少肌性肥胖(SO)已成为老年医学领域关注的热点问题。老年人SO可导致跌倒、失能、骨折、心血管代谢疾病、癌症甚至死亡。SO的发病机制尚不明确，主要包括与年龄相关的身体成分改变、慢性低度炎症、胰岛素抵抗、激素水平改变等。生活方式的干预是治疗SO的主要措施，包括合理营养膳食和体力锻炼(有氧运动和抗阻训练)，达到增加肌肉和减少脂肪的目的。新型的治疗方式包括睾酮补充、选择性雄激素受体调节剂、肌抑素抑制剂、全身振动疗法、维生素K、间充质干细胞疗法等。深入了解SO的发病机制，进行有效的预防和治疗是研究者和临床医生的当务之急。“,”Sarcopenic obesity(SO)has been a hot issue in the field of geriatrics.SO is associated with major adverse health consequences such as falls, disability, fractures, cardiometabolic diseases, cancer and death.The pathogenesis of SO is still unclear, mainly involving age-related changes in body composition, chronic low-grade inflammation, insulin resistance and sex-specific hormonal changes.Lifestyle interventions, including rational nutrition, physical activity, and especially aerobic exercise and resistance training, are the cornerstones of SO treatment.Emerging therapies include testosterone supplements, selective androgen receptor modulators, myostatin inhibitors, whole body vibration therapy, vitamin K and mesenchymal stem cell therapy.There is an urgent need for researchers and clinicians to have an in-depth understanding of the pathogenesis of SO and carry out effective prevention and treatment.