Two Faces of Sarcopenia: Distinct Metabolic and Cardiometabolic Signatures Across Obese and Non-Obese Phenotypes in a Multi-District Urban Population in Jakarta—A Cross Sectional Study

Introduction: Sarcopenia and obesity are increasingly recognized as overlapping conditions that contribute to adverse health outcomes, particularly in rapidly urbanizing populations. The coexistence of both conditions, termed sarcopenic obesity, represents a complex phenotype with potentially greater metabolic burden, yet its differentiation from non-obese sarcopenia remains insufficiently explored. Aim: This study aimed to compare metabolic and cardiometabolic profiles between sarcopenic obesity and non-obese sarcopenia in an urban population. Methods: A cross-sectional study was conducted using secondary data from the PRIMBON 2025 database in Jakarta, Indonesia. Participants were adults aged ≥18 years diagnosed with sarcopenia based on the 2025 Asian Working Group for Sarcopenia (AWGS) criteria. Sarcopenic obesity was defined according to the 2025 AOASO–IAGG consensus using BMI ≥ 25 kg/m2 and visceral fat level > 10. A total of approximately 604 participants were included from five administrative regions of Jakarta. Data were analyzed using Mann–Whitney U test and Chi-square test, with results presented as median (min–max), mean rank, and odds risk (OR). A dot-and-whisker plot was used to visualize effect sizes. Results: Sarcopenic obesity was associated with older age and a higher proportion of males (p < 0.01). Significant differences were observed in systolic and diastolic blood pressure, fasting blood glucose, triglycerides, and HDL (all p < 0.01), indicating a more adverse cardiometabolic profile. No significant differences were found for hemoglobin, total cholesterol, LDL, uric acid, and handgrip strength. Conclusions: Sarcopenic obesity represents a more severe metabolic phenotype compared to non-obese sarcopenia.