Abstract
BackgroundSkeletal muscle mass was negatively associated with metabolic syndrome prevalence in previous cross-sectional studies. The aim of this study was to investigate the impact of baseline skeletal muscle mass and changes in skeletal muscle mass over time on the development of metabolic syndrome in a large population-based 7-year cohort study.MethodsA total of 14,830 and 11,639 individuals who underwent health examinations at the Health Promotion Center at Samsung Medical Center, Seoul, Korea were included in the analyses of baseline skeletal muscle mass and those changes from baseline over 1 year, respectively. Skeletal muscle mass was estimated by bioelectrical impedance analysis and was presented as a skeletal muscle mass index (SMI), a body weight-adjusted appendicular skeletal muscle mass value. Using Cox regression models, hazard ratio for developing metabolic syndrome associated with SMI values at baseline or changes of SMI over a year was analyzed.ResultsDuring 7 years of follow-up, 20.1% of subjects developed metabolic syndrome. Compared to the lowest sex-specific SMI tertile at baseline, the highest sex-specific SMI tertile showed a significant inverse association with metabolic syndrome risk (adjusted hazard ratio [AHR] = 0.61, 95% confidence interval [CI] 0.54–0.68). Furthermore, compared with SMI changes < 0% over a year, multivariate-AHRs for metabolic syndrome development were 0.87 (95% CI 0.78–0.97) for 0–1% changes and 0.67 (0.56–0.79) for > 1% changes in SMI over 1 year after additionally adjusting for baseline SMI and glycometabolic parameters.ConclusionsAn increase in relative skeletal muscle mass over time has a potential preventive effect on developing metabolic syndrome, independently of baseline skeletal muscle mass and glycometabolic parameters.
Highlights
Skeletal muscle mass was negatively associated with metabolic syndrome prevalence in previous cross-sectional studies
Baseline characteristics of study participants according to sex‐specific skeletal muscle mass index tertile The baseline characteristics of the 14,830 individuals who were included in the baseline SMI analyses are shown, according to their baseline sex-specific SMI tertile (Table 1)
We found that the highest baseline SMI tertile was significantly associated with a decreased adjusted HR (AHR) for incident metabolic syndrome (0.60, 95% CI 0.54–0.68, P < 0.001) compared with the lowest tertile, after adjusting for age, sex, body mass index (BMI), family history of diabetes, smoking status, regular exercise, Estimated glomerular filtration rate (eGFR), and C-reactive protein (CRP), (Model 4, Table 2)
Summary
Skeletal muscle mass was negatively associated with metabolic syndrome prevalence in previous cross-sectional studies. In Asian population, the prevalence of metabolic syndrome grew from 24.9% in 1998 to 31.3% in 2007 in Korea [2,3,4]. The recent rapid increase in metabolic syndrome prevalence has major socioeconomic implications worldwide due to its significant association with comorbidities, including cardiovascular disease, diabetes, and various cancers, and mortality [5,6,7,8,9]. In terms of body composition, the role of skeletal muscle mass and adiposity, rather than body mass index (BMI), has been the focus of research into risk for metabolic syndrome, in Asian populations, who have relatively increased insulin resistance despite low BMI [10, 11]. Skeletal muscle is considered to be an endocrine organ because it releases myokines that mediate crosstalk between muscle, adipose tissue, the liver, brain, and other organs in autocrine and paracrine fashions [13]
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