Body Composition Data

Assessment of body composition was performed by Dual Energy X-Ray Absorptiometry (DEXA), which offers a rapid, non-invasive three-compartment evaluation that quantifies fat mass, lean body mass, and bone mineral content with minimal radiation exposure. All DEXA measurements were done on a non-dialysis day using a Lunar Prodigy iDEXA machine, v.11.40.004 (software versions 2003 to 2011, General Electric, Madison, WI). Appendicular skeletal mass (ASM) was defined as the sum of total lean mass of the both arms and legs divided by the square of the height or weight. SO was defined based on three research definitions: Baumgartner (ASM/Ht² + % FM: Men <7.26 kg/m² & >27%FM and Women <5.45 kg/m² & >38%FM); Janssen Criteria 1 (ASM/Ht² + % FM: (CLASS 1 Men 8.51–10.75 kg/m² & >27%FM and Women 5.76–6.75 kg/m² & >38%FM) and (CLASS 2 Men <8.5 kg/m² & >27%FM and Women <5.75 kg/m² & >38%FM)) and Janssen Criteria 2: (ASM/Wt + % FM: Men <29.9%SMM & >27%FM) (Table 1) (15, 16, 23, 24). We have chosen these definitions as they were most commonly used in epidemiological research and has defined threshold cut-offs for muscle and fat mass. We excluded definitions which were derived from fewer than 50 participants. SO definitions were further applied to our MHD database to determine comparisons of prevalence estimates.

Definition of Sarcopenic Obesity Criteria’s

Appendicular Skeletal Mass (ASM) = Arm Lean Mass + Leg Lean Mass; FM= fat mass