Association of osteosarcopenic obesity and its components: osteoporosis, sarcopenia and obesity with insulin resistance

Introduction To evaluate the differences in the associations of combinations of co-existent osteopenia, obesity, and/or sarcopenia with insulin resistance (IR) according to different criteria of obesity. Materials and methods Among 4500 Korean men and postmenopausal women who were aged >= 50 years and did not have diabetes mellitus, osteopenia, sarcopenia, and obesity were defined using bone mineral density, skeletal mass index, and body fat % (or BMI). Body composition groups were generated based on the combinations of these components. IR was defined using the HOMA-IR >= 2.5. Results When obesity was defined by body fat % and the relationships were adjusted for age, sex, education, and health behaviors, the odds ratios (ORs) for IR was highest in the groups with obesity and osteopenic obesity, followed by sarcopenic obesity and osteosarcopenic obesity, followed by osteopenia and sarcopenia, and followed by osteosarcopenia. When BMI was additionally adjusted, the ORs for IR were not significantly different between body composition groups except for osteopenia: those groups had higher ORs for IR compared to osteopenia. When obesity was defined by BMI, obesity co-existent groups had higher ORs for IR than the obesity non-coexistent groups. The ORs for IR were not significantly different within obesity co-existent groups or obesity non-coexistent groups. Conclusions Combinations of co-existent osteopenia, obesity, and/or sarcopenia had different associations with IR according to obesity classification methods and consideration of BMI adjustment. Osteosarcopenic obesity may not have a stronger association with IR compared to obesity only and obesity co-existent other conditions.