Sarcopenic Obesity in Postmenopausal Women: Associations Between Fat Mass, Muscle Mass, and Lower Limb Strength in an Indonesian Clinical Cohort

Wendra Wendra, Teguh Tanuwidjaja, Kishanty Hardaningtyas, Aulia Rahma Fazamuthi

Abstract


Sarcopenic obesity is an emerging public health concern, particularly among postmenopausal women. This condition is characterized by increased fat mass and reduced muscle mass, both of which negatively impact  quality of life and physical function. This study employed an analytical design with a cross-sectional approach, involving  51 obese women aged 45 years and  older who received care atthe Nutrition Clinic of Dustira Hospital. Fat and muscle mass were assessed using Bioelectrical Impedance Analysis (BIA), while leg muscle strength was measured with a leg dynamometer. The chi-square test was used to examine associations between variables due to its suitability for categorical data analysis. Results indicated that the majority of participants were aged 45–55 years, with 52.9% classified as having obesity category I. Descriptive analysis revealed that 66.7% of subjects had elevated fat mass, particularly intramyocellular lipid (IMCL); 80.4% exhibited very low muscle mass; and 58.8% demonstrated poor leg muscle strength. Statistical analysis showed significant associations between fat mass and leg muscle strength (p = 0.003), and between muscle mass and leg muscle strength (p < 0.001). Effect sizes measured using Cramer's V indicated a strong strength of association. These findings underscore the importance of resistance training interventions in managing sarcopenic obesity among postmenopausal women. Enhancing muscle mass and reducing fat mass, especially IMCL, may contribute to improved leg muscle strength and overall quality of life.

 

Keyword: Fat Mass, Leg Muscle Strength, Muscle Mass, Sarcopenic Obesity, Postmenopausal Women.


Full Text:

PDF

References


Altajar, S., & Baffy, G. (2020). Skeletal Muscle Dysfunction in the Development and Progression of Nonalcoholic Fatty Liver Disease. Journal of Clinical and Translational Hepatology, 8(4), 1–10. https://doi.org/10.14218/JCTH.2020.00065

Astuti, S. D., & Jatmiko, T. (2020). Pengaruh Latihan Squat Dan Lunges Terhadap Kekuatan Otot Tungkai Mahasiswa Universitas Negeri Surabaya. Jurnal Prestasi Olahraga, 3(3).

Chan, J., Lu, Y.-C., Yao, M. M.-S., & Kosik, R. O. (2022). Correlation between hand grip strength and regional muscle mass in older Asian adults: an observational study. BMC Geriatrics, 22(1), 206.

Chidi-Ogbolu, N., & Baar, K. (2019). Effect of Estrogen on Musculoskeletal Performance and Injury Risk. Frontiers in Physiology, 9. https://doi.org/10.3389/fphys.2018.01834

Cleasby, M. E., Jamieson, P. M., & Atherton, P. J. (2016). Insulin resistance and sarcopenia: mechanistic links between common co-morbidities. Journal of Endocrinology, 229(2), 67–81. https://doi.org/10.1530/JOE-15-0533

Collins, B. C., Laakkonen, E. K., & Lowe, D. A. (2019). Aging of the musculoskeletal system: How the loss of estrogen impacts muscle strength. Bone, 123, 137–144. https://doi.org/10.1016/j.bone.2019.03.033

Collins, K. H., Herzog, W., MacDonald, G. Z., Reimer, R. A., Rios, J. L., Smith, I. C., Zernicke, R. F., & Hart, D. A. (2018). Obesity, metabolic syndrome, and musculoskeletal disease: common inflammatory pathways suggest a central role for loss of muscle integrity. Frontiers in Physiology, 9, 112. https://doi.org/10.3389/fphys.2018.00112

Febriyanti, H., Utami, I. T., Saputri, A. Y., Anafika, A., Antika, A., & Rahayu, S. (2023). Upaya Peningkatan Kualitas Kesehatan Wanita Menopause Tentang Perubahan Pada Masa Klimakterum. SELAPARANG: Jurnal Pengabdian Masyarakat Berkemajuan, 7(1), 636–639. https://doi.org/10.31764/jpmb.v7i1.13536

Fitriani, D. (2018). Peran Estrogen dan Leptin dalam Homeostasis Energi. Jurnal Ilmu Kedokteran Dan Kesehatan, 5(2), 123–131. https://doi.org/10.33024/.v5i2.794

Gimigliano, F., Moretti, A., de Sire, A., Calafiore, D., & Iolascon, G. (2018). The combination of vitamin D deficiency and overweight affects muscle mass and function in older post-menopausal women. Aging Clinical and Experimental Research, 30, 625–631.

Huang, N., Shankar, V., Rezler, Z., Vittal, R., Pachipala, K., Ali, S., Huang, R., Srinivasan, M., Palaniappan, L., & Long, J. (2024). The Prevalence and Risk Factors for Presarcopenia among Young and Middle-aged Asian Americans: A Cross-Sectional Study using NHANES data. Journal of Asian Health, 4(1). https://doi.org/10.59448/jah.v4i1.51

Javed, A. A., Mayhew, A. J., Shea, A. K., & Raina, P. (2019). Association Between Hormone Therapy and Muscle Mass in Postmenopausal Women. JAMA Network Open, 2(8), e1910154. https://doi.org/10.1001/jamanetworkopen.2019.10154

Klein, S., Gastaldelli, A., Yki-Järvinen, H., & Scherer, P. E. (2022). Why does obesity cause diabetes? Cell Metabolism, 34(1), 11–20. https://doi.org/10.1016/j.cmet.2021.12.012

Kojic, F., Ðurić, S., Ranisavljev, I., Stojiljkovic, S., & Ilic, V. (2021). Quadriceps femoris cross-sectional area and specific leg strength: Relationship between different muscles and squat variations. PeerJ, 9, e12435. https://doi.org/10.7717/peerj.12435

Kuryłowicz, A. (2023). Estrogens in Adipose Tissue Physiology and Obesity-Related Dysfunction. Biomedicines, 11(3), 690. https://doi.org/10.3390/biomedicines11030690

Lamusu, A., & Lamusu, Z. (2021). Strength Training of Abdominal Muscles for Increasing the Ability of the Kayang. Jambura Journal of Sports Coaching, 3(1), 39–47. https://doi.org/10.37311/jjsc.v3i1.9672

Li, C., Yu, K., Shyh‐Chang, N., Jiang, Z., Liu, T., Ma, S., Luo, L., Guang, L., Liang, K., Ma, W., Miao, H., Cao, W., Liu, R., Jiang, L., Yu, S., Li, C., Liu, H., Xu, L., Liu, R., … Liu, G. (2022). Pathogenesis of sarcopenia and the relationship with fat mass: descriptive review. Journal of Cachexia, Sarcopenia and Muscle, 13(2), 781–794. https://doi.org/10.1002/jcsm.12901

Moore, B. A., Bemben, D. A., Lein, D. H., Bemben, M. G., & Singh, H. (2020). Fat Mass is Negatively Associated with Muscle Strength and Jump Test Performance. The Journal of Frailty & Aging, 9(4), 214–218. https://doi.org/10.14283/jfa.2020.11

Mustafa, D. G., Thanaya, S. A. P., Adiputra, L., & Saraswati, N. (2022). Hubungan antara kekuatan otot tungkai bawah dengan risiko jatuh pada lanjut usia di desa dauh puri klod, denpasar barat. Majalah Ilmiah Fisioterapi Indonesia, 10(1), 22–27. https://doi.org/10.24843/MIFI.2022.v10.i01.p05x

Pang, X., Zhang, P., Chen, X., & Liu, W. (2023). Ubiquitin-proteasome pathway in skeletal muscle atrophy. Frontiers in Physiology, 14, 1289537. https://doi.org/10.3389/fphys.2023.1289537

Pasdar, Y., Darbandi, M., Mirtaher, E., Rezaeian, S., Najafi, F., & Hamzeh, B. (2019). Associations between muscle strength with different measures of obesity and lipid profiles in men and women: results from RaNCD cohort study. Clinical Nutrition Research, 8(2), 148. https://doi.org/10.7762/cnr.2019.8.2.148

Putri, S., Corniawati, I., & Imamah, I. N. (2023). Pengaruh Pendidikan Kesehatan Reproduksi Terhadap Pengetahuan dan Sikap Wanita Pra-Lansia Dalam Menghadapi Masa Menopause di Kelurahan Muara Komam. Humantech: Jurnal Ilmiah Multidisiplin Indonesia, 2(4), 750–758.

Roh, E., & Choi, K. M. (2020). Health Consequences of Sarcopenic Obesity: A Narrative Review. Frontiers in Endocrinology, 11. https://doi.org/10.3389/fendo.2020.00332

Saltiel, A. R. (2021). Insulin signaling in health and disease. The Journal of Clinical Investigation, 131(1). https://doi.org/10.1172/JCI142241

Sancho‐Muñoz, A., Guitart, M., Rodríguez, D. A., Gea, J., Martínez‐Llorens, J., & Barreiro, E. (2021). Deficient muscle regeneration potential in sarcopenic COPD patients: Role of satellite cells. Journal of Cellular Physiology, 236(4), 3083–3098. https://doi.org/10.1002/jcp.30073

Shou, J., Chen, P.-J., & Xiao, W.-H. (2020). Mechanism of increased risk of insulin resistance in aging skeletal muscle. Diabetology & Metabolic Syndrome, 12(1), 14. https://doi.org/10.1186/s13098-020-0523-x

Straight, C. R., Toth, M. J., & Miller, M. S. (2021). Current perspectives on obesity and skeletal muscle contractile function in older adults. Journal of Applied Physiology, 130(1), 10–16. https://doi.org/10.1152/japplphysiol.00739.2020

Sukarno, D. A. (2021). Pengaruh Latihan Fisik terhadap Perbaikan Resistensi Insulin. Keluwih: Jurnal Kesehatan Dan Kedokteran, 2(2), 110–114. https://doi.org/10.24123/kesdok.V2i2.4033

Venturelli, M., Reggiani, C., Richardson, R. S., & Schena, F. (2018). Skeletal muscle function in the oldest-old: the role of intrinsic and extrinsic factors. Exercise and Sport Sciences Reviews, 46(3), 188–194. https://doi.org/10.1249/JES.0000000000000155

Wiranata, Y., & Inayah, I. (2020). Perbandingan Penghitungan Massa Tubuh Dengan Menggunakan Metode Indeks Massa Tubuh (IMT) dan Bioelectrical Impedance Analysis (BIA). Jurnal Manajemen Kesehatan Yayasan RS.Dr. Soetomo, 6(1), 43. https://doi.org/10.29241/jmk.v6i1.280

Zanker, J., Sim, M., Anderson, K., Balogun, S., Brennan‐Olsen, S. L., Dent, E., Duque, G., Girgis, C. M., Grossmann, M., & Hayes, A. (2023). Consensus guidelines for sarcopenia prevention, diagnosis and management in Australia and New Zealand. Journal of Cachexia, Sarcopenia and Muscle, 14(1), 142–156. https://doi.org/10.1002/jcsm.13115




DOI: http://dx.doi.org/10.30829/contagion.v7i2.24341

Refbacks

  • There are currently no refbacks.


Copyright (c) 2025 Wendra Wendra, Teguh Tanuwidjaja, Kishanty Hardaningtyas, Aulia Rahma Fazamuthi

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

 
Contagion: Scientific Periodical Journal of Public Health and Coastal Health by Program Studi Ilmu Kesehatan Masyarakat is licensed under Creative Commons Attribution-ShareAlike 4.0 International License.