Association between Cigarette Smoking and Sarcopenia according to Obesity in the Middle-Aged and Elderly Korean Population: The Korea National Health and Nutrition Examination Survey (2008–2011)

BACKGROUND: The definition of sarcopenia focuses on muscle mass and function. Sarcopenic obesity is the relative excess of fat tissue with decreased muscle mass. We examined the association between cigarette smoking and sarcopenia according to obesity in middle-aged and elderly Koreans. METHODS: We conducted a cross-sectional study of 9,385 subjects (age ≥50 years) based on data from the fourth and fifth Korea National Health and Nutrition Examination Surveys (2008–2011). Smoking groups were categorized by smoking status and the number of cigarettes smoked daily. Sarcopenia was defined as weight-adjusted appendicular skeletal muscle mass of 2 standard deviations below the sex-specific mean for young adults. Obesity was defined as fat mass ≥30% for men and ≥40% for women. Subjects were categorized into three groups: sarcopenic obese (SO), sarcopenic non-obese (SNO), and normal. Multiple logistic regression analysis was performed to assess the association between smoking and SNO and SO. RESULTS: Among men, current smokers were more associated with SNO than never-smokers (adjusted odds ratio [OR], 3.34; 95% confidence interval [CI], 1.09–10.26). However, there was no significant association between smoking status and SNO in women or SO in either sex. Among current smokers, moderate smokers (11–20 cigarettes/d) were more likely to be SNO (adjusted OR, 5.81; 95% CI, 1.12–30.31) and heavy smokers (>20 cigarettes/d) were more likely to be SO (adjusted OR, 9.53; 95% CI, 1.65–55.01) than light smokers (<11 cigarettes/d). CONCLUSION: In men, smoking was positively associated with SNO, and heavy smokers were more likely to be SO than light smokers.