{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T05:05:49Z","timestamp":1779771949162,"version":"3.53.1"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"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. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the associations of sarcopenic overweight and obesity with ruptured abdominal aortic aneurysm (rAAA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross-sectional study retrospectively enrolled 244 patients with abdominal aortic aneurysm (AAA) between January 2022 and December 2024 (mean age: 71.09\u202f\u00b1\u202f10.59\u202fyears, mean BMI: 23.39\u202f\u00b1\u202f3.40\u202fkg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , men: 80.74%). Baseline clinical characteristics, computed tomography (CT) parameters, and laboratory results were collected. Sarcopenia was diagnosed using CT measured skeletal muscle index (SMI) measured at the third lumbar vertebral level (L3). Overweight and obesity were defined according to the World Health Organization (WHO) Asia-Pacific criteria (overweight: BMI\u202f\u2265\u202f23\u202fkg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; obesity: BMI\u202f\u2265\u202f25\u202fkg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). Patients were stratified into two group: non-ruptured AAA group (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f191) and ruptured AAA group (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f53). The associations of sarcopenia, overweight, obesity, and their interaction with rAAA were examined using two-factor logistic regression models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Neither sarcopenia nor overweight alone showed a significant independent association with rAAA. Obesity was significantly associated with rAAA (odds ratio [OR] 2.15, 95% confidence interval [CI] 1.13\u202f~\u202f4.08,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.020). In the two-factor logistic regression model, the interaction between sarcopenia and overweight was significantly associated with rAAA (OR\u202f=\u202f3.86; 95% CI: 1.30\u202f~\u202f11.45;\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.015). A similar interaction was observed for sarcopenia and obesity (OR\u202f=\u202f4.91; 95% CI: 1.57\u202f~\u202f15.34;\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sarcopenic overweight and obesity were independently associated with rAAA. The coexistence of low muscle mass and excess adiposity, rather than either condition alone, was associated with higher odds of rupture. Integrating CT-derived skeletal muscle assessment with BMI may help identify patients with higher odds of rupture.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1851995","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T04:44:43Z","timestamp":1779770683000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between CT-assessed sarcopenic overweight, obesity and rupture abdominal aortic aneurysm: a cross-sectional analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Jiashu","family":"Yao","sequence":"first","affiliation":[{"name":"Department of Clinical Nutrition, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yepeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenqing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangrui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangyan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhonghua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Affiliated Yixing Hospital of Jiangsu University (Yixing People\u2019s Hospital)","place":["Yixing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaotian","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1001\/jamacardio.2025.2698","article-title":"Circulating trimethylamine N-oxide and growth rate of abdominal aortic aneurysms and surgical risk","volume":"10","author":"Cameron","year":"2025","journal-title":"JAMA Cardiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"6837","DOI":"10.3390\/jcm12216837","article-title":"Systematic review and Meta-analysis of the incidence of rupture, repair, and death of small and large abdominal aortic aneurysms under surveillance","volume":"12","author":"Leone","year":"2023","journal-title":"J Clin Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1016\/j.ejvs.2025.02.017","article-title":"External validation of eight ruptured abdominal aortic aneurysm mortality prediction models demonstrates limited predictive accuracy","volume":"69","author":"Li","year":"2025","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1016\/s0140-6736(14)60109-4","article-title":"Mortality from ruptured abdominal aortic aneurysms: clinical lessons from a comparison of outcomes in England and the 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Role of Physical Exercise, Microbiota and Myokines","volume":"11","author":"Bilski","year":"2022","journal-title":"Cells"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"587","DOI":"10.12669\/pjms.39.2.7366","article-title":"Effect of low skeletal muscle mass on long-term mortality after abdominal aortic aneurysm repair: a meta-analysis","volume":"39","author":"Chen","year":"2023","journal-title":"Pak J Med Sci"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1016\/j.ejvs.2023.01.008","article-title":"Effect of sarcopenia on mortality and spinal cord Ischaemia after complex aortic aneurysm repair: systematic review and Meta-analysis","volume":"65","author":"Nana","year":"2023","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1007\/s00595-021-02362-x","article-title":"Preoperative sarcopenia and malnutrition are correlated with poor long-term survival after endovascular abdominal aortic aneurysm repair","volume":"52","author":"Ikeda","year":"2022","journal-title":"Surg Today"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"7937","DOI":"10.21037\/qims-24-365","article-title":"Myosteatosis: diagnostic significance and assessment by imaging approaches","volume":"14","author":"Garcia-Diez","year":"2024","journal-title":"Quant Imaging Med Surg"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1002\/jcsm.12901","article-title":"Pathogenesis of sarcopenia and the relationship with fat mass: descriptive review","volume":"13","author":"Li","year":"2022","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1038\/s41387-025-00381-y","article-title":"Density of ectopic fat depots predict distinct biomarkers of glycemic and insulinemic status in persons with HIV","volume":"15","author":"Park","year":"2025","journal-title":"Nutr Diabetes"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"zrae114","DOI":"10.1093\/bjsopen\/zrae114","article-title":"Relationship between CT-derived cervical muscle mass and quality, systemic inflammation, and survival in symptomatic patients undergoing carotid endarterectomy","volume":"8","author":"Bradley","year":"2024","journal-title":"BJS Open"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7555\/jbr.39.20250415","article-title":"Perivascular adipose tissue inflammation in abdominal aortic aneurysm: an underrecognized contributor","volume":"39","author":"Chen","year":"2025","journal-title":"J Biomed Res"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1851995\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T04:44:59Z","timestamp":1779770699000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1851995\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":50,"alternative-id":["10.3389\/fnut.2026.1851995"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1851995","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]},"article-number":"1851995"}}