Chances of Muscle Wasting are Less in Obese People

Chances of muscle wasting in critical care are lesser in obese people when compared to ordinary people, finds a new study. The findings of this study were discussed at the European Congress on Obesity (ECO2018). The study, by Jeroen Molinger. Erasmus MC, University Medical Center Rotterdam, Netherlands, and colleagues suggests that obese people could potentially have a better chance of survival during intensive care stay because the extra weight causes an adaptive response of the muscle, which in turn results in higher muscle quality; and lower rates of damaging muscle wasting.

While obesity and overweight are associated with an increased risk of death in the general population, a decrease in mortality has been reported in specific disease conditions. This so-called 'obesity paradox' of critical illness refers to better survival with a higher body mass Index (BMI).

Hyper-catabolism -- the body breaking itself down -- in the acute phase of the critical illness is presumed to be an adaptive response providing the essential fuel for energy production in vital organs. However, when this hypercatabolic state persists, it may result in muscle wasting and muscle weakness. Skeletal muscle quality is recognized as a marker of function in healthy individuals and critically ill patients. To determine muscle histology on an ICU; a muscle biopsy is normally needed. However, this procedure is invasive and does not give a result of the whole muscle. In this new study, by using new noninvasive ultrasound technology, assessment of muscle histology and morphology, the authors aimed to study muscle quality in obese and nonobese critically ill patients.

In the total group of 26 patients, nine were defined as obese by a body mass index higher than 30kg/m2. In this obese subgroup, the wasting patterns were distinctly different than the nonobese group, when comparing sepsis and neurotrauma. The obese group had a higher muscle quality index corrected by muscle thickness in regard to the nonobese. The speed of wasting, as defined in decline in muscle quality, was also lower in the first 4?5 days in the obese group in comparison with the nonobese.

The authors conclude: "Critically ill patients with obesity seem to have higher muscle quality, as measured by ultrasound at the point of admittance to intensive care compared to nonobese patients. This might be the metabolic protective shield also described as the 'obesity paradox.'"

Source-Eurekalert