Sarcopenic Obesity Clinical Trial
Official title:
Sleep Disturbances and Biomarkers of Sarcopenic OBesity: Insight Into Mechanisms of Prefrailty
The general objective of this study is to identify biomarkers of sleep quality, sarcopenia,
insulin resistance, oxidative stress and inflammation associated with prefrailty in
middle-aged and elderly obese subjects through the integrated study of sleep patterns,
functional cardiovascular testing, olfactory function and circulating molecules.
Results from the SleSOB study will contribute to identify molecular and functional
determinants of prefrailty, to allow early targeted interventions and will have important
implications for empowerment of elderly citizens to self-management of preventive measures
and healthy lifestyle.
Frailty, an age-related state of low physiological reserve and high vulnerability to
stressors, impacts on health, functional independence, quality of life and survival; its
early detection at the prefrailty stage offers the opportunity for preventive intervention.
Sarcopenia, a hallmark of frailty, may occur in association with obesity and worsen
functional deterioration. Obesity is strongly associated with insulin resistance and is a
risk factor for both cardiometabolic diseases and cognitive impairment. Adipose tissue
exerts autocrine and paracrine functions leading to chronic low-grade inflammation and
increased oxidative stress that, in turn, decrease muscle density and precipitate muscle
strength loss. Sleep disturbances and sarcopenia might be causally related through
dysregulation of glucose metabolism and disruption of the secretory pattern of hormones
involved in muscle metabolism.
Main objective:
To establish among young-elderly obese subjects the prevalence of prefrailty as defined by
presence of ≥1 of reduced muscle mass, fatigue, weakness, slowness, and low physical
activity (Fried's criteria)
Secondary objectives:
- To assess prevalence and severity of sarcopenia as defined by reduced muscle mass
coupled with decreased muscle strength and /or reduced functional capacity
- To establish the cardiometabolic risk profile and its correlation with vitamin D
- To determine type and extent of sleep abnormalities by validated questionnaires and
their association with prefrailty
- To assess the extent of sympathetic imbalance, arrhythmia burden and olfactory
impairment
- To determine patterns of biomarkers of oxidative stress, inflammatory cytokines,
adipokines, myokines, tissue damage and remodeling and correlation with prefrailty and
insulin resistance.
Study design:
Eligible subjects will attend the clinic in the morning in the fasting state to undergo
- blood samples collection for routine and specific biochemistry;
- anthropometric measurements: height, weight, body mass index, waist and hip
circumference;
- assement of sarcopenia: muscle strength, gait speed, muscle mass by
biomimpedentiometric assessment (BIA) and air displacement pletismography (BODPOD);
- glucose metabolism biomarker as tissue accumulation of advanced glycation endproducts
(AGE);
- sympathetic activation;
- interview for medical history and comorbidity registration;
- screening for cognitive impairment;
- sleep pattern analysis through questionnaires;
- olfactory assessment.
A wearable system (Win@home, CE0434) for 24 h recording of rhythm, circadian heart rate,
respiratory rate and oxygen saturation, posture and physical activity will be applied to
each subject for the subsequent 24 hours
;
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