Low subcutaneous fat as a risk factor for sarcopenia among elderly women in Bali, Indonesia a community-based age-matched case-control study

Background This study aimed to examine risk factors of sarcopenia among elderly females in Bali after matching for each age group. Methods A Balinese community age-matched case-control study was conducted by randomly selecting 39 elderly women with sarcopenia using The European Working Group in Older People 2 (EWGSOP 2) 2018 criteria and 39 participants without sarcopenia. Results The present study has found that body mass index (underweight), whole-body subcutaneous fat, the percentage of body fat, whole-body skeletal muscle have effects on sarcopenia. The multivariate conditional logistic regression analysis showed a significant increase in the risk of sarcopenia for participants with a lower percentage of whole-body subcutaneous tissue (odds ratio:20.00, 95% confidence interval: 2.68-149.02). Redistribution of lipid from subcutaneous adipose tissue (SAT) to visceral adipose tissue in menopausal women has caused the aging-related programmed loss of brown adipocytes in the SAT, caused an increase in pro-inflammatory adipokines and a decrease in anti-inflammatory mediators, and contributed to sarcopenia through various mechanisms, such as insulin resistance, the disruption protein synthesis, and the inhibition of myoblast differentiation. Myokines produced by skeletal muscle, such as Irisin can facilitate the browning of white adipose tissue (WAT) and promote the increase of subcutaneous fat. Conclusion Our study found that the low percentage of whole-body subcutaneous fat is a potent risk factor for sarcopenia.