cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2023-3576OWOAYOcardiovascular-3576Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEW ARTICLESСаркопеническое ожирение: эпидемиология, патогенез и особенности диагностикиSarcopenic obesity: epidemiology, pathogenesis and diagnostic criteriahttps://orcid.org/0000-0003-1002-1895БернсС. А.BernsS. A.

Светлана Александровна Бернс — доктор медицинских наук, профессор, профессор кафедры терапии и общей врачебной практики института профессионального образования и аккредитации, руководитель отдела изучения патогенетических аспектов старения.

Москва

Moscow

svberns@yandex.ruhttps://orcid.org/0000-0001-7230-0780ШептулинаА. Ф.SheptulinaA. F.

Кандидат медицинских наук, старший научный сотрудник, руководитель лаборатории по изучению кишечной микробиоты человека отдела фундаментальных и прикладных аспектов ожирения, доцент кафедры терапии и профилактической медицины.

Москва

Moscow

svberns@yandex.ruhttps://orcid.org/0000-0001-6313-8582МамутоваЭ. М.MamutovaE. M.

Лаборант-исследователь лаборатории по изучению кишечной микробиоты человека отдела фундаментальных и прикладных аспектов ожирения.

Москва

Moscow

svberns@yandex.ruhttps://orcid.org/0000-0003-3967-3950КиселевА. Р.KiselevA. R.

Доктор медицинских наук, руководитель отдела координации научной деятельности.

Москва

Moscow

svberns@yandex.ruhttps://orcid.org/0000-0002-4453-8430ДрапкинаО. М.DrapkinaO. M.

Доктор медицинских наук, профессор, академик РАН, главный внештатный специалист по терапии и общемедицинской практике Минздрава России, директор, зав. кафедрой терапии и профилактической медицины.

Москва

Moscow

svberns@yandex.ruФГБУ "Национальный медицинский исследовательский центр терапии и профилактической медицины" Минздрава РоссииNational Medical Research Center for Therapy and Preventive MedicineФГБУ "Национальный медицинский исследовательский центр терапии и профилактической медицины" Минздрава России; ФГБОУ ВО "Московский государственный медико-стоматологический университет им. А.И. Евдокимова" Минздрава РоссииNational Medical Research Center for Therapy and Preventive Medicine; A.I. Evdokimov Moscow State University of Medicine and Dentistry20232007202322635763576Copyright © Бернс С.А., Шептулина А.Ф., Мамутова Э.М., Киселев А.Р., Драпкина О.М., 20232023Бернс С.А., Шептулина А.Ф., Мамутова Э.М., Киселев А.Р., Драпкина О.М.Berns S.A., Sheptulina A.F., Mamutova E.M., Kiselev A.R., Drapkina O.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/3576

В последние годы в мире отчетливо прослеживаются две демографические тенденции: тенденция к старению популяции и тенденция к увеличению распространенности ожирения. В феврале 2022г были опубликованы первые консенсусные рекомендации Европейского общества по клиническому питанию и обмену веществ (ESPEN) и Европейской ассоциации по изучению ожирения (EASO) по определению и диагностике саркопенического ожирения — состояния, которое характеризуется сочетанием избытка жировой ткани в организме с уменьшением количества мышц, снижением мышечной силы и нарушением мышечной функции. Цель настоящего обзора состоит в описании распространенности саркопенического ожирения, основных этиопатогенетических факторов его развития, а также современных представлений о подходах к диагностике данного состояния.

Recently, two following demographic trends have been clearly obser­ved in the world: population aging and an increase in the prevalence of obesity. In February 2022, the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) published the first consensus guidelines for the definition and diagnosis of sarcopenic obesity, which characterizes by a combination of excess adipose tissue with a decrease in muscle mass, muscle strength and impaired muscle function. The purpose of this review is to describe the prevalence, the main etiopathogenetic factors of sarcopenic obesity, as well as currently accepted approaches to the diagnosis of this condition.

саркопенияожирениеиндекс массы теласостав телавоспалениеинсулинорезистентностьsarcopeniaobesitybody mass indexbody compositionin­flammationinsulin resistanceИсследование проведено в рамках научной работы "Ассоциация саркопении с метаболическими нарушениями, хроническим воспалением и изменениями психологического статуса у пациентов с ожирением", выполняемой в ФГБУ "НМИЦ ТПМ" Минздрава России в соответствии с государственным заданием Минздрава России № 123020600129-8 (2023-2025гг)The study was conducted within the framework of the scientific work "Association of sarcopenia with metabolic disorders, chronic inflammation and changes in psycho­logical status in obese patients", performed at the National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation in accordance with the state task of the Ministry of Health of the Russian Federation № 123020600129-8 (2023-2025)ReferencesToptas M, Yalcin M, Akkoc İ, et al. The Relation between Sar­copenia and Mortality in Patients at Intensive Care Unit. Biomed Res Int. 2018;12;2018:5263208. doi:10.1155/2018/5263208.Toptas M, Yalcin M, Akkoc İ, et al. The Relation between Sar­copenia and Mortality in Patients at Intensive Care Unit. Biomed Res Int. 2018;12;2018:5263208. doi:10.1155/2018/5263208.Ethgen O, Beaudart C, Buckinx F, et al. The Future Prevalence of Sarcopenia in Europe: A Claim for Public Health Action. Calcif Tissue Int. 2017;100(3):229-34. doi:10.1007/s00223-016-0220-9.Ethgen O, Beaudart C, Buckinx F, et al. The Future Prevalence of Sarcopenia in Europe: A Claim for Public Health Action. Calcif Tissue Int. 2017;100(3):229-34. doi:10.1007/s00223-016-0220-9.Cruz-Jentoft AJ, Bahat G, Bauer J, et al; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. doi:10.1093/ageing/afy169. Erratum in: Age Ageing. 2019;48(4):601.Cruz-Jentoft AJ, Bahat G, Bauer J, et al; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. doi:10.1093/ageing/afy169. Erratum in: Age Ageing. 2019;48(4):601.Драпкина О. М., Будневский А. В., Овсянников Е. С. и др. Саркопеническое ожирение: закономерности и парадоксы. Профилактическая медицина. 2021;24(1):73-8. doi:10.17116/profmed20212401173.Drapkina OM, Budnevsky AV, Ovsyannikov ES, et al. Sarcopenic obesity: patterns and paradoxes. Profilakticheskaya Meditsina. 2021;24(1):73-8. (In Russ.) doi:10.17116/profmed20212401173.Дикова Т. С., Зацепина А. Ю., Федоринов Д. С. и др. Саркопения, саркопеническое ожирение, миостеатоз как факторы неблагоприятного прогноза при опухолях желудочно-кишечного тракта: обзор литературы. Современная онкология. 2021;23(1):141-7. doi:10.26442/18151434.2021.1.200715.Dikova TS, Zatsepina AY, Fedorinov DS, et al. Sarcopenia, sarcopenic obesity, myosteatosis as factors of poor prognosis in gastrointestinal tract tumors: review. Journal of Modern On­cology. 2021;23(1):141-7. (In Russ.) doi:10.26442/18151434.2021.1.200715.Donini LM, Busetto L, Bischoff SC, et al. Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement. Obes Facts. 2022;15:321-35. doi:10.1159/000521241.Donini LM, Busetto L, Bischoff SC, et al. Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement. Obes Facts. 2022;15:321-35. doi:10.1159/000521241.Пасечник И. Н., Закревский А. И., Талызин П. А. и др. Саркопения: взгляд анестезиолога-реаниматолога. Кремлевская медицина. Клинический вестник. 2021;1:82-9. doi:10.26269/zqkk-j843.Pasechnik IN, Zakrevskij AI, Talyzin PA, et al. Sarcopenia: Opinion of an Anesthesiologist-Resuscitator. Kremlin Medicine Journal. 2021;1:82-9. (In Russ.) doi:10.26269/zqkk-j843.Lonnie M, Hooker E, Brunstrom JM, et al. Protein for Life: Review of Optimal Protein Intake, Sustainable Dietary Sources and the Effect on Appetite in Ageing Adults. Nutrients. 2018;10(3):360. doi:10.3390/nu10030360.Lonnie M, Hooker E, Brunstrom JM, et al. Protein for Life: Review of Optimal Protein Intake, Sustainable Dietary Sources and the Effect on Appetite in Ageing Adults. Nutrients. 2018;10(3):360. doi:10.3390/nu10030360.Purcell SA, Mackenzie M, Barbosa-Silva TG, et al. Prevalence of Sarcopenic Obesity Using Different Definitions and the Relationship with Strength and Physical Performance in the Canadian Longitudinal Study of Aging. Front Physiol. 2021;11:583825. doi:10.3389/fphys.2020.583825.Purcell SA, Mackenzie M, Barbosa-Silva TG, et al. Prevalence of Sarcopenic Obesity Using Different Definitions and the Relationship with Strength and Physical Performance in the Canadian Longitudinal Study of Aging. Front Physiol. 2021;11:583825. doi:10.3389/fphys.2020.583825.Dupuy C, Lauwers-Cances V, Guyonnet S, et al. Searching for a relevant definition of sarcopenia: results from the cross-sectional EPIDOS study. J Cachexia Sarcopenia Muscle. 2015;6(2):144-54. doi:10.1002/jcsm.12021.Dupuy C, Lauwers-Cances V, Guyonnet S, et al. Searching for a relevant definition of sarcopenia: results from the cross-sectional EPIDOS study. J Cachexia Sarcopenia Muscle. 2015;6(2):144-54. doi:10.1002/jcsm.12021.Gao Q, Mei F, Shang Y, et al. Global prevalence of sarcopenic obesity in older adults: A systematic review and meta-analysis. Clin Nutr. 2021;40(7):4633-41. doi:10.1016/j.clnu.2021.06.009.Gao Q, Mei F, Shang Y, et al. Global prevalence of sarcopenic obesity in older adults: A systematic review and meta-analysis. Clin Nutr. 2021;40(7):4633-41. doi:10.1016/j.clnu.2021.06.009.Румянцев А. Ш., Филинюк П. Ю., Яковенко А. А. и др. Саркопеническое ожирение у больных, получающих лечение программным гемодиализом. Нефрология. 2022;26(2):77-84. doi:10.36485/1561-6274-2022-26-2-77-84.Rumyantsev AS, Filinyuk PY, Jakovenko AA, et al. Sarcopenic Obesity in Patients Receiving Treatment with Programmed Hemodialysis. Nephrology (Saint-Petersburg). 2022;26(2):77-84. (In Russ.) doi:10.36485/1561-6274-2022-26-2-77-84.Мясоедова С. Е., Рубцова О. А., Мясоедова Е. Е. Композиционный состав тела и минеральная плотность кости у женщин при ревматоидном артрите. Клиницист. 2016;10(3):41-5. doi:10.17650/1818-8338-2016-10-3-41-45.Myasoedova SE, Rubtsova OA, Myasoedova EE. Body Com­po­sition and Bone Mineral Density in Women with Rheu­matoid Arthritis. The Clinician. 2016;10(3):41-5. (In Russ.) doi:10.17650/1818-8338-2016-10-3-41-45.Мисникова И. В., Ковалева Ю. А., Климина Н. А. и др. Оценка мышечной и жировой массы у пациентов с сахарным диабетом 2-го типа по результатам двухэнергетической рентгеновской абсорбциометрии. Альманах клинической медицины. 2018;46(3):222-32. doi:10.18786/2072-0505-2018-46-3-222-232.Misnikova IV, Kovaleva YuA, Klimina NA, et al. Assessment of muscle and fat mass in type 2 diabetes mellitus patients by dual-energy X-ray absorptiometry. Almanac of Clinical Medicine. 2018;46(3):222-32. (In Russ.) doi:10.18786/2072-0505-2018-46-3-222-232.Silva TL, Mulder AP. Sarcopenia and poor muscle quality associated with severe obesity in young adults and middle-aged adults. Clin Nutr ESPEN. 2021;45:299-305. doi:10.1016/j.clnesp.2021.07.031.Silva TL, Mulder AP. Sarcopenia and poor muscle quality associated with severe obesity in young adults and middle-aged adults. Clin Nutr ESPEN. 2021;45:299-305. doi:10.1016/j.clnesp.2021.07.031.Wagenaar CA, Dekker LH, Navis GJ. Prevalence of sarcopenic obesity and sarcopenic overweight in the general population: The lifelines cohort study. Clin Nutr. 2021;40(6):4422-9. doi:10.1016/j.clnu.2021.01.005.Wagenaar CA, Dekker LH, Navis GJ. Prevalence of sarcopenic obesity and sarcopenic overweight in the general population: The lifelines cohort study. Clin Nutr. 2021;40(6):4422-9. doi:10.1016/j.clnu.2021.01.005.Zembura M, Matusik P. Sarcopenic Obesity in Children and Adolescents: A Systematic Review. Front Endocrinol (Lausanne). 2022;13:914740. doi:10.3389/fendo.2022.914740.Zembura M, Matusik P. Sarcopenic Obesity in Children and Adolescents: A Systematic Review. Front Endocrinol (Lausanne). 2022;13:914740. doi:10.3389/fendo.2022.914740.Moreira VG, Perez M, Lourenço RA. Prevalence of sarcopenia and its associated factors: the impact of muscle mass, gait speed, and handgrip strength reference values on reported frequencies. Clinics (Sao Paulo). 2019;74:e477. doi:10.6061/clinics/2019/e477.Moreira VG, Perez M, Lourenço RA. Prevalence of sarcopenia and its associated factors: the impact of muscle mass, gait speed, and handgrip strength reference values on reported frequencies. Clinics (Sao Paulo). 2019;74:e477. doi:10.6061/clinics/2019/e477.Santanasto AJ, Miljkovic I, Cvejkus RK, et al. Body Composition Across the Adult Lifespan in African Caribbean Men: The Tobago Longitudinal Study of Aging. J Frailty Aging. 2022;11(1):40-4. doi:10.14283/jfa.2021.47.Santanasto AJ, Miljkovic I, Cvejkus RK, et al. Body Composition Across the Adult Lifespan in African Caribbean Men: The Tobago Longitudinal Study of Aging. J Frailty Aging. 2022;11(1):40-4. doi:10.14283/jfa.2021.47.Пасечник И. Н., Бернс С. А., Бояринцева В. В. Миопатии в практике клинициста: руководство для врачей. Москва.: ГЭОТАР-Медиа, 2023. с. 448. ISBN: 978-5-9704-76-48-2.Pasechnik IN, Berns SA, Boyarintseva VV. Myopathies in the practice of a clinician: a guide for doctors. Moscow.: GEOTAR-Media, 2023, p. 448. (In Russ.) ISBN: 978-5-9704-76-48-2.Wiedmer P, Jung T, Castro JP. Sarcopenia — Molecular mechanisms and open questions. Ageing Res Rev. 2021; 65:101200. doi:10.1016/j.arr.2020.101200.Wiedmer P, Jung T, Castro JP. Sarcopenia — Molecular mechanisms and open questions. Ageing Res Rev. 2021; 65:101200. doi:10.1016/j.arr.2020.101200.Курмаев Д. П., Булгакова С. В., Тренева Е. В. Саркопеническое ожирение — актуальная проблема современной гериатрии. Российский журнал гериатрической медицины. 2022;4(12):228-35. doi:10.37586/2686-8636-4-2022-228-235.Kurmaev DP, Bulgakova SV, Treneva EV. Sarcopenic obesity — a current problem of modern geriatrics. Russian Journal of Geriatric Medicine. 2022;4(12):228-35. (In Russ.) doi:10.37586/2686-8636-4-2022-228-235.Мисникова И. В., Ковалева Ю. А., Климина Н. А. Саркопеническое ожирение. РМЖ.2017;1:24-9.Misnikova IV, Kovaleva YuA, Klimina NA. Sarcopenic obesity. breast cancer. RMJ.2017;1:24-9. (In Russ.)Kirk B, Feehan J, Lombardi G, et al. Muscle, Bone, and Fat Crosstalk: the Biological Role of Myokines, Osteokines, and Adipokines. Curr Osteoporos Rep. 2020;18(4):388-400. doi:10.1007/s11914-020-00599-y.Kirk B, Feehan J, Lombardi G, et al. Muscle, Bone, and Fat Crosstalk: the Biological Role of Myokines, Osteokines, and Adipokines. Curr Osteoporos Rep. 2020;18(4):388-400. doi:10.1007/s11914-020-00599-y.Cheng L, Wang J, Dai H, et al. Brown and beige adipose tissue: a novel therapeutic strategy for obesity and type 2 diabetes mellitus. Adipocyte. 2021;10(1):48-65. doi:10.1080/21623945.2020.1870060.Cheng L, Wang J, Dai H, et al. Brown and beige adipose tissue: a novel therapeutic strategy for obesity and type 2 diabetes mellitus. Adipocyte. 2021;10(1):48-65. doi:10.1080/21623945.2020.1870060.Grunow JJ, Gan T, Lewald H, et al. Insulin signaling in skeletal muscle during inflammation and/or immobilisation. Intensive Care Med Exp. 2023;11(1):16. doi:10.1186/s40635-023-00503-9.Grunow JJ, Gan T, Lewald H, et al. Insulin signaling in skeletal muscle during inflammation and/or immobilisation. Intensive Care Med Exp. 2023;11(1):16. doi:10.1186/s40635-023-00503-9.Salminen A, Kaarniranta K, Kauppinen A. Insulin/IGF-1 signaling promotes immunosuppression via the STAT3 pathway: impact on the aging process and age-related diseases. Inflamm Res. 2021;70(10-12):1043-61. doi:10.1007/s00011-021-01498-3.Salminen A, Kaarniranta K, Kauppinen A. Insulin/IGF-1 signaling promotes immunosuppression via the STAT3 pathway: impact on the aging process and agerelated diseases. Inflamm Res. 2021;70(10-12):1043-61. doi:10.1007/s00011-021-01498-3.Goodpaster BH, Bergman BC, Brennan AM, et al. Intermuscular adipose tissue in metabolic disease. Nat Rev Endocrinol. 2023;19(5):285-98. doi:10.1038/s41574-022-00784-2.Goodpaster BH, Bergman BC, Brennan AM, et al. Intermuscular adipose tissue in metabolic disease. Nat Rev Endocrinol. 2023;19(5):285-98. doi:10.1038/s41574-022-00784-2.Kahn D, Macias E, Zarini S, et al. Exploring Visceral and Subcutaneous Adipose Tissue Secretomes in Human Obesity: Implications for Metabolic Disease. Endocrinology. 2022;163(11):bqac140. doi:10.1210/endocr/bqac140.Kahn D, Macias E, Zarini S, et al. Exploring Visceral and Subcutaneous Adipose Tissue Secretomes in Human Obesity: Implications for Metabolic Disease. Endocrinology. 2022;163(11):bqac140. doi:10.1210/endocr/bqac140.Iwase T, Wang X, Shrimanker TV, et al. Body composition and breast cancer risk and treatment: mechanisms and impact. Breast Cancer Res Treat. 2021;186(2):273-83. doi:10.1007/s10549-020-06092-5.Iwase T, Wang X, Shrimanker TV, et al. Body composition and breast cancer risk and treatment: mechanisms and impact. Breast Cancer Res Treat. 2021;186(2):273-83. doi:10.1007/s10549-020-06092-5.Kobayashi M, Deguchi Y, Nozaki Y, et al. Contribution of PGC-1α to Obesity- and Caloric Restriction-Related Physiological Changes in White Adipose Tissue. Int J Mol Sci. 2021;22(11):6025. doi:10.3390/ijms22116025.Kobayashi M, Deguchi Y, Nozaki Y, et al. Contribution of PGC-1α to Obesity- and Caloric Restriction-Related Physiological Changes in White Adipose Tissue. Int J Mol Sci. 2021;22(11):6025. doi:10.3390/ijms22116025.Zhu W, Sahar NE, Javaid HMA, et al. Exercise-Induced Irisin Decreases Inflammation and Improves NAFLD by Competitive Binding with MD2. Cells. 2021;10(12):3306. doi:10.3390/cells10123306.Zhu W, Sahar NE, Javaid HMA, et al. Exercise-Induced Irisin Decreases Inflammation and Improves NAFLD by Competitive Binding with MD2. Cells. 2021;10(12):3306. doi:10.3390/cells10123306.Liu XH, Pan JP, Bauman WA, et al. AdipoRon prevents myostatin-induced upregulation of fatty acid synthesis and downregulation of insulin activity in a mouse hepatocyte line. Physiol Rep. 2019;7(13):e14152. doi:10.14814/phy2.14152.Liu XH, Pan JP, Bauman WA, et al. AdipoRon prevents myostatin-induced upregulation of fatty acid synthesis and downregulation of insulin activity in a mouse hepatocyte line. Physiol Rep. 2019;7(13):e14152. doi:10.14814/phy2.14152.Little HC, Rodriguez S, Lei X, et al. Myonectin deletion promotes adipose fat storage and reduces liver steatosis. FASEB J. 2019;33(7):8666-87. doi:10.1096/fj.201900520R.Little HC, Rodriguez S, Lei X, et al. Myonectin deletion promotes adipose fat storage and reduces liver steatosis. FASEB J. 2019;33(7):8666-87. doi:10.1096/fj.201900520R.Uchitomi R, Oyabu M, Kamei Y. Vitamin D and Sarcopenia: Potential of Vitamin D Supplementation in Sarcopenia Prevention and Treatment. Nutrients. 2020;12(10):3189. doi:10.3390/nu12103189.Uchitomi R, Oyabu M, Kamei Y. Vitamin D and Sarcopenia: Potential of Vitamin D Supplementation in Sarcopenia Prevention and Treatment. Nutrients. 2020;12(10):3189. doi:10.3390/nu12103189.Romeu Montenegro K, Carlessi R, Cruzat V, et al. Effects of vitamin D on primary human skeletal muscle cell proliferation, differentiation, protein synthesis and bioenergetics. J Steroid Biochem Mol Biol. 2019;193:105423. doi:10.1016/j.jsbmb.2019.105423.Romeu Montenegro K, Carlessi R, Cruzat V, et al. Effects of vitamin D on primary human skeletal muscle cell proliferation, differentiation, protein synthesis and bioenergetics. J Steroid Biochem Mol Biol. 2019;193:105423. doi:10.1016/j.jsbmb.2019.105423.Bass JJ, Kazi AA, Deane CS, et al. The mechanisms of skeletal muscle atrophy in response to transient knockdown of the vitamin D receptor in vivo. J Physiol. 2021;599(3):963-79. doi:10.1113/JP280652.Bass JJ, Kazi AA, Deane CS, et al. The mechanisms of skeletal muscle atrophy in response to transient knockdown of the vitamin D receptor in vivo. J Physiol. 2021;599(3):963-79. doi:10.1113/JP280652.Bass JJ, Nakhuda A, Deane CS, et al. Overexpression of the vitamin D receptor (VDR) induces skeletal muscle hypertrophy. Mol Metab. 2020;42:101059. doi:10.1016/j.molmet.2020.101059.Bass JJ, Nakhuda A, Deane CS, et al. Overexpression of the vitamin D receptor (VDR) induces skeletal muscle hypertrophy. Mol Metab. 2020;42:101059. doi:10.1016/j.molmet.2020.101059.Ehrampoush E, Mirzay Razzaz J, Arjmand H, et al. The association of vitamin D levels and insulin resistance. Clin Nutr ESPEN. 2021;42:325-32. doi:10.1016/j.clnesp.2021.01.012.Ehrampoush E, Mirzay Razzaz J, Arjmand H, et al. The association of vitamin D levels and insulin resistance. Clin Nutr ESPEN. 2021;42:325-32. doi:10.1016/j.clnesp.2021.01.012.Charoenngam N, Holick MF. Immunologic Effects of Vitamin D on Human Health and Disease. Nutrients. 2020;12(7):2097. doi:10.3390/nu12072097.Charoenngam N, Holick MF. Immunologic Effects of Vitamin D on Human Health and Disease. Nutrients. 2020;12(7):2097. doi:10.3390/nu12072097.Fielding RA, Vellas B, Evans WJ, et al. Sarcopenia: an undia­gnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. Interna­tional working group on sarcopenia. J Am Med Dir Assoc. 2011;12(4):249-56. doi:10.1016/j.jamda.2011.01.003.Fielding RA, Vellas B, Evans WJ, et al. Sarcopenia: an undia­gnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011;12(4):249-56. doi:10.1016/j.jamda.2011.01.003.Studenski SA, Peters KW, Alley DE, et al. The FNIH sarco­penia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci. 2014;69(5):547-58. doi:10.1093/gerona/glu010.Studenski SA, Peters KW, Alley DE, et al. The FNIH sarco­penia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci. 2014;69(5):547-58. doi:10.1093/gerona/glu010.Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020;21(3):300-7.e2. doi:10.1016/j.jamda.2019.12.012.Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020;21(3):300-7.e2. doi:10.1016/j.jamda.2019.12.012.Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al; European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412-23. doi:10.1093/ageing/afq034.Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al; European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412-23. doi:10.1093/ageing/afq034.WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157-63.WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157-63.Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults–The Evidence Report. National Institutes of Health. Obes Res. 1998;6 Suppl 2:51S-209S. Erratum in: Obes Res. 1998 Nov;6(6):464.Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults–The Evidence Report. National Institutes of Health. Obes Res. 1998;6 Suppl 2:51S-209S. Erratum in: Obes Res. 1998 Nov;6(6):464.Misra A, Vikram NK, Gupta R, et al. Waist circumference cutoff points and action levels for Asian Indians for identification of abdominal obesity. Int J Obes (Lond). 2006;30(1):106-11. doi:10.1038/sj.ijo.0803111.Misra A, Vikram NK, Gupta R, et al. Waist circumference cutoff points and action levels for Asian Indians for identification of abdominal obesity. Int J Obes (Lond). 2006;30(1):106-11. doi:10.1038/sj.ijo.0803111.Koliaki C, Liatis S, Kokkinos A. Obesity and cardiovascular disease: revisiting an old relationship. Metabolism. 2019;92:98-107. doi:10.1016/j.metabol.2018.10.011.Koliaki C, Liatis S, Kokkinos A. Obesity and cardiovascular disease: revisiting an old relationship. Metabolism. 2019;92:98-107. doi:10.1016/j.metabol.2018.10.011.Тимофеев Ю. С., Джиоева О. Н., Драпкина О. М. Циркулирующие биологические маркеры ожирения: на пути к системному подходу. Кардиоваскулярная терапия и профилактика. 2023;22(4):3551. doi:10.15829/1728-8800-2023-3551.Timofeev YuS, Dzhioeva ON, Drapkina OM. Circulating biolo­gical markers of obesity: towards a systems approach. Car­diovascular Therapy and Prevention. 2023;22(4):3551. (In Russ.) doi:10.15829/1728-8800-2023-3551.Ким О. Т., Драпкина О. М. Эпидемия ожирения через призму эволюционных процессов. Кардиоваскулярная терапия и профилактика. 2022;21(1): 3109. doi:10.15829/1728-8800-2022-3109.Kim OT, Drapkina OM. Obesity epidemic through the prism of evolutionary processes. Cardiovascular Therapy and Prevention. 2022;21(1):3109. (In Russ.) doi:10.15829/1728-8800-2022-3109.Batsis JA. Obesity in the Older Adult: Special Issue. J Nutr Gerontol Geriatr. 2019;38(1):1-5. doi:10.1080/21551197.2018.1564197.Batsis JA. Obesity in the Older Adult: Special Issue. J Nutr Gerontol Geriatr. 2019;38(1):1-5. doi:10.1080/21551197.2018.1564197.

The authors declare that there are no conflicts of interest present.