Sarcopenic obesity trajectories during the menopausal transition in Korean women: The role of physical activity.

OBJECTIVES

Sarcopenic obesity may worsen during the menopausal transition, but long-term patterns and the influence of physical activity are unclear. We identified sarcopenic obesity trajectories and evaluated their association with physical activity.

STUDY

DESIGN

This longitudinal cohort study included 1450 Korean women aged 42-52 years who underwent health examinations between January 2012 and August 2024 and experienced menopause during follow-up.

MAIN OUTCOME MEASURES: Sarcopenic obesity was defined as skeletal muscle index <5.7 kg/m2 and body fat percentage ≥ 30%, measured by bioelectrical impedance analysis. Group-based trajectory modeling identified sarcopenic obesity patterns relative to the final menstrual period. Physical activity was classified as inactive, somewhat active, or active (<600, 600-2999, or ≥ 3000 metabolic equivalent of task minutes/week). Multinomial logistic regression assessed associations with trajectory membership.

RESULTS

Median follow-up was 10.6 years. Mean annual changes from 11 years before to 9 years after the final menstrual period were 0.215 percentage points in body fat, 0.038 kg/m2 for body mass index, and - 0.011 kg/m2 for skeletal muscle mass index. Three trajectories were identified: stable low-risk (82.6%), peri-menopausal onset (6.0%), and post-menopausal progressive (11.4%). Compared with inactive women, somewhat active women had lower risk of peri-menopausal onset (odds ratio 0.42; 95% confidence interval 0.25-0.71), while active women had lower risk of post-menopausal progression (0.39; 0.20-0.75; P for trend = 0.007).

CONCLUSION

One-fifth of women experienced adverse sarcopenic obesity trajectories during the menopausal transition. Being somewhat active or active was associated with a lower risk of this, supporting physical activity promotion during this period.