Abstract
Recent epidemiological evidence suggests that effects of cardiovascular risk factors may vary depending on sex and age. In this study, we assessed the associations of metabolic syndrome (MetS) with sarcopenia and its components in older adults, and examined whether the associations vary by sex and age. We also tested if any one of the MetS components could explain the associations. We conducted a cross-sectional analysis of the baseline data from the cohort study conducted in Kashiwa city, Chiba, Japan in 2012 which included 1971 functionally-independent, community-dwelling Japanese adults aged 65 years or older (977 men, 994 women). Sarcopenia was defined based on appendicular skeletal muscle mass, grip strength and usual gait speed. MetS was defined based on the National Cholesterol Education Program’s Adult Treatment Panel-III criteria. The prevalence of sarcopenia was 14.2% in men and 22.1% in women, while the prevalence of MetS was 43.6% in men and 28.9% in women. After adjustment for potential confounders, MetS was positively associated with sarcopenia in men aged 65 to 74 years (odds ratio 5.5; 95% confidence interval 1.9–15.9) but not in older men or women. Among the sarcopenia components, MetS was associated with lower muscle mass and grip strength, particularly in men aged 65 to 74 years. The associations of MetS with sarcopenia and its components were mainly driven by abdominal obesity regardless of sex or age. In conclusion, MetS is positively associated with sarcopenia in older men. The association is modified by sex and age, but abdominal obesity is the main contributor to the association across sex and age.
Highlights
Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors which include abdominal obesity, dyslipidemia, hypertension and elevated glucose [1]
Our preliminary analysis suggested that the association of metabolic syndrome with sarcopenia was modified by sex (p,0.01), and the following analyses were stratified by sex
Without adjustment for body size, MetS was associated with decreased risk of sarcopenia, suggesting that body size can confound the association between MetS and sarcopenia and should be taken into account when considering the impact of cardiovascular risk factors on muscle
Summary
Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors which include abdominal obesity, dyslipidemia, hypertension and elevated glucose [1]. Insulin resistance and chronic inflammation are considered central mechanisms responsible for MetS [2] and inextricably correlate with each other to exert detrimental metabolic effects and lead to cardiovascular morbidity and mortality [3,4,5]. Even insulin resistance without diabetes, is associated with greater declines in skeletal muscle mass and strength [6,7]. We postulate that MetS can accelerate age-related loss of muscle mass and strength, leading to the development of sarcopenia, a syndrome characterized by loss of skeletal muscle mass and function with a risk of physical disability [10]. Recent studies showed that MetS is associated with physical capacity impairment and increased risk of developing physical and functional disabilities [11,12,13]
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