Abstract: Background　The coexistence and interaction of obesity and sarcopenia in some elderly adults will easily lead to multiple adverse clinical outcomes. But there are few reports about risk factors of sarcopenia in obese elderly adults. Objective　To examine the prevalence and risk factors of sarcopenia in obese elderly adults. Methods　Totally 140 obese elderly patients were consecutively recruited from Department of Geriatrics，Peking University People's Hospital，and Beijing Zhanlanlu Community Health Center，from August 2018 to August 2019，including 115 with simple obesity and 25 also with sarcopenia. General clinical information，biochemical and metabolic indicators，comprehensive geriatric assessment results and body composition were compared between the two groups. Multivariate Logistic regression analysis was conducted to explore the risk factors of sarcopenia in obese elderly patients. Results　The prevalence of sarcopenia with obesity in all the participants，male and female participants was 17.9%（25/140），21.4%（18/84）and 12.5%（7/56），respectively. Compared to those with simple obesity，patients with sarcopenia and obesity had greater mean age，systolic blood pressure and visceral fat area as well as lower mean BMI（P<0.05）. Moreover，they had higher prevalence of fatty liver and serum creatinine（P<0.05）. Furthermore，they had lower mean levels of hemoglobin，albumin，triacylglycerol，fasting insulin，blood calcium，25-hydroxy vitamin D，estimated glomerular filtration rate，incidence of depression，muscle content，protein content and inorganic sulfate content（P<0.05）. Multivariate Logistic regression analysis demonstrated that，older age，greater visceral fat area，lower BMI and albumin were independent risk factors of sarcopenia in obese elderly patients（P<0.05）. Conclusion　The prevalence（17.9%）of sarcopenia was relatively high in this group of obese elderly patients，which may be independently associated with older age，greater visceral fat area，lower BMI and albumin.

Key words: Obesity, Aged, Sarcopenia, Sarcopenic obesity, Risk factors

摘要： 背景　部分老年人肥胖与肌少症共存并相互作用，易导致多种不良临床结局，但目前关于老年肥胖患者肌少症的危险因素研究较少见。目的　分析老年肥胖患者肌少症发生情况及其危险因素。方法　连续选取2018年8月—2019年8月在北京大学人民医院老年科及北京市西城区展览路社区卫生服务中心就诊的老年肥胖患者140例，其中单纯肥胖者115例（单纯肥胖组），肌少症合并肥胖者25例（少肌性肥胖组）。比较两组患者一般资料、生化及代谢指标、老年综合评估结果及身体成分。老年肥胖患者肌少症的危险因素分析采用多因素Logistic 回归分析。结果　本研究中老年肥胖患者肌少症发生率为17.9%（25/140），其中男性、女性肌少症发生率分别为21.4%（18/84）、12.5%（7/56）。少肌性肥胖组患者年龄、收缩压、内脏脂肪面积（VFA）大于单纯肥胖组，体质指数（BMI）小于单纯肥胖组，脂肪肝发生率、血肌酐高于单纯肥胖组，血红蛋白、白蛋白（Alb）、三酰甘油、空腹胰岛素、血钙、25-羟维生素D、估算肾小球滤过率、抑郁发生率、肌肉含量、蛋白质含量、无机盐含量低于单纯肥胖组（P<0.05）。多因素Logistic回归分析结果显示，年龄及VFA增大、BMI及Alb降低是老年肥胖患者发生肌少症的独立危险因素（P<0.05）。结论　老年肥胖患者肌少症发生率较高（17.9%），年龄及VFA增大、BMI及Alb降低是老年肥胖患者发生肌少症的独立危险因素。

关键词: 肥胖, 老年人, 肌肉减少症, 少肌性肥胖, 危险因素