u201320.23) higher odds of reporting falls in the previous year, respectively, when compared to those without SO considering the same diagnostic tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SO defined by low HGS combined with high FM% and low muscle mass adjusted for body weight\u2014whether measured using DXA or BIA\u2014was associated with greater odds of falls in older Italian adults. These findings support the use of muscle strength-based definitions of SO when evaluating fall risk in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2025.1727488","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:34:47Z","timestamp":1768286087000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Sarcopenic obesity and history of falls in older Italian adults: associations according to different diagnostic combinations"],"prefix":"10.3389","volume":"16","author":[{"given":"Ana L\u00facia","family":"Danielewicz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle","family":"Freitas de Assis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Let\u00edcia","family":"Martins C\u00e2ndido","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Amaral Mendon\u00e7a","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Cristina Rodrigues","family":"Lacerda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Tringali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"De Micheli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Bondesan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00fabia","family":"Carelli Pereira de Avelar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Sartorio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"B1","volume-title":"Ageing","year":""},{"key":"B2","volume-title":"Over half of adults in the EU are overweight. World Health Organization. World report on ageing and health","year":"2015"},{"key":"B3","volume-title":"World report on ageing and health","year":"2015"},{"key":"B4","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: revised European consensus on definition and diagnosis","volume":"48","author":"Cruz-Jentoft","year":"2019","journal-title":"Age Ageing"},{"key":"B5","doi-asserted-by":"publisher","first-page":"afae052","DOI":"10.1093\/ageing\/afae052","article-title":"The conceptual definition of sarcopenia: delphi consensus from the global leadership initiative in sarcopenia (GLIS)","volume":"53","author":"Kirk","year":"2024","journal-title":"Age Ageing"},{"key":"B6","doi-asserted-by":"publisher","first-page":"155533","DOI":"10.1016\/j.metabol.2023.155533","article-title":"Epidemiology of sarcopenia: prevalence","volume":"144","author":"Yuan","year":"2023","journal-title":"Risk Factors Consequences"},{"key":"B7","volume-title":"Obesity","year":"2025"},{"key":"B8","volume-title":"Population structure and ageing. European Commission, Eurostat. Population structure and ageing","year":"2025"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2018.04.018","article-title":"Sarcopenic obesity: time to meet the challenge","volume":"37","author":"Barazzoni","year":"2018","journal-title":"Clin. Nutr"},{"key":"B10","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1016\/j.clnu.2021.11.014","article-title":"Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement","volume":"41","author":"Donini","year":"2022","journal-title":"Clin. Nutr"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.14336\/AD.2021.1006","article-title":"Sarcopenic obesity: an emerging public health problem","volume":"13","author":"Ji","year":"2022","journal-title":"Aging Dis"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1366229","article-title":"Analysis of sarcopenic obesity prevalence and diagnostic agreement according to the 2022 ESPEN and EASO Consensus in hospitalized older adults with severe obesity","volume":"15","author":"Danielewicz","year":"2024","journal-title":"Front. Endocrinol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"105444","DOI":"10.1016\/j.archger.2024.105444","article-title":"Sarcopenic obesity defined by the ESPEN and EASO consensus statement in older women: risk of falls and bone mineral density implications","volume":"124","author":"Montalv\u00e3o-Sousa","year":"2024","journal-title":"Arch Gerontol Geriatr"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-021-01843-w","article-title":"Elderly patients and falls: a systematic review and meta-analysis","volume":"33","author":"Hac\u0131dursuno\u011flu Erba\u015f","year":"2021","journal-title":"Aging Clin Exp Res"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e13187","DOI":"10.1111\/obr.13187","article-title":"Falls, fractures, and areal bone mineral density in older adults with sarcopenic obesity: A systematic review and meta-analysis","volume":"22","author":"Gandham","year":"2021","journal-title":"Obes. Rev"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.1054941","article-title":"A three-week in-hospital multidisciplinary body weight reduction program exerts beneficial effects on physical and mental health and fatiguability of elderly patients with obesity","volume":"14","author":"Guerrini Usubini","year":"2022","journal-title":"Front. Aging Neurosci"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2023.02.018","article-title":"Sarcopenic obesity research perspectives outlined by the sarcopenic obesity global leadership initiative (SOGLI) \u2013 proceedings from the SOGLI consortium meeting in Rome November 2022","volume":"42","author":"Gortan Cappellari","year":"2023","journal-title":"Clin. Nutr"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.22456\/2316-2171.128536","article-title":"Influ\u00eancia da obesidade sarcop\u00eanica no risco de quedas em idosos: uma revis\u00e3o sistem\u00e1tica","volume":"28","author":"de Queiroz J\u00fanior","year":"2023","journal-title":"Estudos Interdisciplinares Sobre o Envelhecimento"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15613","article-title":"Association between sarcopenic obesity and falls in a multiethnic cohort of postmenopausal women","volume":"66","author":"Follis","year":"2018","journal-title":"J. Am. Geriatr. Soc. Int"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1185221","article-title":"Sarcopenic obesity: epidemiology, pathophysiology, cardiovascular disease, mortality, and management","volume":"14","author":"Wei","year":"2023","journal-title":"Front endocrinol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"4493817","DOI":"10.1155\/2021\/4493817","article-title":"The critical role of oxidative stress in sarcopenic obesity","volume":"2021","author":"Gonzalez","year":"2021","journal-title":"Oxid Med Cell Longev"},{"key":"B22","doi-asserted-by":"publisher","first-page":"494","DOI":"10.3390\/ijms21020494","article-title":"Sarcopenic obesity, insulin resistance, and their implications in cardiovascular and metabolic consequences","volume":"21","author":"Hong","year":"2020","journal-title":"J. Mol. Sci"},{"key":"B23","doi-asserted-by":"publisher","first-page":"105557","DOI":"10.1016\/j.archger.2024.105557","article-title":"Sarcopenic obesity and falls in older adults: A validation study of ESPEN\/EASO criteria and modifications in Western China communities","volume":"127","author":"Li","year":"2024","journal-title":"Arch Gerontol Geriatr"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2021.06.009","article-title":"Global prevalence of sarcopenic obesity in older adults: A systematic review and meta-analysis","volume":"40","author":"Gao","year":"2021","journal-title":"Clin. Nutr"},{"key":"B25","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1186\/s12877-024-04952-z","article-title":"Prevalence of sarcopenic obesity in the older non-hospitalized population: a systematic review and meta-analysis","volume":"24","author":"Luo","year":"2024","journal-title":"BMC Geriatr"},{"key":"B26","doi-asserted-by":"publisher","first-page":"101014","DOI":"10.1016\/j.jshs.2024.101014","article-title":"International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions","volume":"14","author":"Tomkinson","year":"2024","journal-title":"J Sport Health Sci"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2025.101529","article-title":"Five-repetition chair-stand test vs. handgrip strength: Which better predicts mortality risk? A follow-up study in 43,605 middle-aged and older adults","volume":"29","author":"N\u00fa\u00f1ez-Cort\u00e9s","year":"2025","journal-title":"Braz J Phys Ther"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afac242","article-title":"Handgrip strength rather than chair stand test should be used to diagnose sarcopenia in geriatric rehabilitation inpatients: REStORing health of acutely unwell adults (RESORT)","volume":"51","author":"Verstraeten","year":"2022","journal-title":"Age Ageing"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1111\/os.14029","article-title":"Association of handgrip strength with hip fracture and falls in community-dwelling middle-aged and older adults: A 4-year longitudinal study","volume":"16","author":"Guo","year":"2024","journal-title":"Orthop Surg"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s11556-020-00255-5","article-title":"Performance on sit-to-stand tests in relation to measures of functional fitness and sarcopenia diagnosis in community-dwelling older adults","volume":"18","author":"Yee","year":"2021","journal-title":"Eur Rev Aging Phys Act"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1847","DOI":"10.3390\/app15041847","article-title":"Handgrip strength as an indicator of overall strength and functional performance\u2014Systematic review","volume":"15","author":"Szaflik","year":"2025","journal-title":"Appl Sci"},{"key":"B32","doi-asserted-by":"publisher","first-page":"6510","DOI":"10.3390\/biology10060510","article-title":"Test-retest reliability of five times sit to stand test (FTSST) in adults: A systematic review and meta-analysis","volume":"10","author":"Mu\u00f1oz-Bermejo","year":"2021","journal-title":"Biol (Basel)"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12825","article-title":"Diagnosis of sarcopenia by evaluating skeletal muscle mass by adjusted bioimpedance analysis validated with dual-energy X-ray absorptiometry","volume":"12","author":"Cheng","year":"2021","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192113940","article-title":"Bioimpedance and dual-energy X-ray absorptiometry are not equivalent technologies: Comparing fat mass and fat-free mass","volume":"19","author":"Lopes","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s40520-022-02282-x","article-title":"Use of bioelectrical impedance analysis in centenarians: a systematic review","volume":"35","author":"Mandal\u00e0","year":"2023","journal-title":"Aging Clin Exp Res"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2010.03147.x","article-title":"Associations between dietary nutrient intake and muscle mass and strength i n community-dwelling older adults: the Tasmanian Older Adult Cohort Study","volume":"58","author":"Scott","year":"2010","journal-title":"Journal of the American Geriatrics Society"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1727488\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:34:49Z","timestamp":1768286089000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1727488\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,13]]},"references-count":36,"alternative-id":["10.3389\/fendo.2025.1727488"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1727488","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,13]]},"article-number":"1727488"}}