Relationship between degree of central adiposity, inflammatory status and risk of sarcopenia in obese children.

The majority of obese children in this study had low muscle mass, reduced muscle strength, and impaired physical performance.

• Of the 86 obese children studied, 84.8% had low muscle mass, 38.4% had reduced muscle strength, and 69.8% demonstrated impaired physical performance.
• Low muscle mass was defined as skeletal muscle mass adjusted for age and sex (SMMa z-score) less than -2 SD.
• Reduced muscle strength was defined as handgrip strength below the 15th percentile (age/sex-specific).
• The study used a cross-sectional design with consecutive sampling involving obese primary school children aged 7-13 years from Semarang and its surrounding areas.

High waist-to-height ratio (WHtR) was significantly associated with both low muscle mass and reduced muscle strength in obese children.

• WHtR was significantly associated with low muscle mass (p = 0.016) and reduced muscle strength (p = 0.007).
• Central adiposity was defined as WHtR ≥ 0.50 or waist-to-hip ratio (WHR) above the 90th percentile for age and sex.
• Associations were analyzed using chi-square or Fisher's exact tests with a significance level set at α = 0.05.

WHtR was an independent predictor of both reduced muscle strength and low muscle mass in logistic regression analysis.

• WHtR was an independent predictor of reduced muscle strength (OR = 5.324, p = 0.021, 95% CI: 1.280-22.148).
• WHtR was also an independent predictor of low muscle mass (OR = 0.163, p = 0.011, 95% CI: 0.037-0.714).
• Logistic regression models were applied with a significance level set at α = 0.05.

Elevated C-reactive protein (CRP) levels were significantly associated with low muscle mass in obese children.

• High CRP levels were associated with low muscle mass (p = 0.013).
• Elevated CRP was defined as CRP ≥ 3 mg/L.
• CRP was measured as a blood biomarker alongside IL-6 to assess inflammatory status.

Interleukin-6 (IL-6) was elevated in the majority of children but did not show a significant association with sarcopenia outcomes.

• Although IL-6 was elevated in the majority of children, it did not show a significant association with sarcopenia outcomes.
• Elevated IL-6 was defined as IL-6 > 5 pg/mL.
• IL-6 was measured as a blood biomarker alongside CRP to assess inflammatory status.

Protein intake was significantly related to muscle mass in obese children.

• Protein intake was significantly related to muscle mass (p = 0.016).
• Dietary intake was assessed using a three-day dietary recall method.
• This finding was identified alongside anthropometric and inflammatory biomarker associations.

Waist-to-hip ratio (WHR) was not reported as significantly associated with sarcopenia outcomes, in contrast to WHtR.

• Central adiposity was assessed using both WHtR (≥ 0.50) and WHR (above the 90th percentile for age and sex), but only WHtR showed significant associations with muscle mass and strength outcomes.
• WHR was measured as part of anthropometric data collection including waist and hip circumferences.
• The study highlights WHtR as the more clinically relevant measure of central adiposity for predicting sarcopenia in this population.