Top

Published in:

Open Access 01-12-2021 | Sarcopenia | Research article

Muscle mass rather than muscle strength or physical performance is associated with metabolic syndrome in community-dwelling older Chinese adults

Authors: Peiyu Song, Peipei Han, Yinjiao Zhao, Yuanyuan Zhang, Liyan Wang, Zhuoying Tao, Zhengxing Jiang, Shijing Shen, Yunxiao Wu, Jiajie Wu, Xiaoyu Chen, Xing Yu, Yong Zhao, Qi Guo

Published in: BMC Geriatrics | Issue 1/2021

Abstract

Objective

The purpose of this study was to examine whether muscle mass, muscle strength, and physical performance were associated with metabolic syndrome (MetS) in community-dwelling older Chinese adults.

Methods

The study comprised of 1413 community-dwelling Chinese participants (577 men; mean ± standard deviation age: 71.3 ± 5.9) recruited from Tianjin and Shanghai, China who were invited to participate in a comprehensive geriatric assessment. The International Diabetes Federation metabolic syndrome guidelines were used to define MetS, including high waist circumference, elevated blood pressure, elevated fasting blood glucose, elevated triglycerides, and reduced HDL cholesterol. Muscle mass was measured by appendicular skeletal muscle mass/weight (ASM/weight), and ASM was measured by BIA. Muscle strength was measured using grip strength. Physical performance was represented by walking speed and the time up and go test (TUGT).

Results

The overall prevalence of MetS was 46.8% (34.1% in males and 55.5% in females). In the final logistic regression model, there was a significant, graded inverse association between muscle mass and MetS (p for trend = 0.014). Muscle strength and physical performance, including walking speed and TUGT, were not associated with overall MetS. In the components of MetS, muscle mass and grip strength were significantly inversely associated with high waist circumference and elevated blood pressure (p < 0.05), while physical performance was not associated with components of MetS.

Conclusions

Compared with muscle strength and muscle function, muscle mass was inversely associated with MetS in a community-dwelling elderly Chinese population. Among muscle mass、muscle strength and physical performance, muscle mass appears to have the strongest association with MetS in the elderly.

Available only for authorised users

Dominguez LJ, Barbagallo M. The biology of the metabolic syndrome and aging. Curr Opinion Clin Nutri Metabol Care. 2016;19(1):5–11. https://doi.org/10.1097/MCO.0000000000000243.CrossRef

Lu J, Wang L, Li M, Xu Y, Jiang Y, Wang W, Li J, Mi S, Zhang M, Li Y, Wang T, Xu M, Zhao Z, Dai M, Lai S, Zhao W, Wang L, Bi Y, Ning G, 2010 China Noncommunicable Disease Surveillance Group. Metabolic syndrome among adults in China: the 2010 China noncommunicable disease surveillance. J Clin Endocrinol Metab. 2017;102(2):507–15. https://doi.org/10.1210/jc.2016-2477.CrossRefPubMed

Aguilar M, Bhuket T, Torres S, Liu B, Wong RJ. Prevalence of the metabolic syndrome in the United States, 2003-2012. Jama. 2015;313(19):1973–4. https://doi.org/10.1001/jama.2015.4260.CrossRefPubMed

Li X, Fan L, Leng SX. The aging tsunami and senior healthcare development in China. J Am Geriatr Soc. 2018;66(8):1462–8. https://doi.org/10.1111/jgs.15424.CrossRefPubMed

Larsson L, Degens H, Li M, Salviati L, Lee YI, Thompson W, Kirkland JL, Sandri M. Sarcopenia: aging-related loss of muscle mass and function. Physiol Rev. 2019;99(1):427–511. https://doi.org/10.1152/physrev.00061.2017.CrossRefPubMed

Zhang H, Lin S, Gao T, Zhong F, Cai J, Sun Y, Ma A. Association between Sarcopenia and Metabolic Syndrome in Middle-Aged and Older Non-Obese Adults: A Systematic Review and Meta-Analysis. Nutrients. 2018;10(3):364.

Myers J, Kokkinos P, Nyelin E. Physical Activity, Cardiorespiratory Fitness, and the Metabolic Syndrome. Nutrients. 2019;11(7):1652.

Kim G, Lee SE, Jun JE, Lee YB, Ahn J, Bae JC, Jin SM, Hur KY, Jee JH, Lee MK, Kim JH. Increase in relative skeletal muscle mass over time and its inverse association with metabolic syndrome development: a 7-year retrospective cohort study. Cardiovasc Diabetol. 2018;17(1):23. https://doi.org/10.1186/s12933-018-0659-2.CrossRefPubMedPubMedCentral

Koo HS, Kim MJ, Kim KM, Kim YS. Decreased muscle mass is not an independent risk factor for metabolic syndrome in Korean population aged 70 or older. Clin Endocrinol. 2015;82(4):509–16. https://doi.org/10.1111/cen.12509.CrossRef

10.

Cruz-Jentoft AJ, Sayer AA. Sarcopenia. Lancet (London, England). 2019;393(10191):2636–46.CrossRef

11.

Yang EJ, Lim S, Lim JY, Kim KW, Jang HC, Paik NJ. Association between muscle strength and metabolic syndrome in older Korean men and women: the Korean longitudinal study on health and aging. Metab Clin Exp. 2012;61(3):317–24. https://doi.org/10.1016/j.metabol.2011.07.005.CrossRefPubMed

12.

Chang KV, Hung CY, Li CM, Lin YH, Wang TG, Tsai KS, Han DS. Reduced flexibility associated with metabolic syndrome in community-dwelling elders. PLoS One. 2015;10(1):e0117167. https://doi.org/10.1371/journal.pone.0117167.CrossRefPubMedPubMedCentral

13.

Everson-Rose SA, Paudel M, Taylor BC, Dam T, Cawthon PM, Leblanc E, Strotmeyer ES, Cauley JA, Stefanick ML, Barrett-Connor E, et al. Metabolic syndrome and physical performance in elderly men: the osteoporotic fractures in men study. J Am Geriatr Soc. 2011;59(8):1376–84. https://doi.org/10.1111/j.1532-5415.2011.03518.x.CrossRefPubMedPubMedCentral

14.

Botoseneanu A, Ambrosius WT, Beavers DP, de Rekeneire N, Anton S, Church T, Folta SC, Goodpaster BH, King AC, Nicklas BJ, Spring B, Wang X, Gill TM, the LIFE Study Groups. Prevalence of metabolic syndrome and its association with physical capacity, disability, and self-rated health in lifestyle interventions and Independence for elders study participants. J Am Geriatr Soc. 2015;63(2):222–32. https://doi.org/10.1111/jgs.13205.CrossRefPubMedPubMedCentral

15.

Sayer AA, Kirkwood TB. Grip strength and mortality: a biomarker of ageing? Lancet (London, England). 2015;386(9990):226–7.CrossRef

16.

Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95. https://doi.org/10.1249/01.MSS.0000078924.61453.FB.CrossRefPubMed

17.

Montejano Lozoya R, Martinez-Alzamora N, Clemente Marin G, Guirao-Goris SJA, Ferrer-Diego RM. Predictive ability of the mini nutritional assessment short form (MNA-SF) in a free-living elderly population: a cross-sectional study. PeerJ. 2017;5:e3345. https://doi.org/10.7717/peerj.3345.CrossRefPubMedPubMedCentral

18.

Hong HC, Hwang SY, Choi HY, Yoo HJ, Seo JA, Kim SG, Kim NH, Baik SH, Choi DS, Choi KM. Relationship between sarcopenia and nonalcoholic fatty liver disease: the Korean Sarcopenic Obesity Study. Hepatology (Baltimore, Md). 2014;59(5):1772–8.CrossRef

19.

Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc. 2002;50(5):889–96. https://doi.org/10.1046/j.1532-5415.2002.50216.x.CrossRefPubMed

20.

Han P, Yu H, Ma Y, Kang L, Fu L, Jia L, Chen X, Yu X, Hou L, Wang L, Zhang W, Yin H, Niu K, Guo Q. The increased risk of sarcopenia in patients with cardiovascular risk factors in suburb-dwelling older Chinese using the AWGS definition. Sci Rep. 2017;7(1):9592. https://doi.org/10.1038/s41598-017-08488-8.CrossRefPubMedPubMedCentral

21.

Fu L, Yu X, Zhang W, Han P, Kang L, Ma Y, Jia L, Yu H, Chen X, Hou L, Wang L, Guo Q. The relationship between sleep duration, falls, and muscle mass: a cohort study in an elderly Chinese population. Rejuvenation Res. 2019;22(5):390–8. https://doi.org/10.1089/rej.2018.2102.CrossRefPubMed

22.

Song P, Zhang Y, Wang Y, Han P, Fu L, Chen X, Yu H, Hou L, Yu X, Wang L, Yang F, Guo Q. Clinical relevance of different handgrip strength indexes and metabolic syndrome in Chinese community-dwelling elderly individuals. Arch Gerontol Geriatr. 2020;87:104010. https://doi.org/10.1016/j.archger.2020.104010.CrossRefPubMed

23.

Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, Chou MY, Chen LY, Hsu PS, Krairit O, Lee JSW, Lee WJ, Lee Y, Liang CK, Limpawattana P, Lin CS, Peng LN, Satake S, Suzuki T, Won CW, Wu CH, Wu SN, Zhang T, Zeng P, Akishita M, Arai H. Sarcopenia in Asia: consensus report of the Asian working Group for Sarcopenia. J Am Med Dir Assoc. 2014;15(2):95–101. https://doi.org/10.1016/j.jamda.2013.11.025.CrossRefPubMed

24.

Ma Y, Fu L, Jia L, Han P, Kang L, Yu H, Chen X, Yu X, Hou L, Wang L, et al. Muscle strength rather than muscle mass is associated with osteoporosis in older Chinese adults. Journal of the Formosan Medical Association = Taiwan yi zhi. 2018;117(2):101–8.CrossRef

25.

Yao Z, Gu Y, Zhang Q, Liu L, Meng G, Wu H, Xia Y, Bao X, Shi H, Sun S, Wang X, Zhou M, Jia Q, Wu Y, Song K, Gao W, Guo C, Niu K. Estimated daily quercetin intake and association with the prevalence of type 2 diabetes mellitus in Chinese adults. Eur J Nutr. 2019;58(2):819–30. https://doi.org/10.1007/s00394-018-1713-2.CrossRefPubMed

26.

Gu Y, Li X, Zhang Q, Liu L, Meng G, Wu H, Zhang S, Wang Y, Zhang T, Wang X, Cao X, Li H, Liu Y, Sun S, Wang X, Jia Q, Song K, Sun Z, Niu K. Grip strength and depressive symptoms in a large-scale adult population: the TCLSIH cohort study. J Affect Disord. 2021;279:222–8. https://doi.org/10.1016/j.jad.2020.08.023.CrossRefPubMed

27.

Kim JH, Park YS. Low muscle mass is associated with metabolic syndrome in Korean adolescents: the Korea National Health and nutrition examination survey 2009-2011. Nutrition research (New York, NY). 2016;36(12):1423–8.CrossRef

28.

Moon SS. Low skeletal muscle mass is associated with insulin resistance, diabetes, and metabolic syndrome in the Korean population: the Korea National Health and nutrition examination survey (KNHANES) 2009-2010. Endocr J. 2014;61(1):61–70. https://doi.org/10.1507/endocrj.EJ13-0244.CrossRefPubMed

29.

Baumgartner RN, Wayne SJ, Waters DL, Janssen I, Gallagher D, Morley JE. Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obes Res. 2004;12(12):1995–2004. https://doi.org/10.1038/oby.2004.250.CrossRefPubMed

30.

Lim S, Kim JH, Yoon JW, Kang SM, Choi SH, Park YJ, Kim KW, Lim JY, Park KS, Jang HC. Sarcopenic obesity: prevalence and association with metabolic syndrome in the Korean longitudinal study on health and aging (KLoSHA). Diabetes Care. 2010;33(7):1652–4. https://doi.org/10.2337/dc10-0107.CrossRefPubMedPubMedCentral

31.

Ramírez-Vélez R, Garcia-Hermoso A, Prieto-Benavides DH, Correa-Bautista JE, Quino-Ávila AC, Rubio-Barreto CM, González-Ruíz K, Carrillo HA, Correa-Rodríguez M, González-Jiménez E, et al. Muscle mass to visceral fat ratio is an important predictor of the metabolic syndrome in college students. Br J Nutr. 2018;121(3):1–10.

32.

Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A Jr, Orlandini A, Seron P, Ahmed SH, Rosengren A, Kelishadi R, et al. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet (London, England). 2015;386(9990):266–73.CrossRef

33.

Miyatake N, Saito T, Wada J, Nishikawa H, Matsumoto S, Miyachi M, Fujii M, Makino H, Numata T. Linkage between oxygen uptake at ventilatory threshold and muscle strength in subjects with and without metabolic syndrome. Acta Med Okayama. 2007;61(5):255–9. https://doi.org/10.18926/AMO/32895.CrossRefPubMed

34.

Batsis JA, Germain CM, Vásquez E, Bartels SJ. Prevalence of weakness and its relationship with limitations based on the foundations for the National Institutes for health project: data from the health and retirement study. Eur J Clin Nutr. 2016;70(10):1168–73. https://doi.org/10.1038/ejcn.2016.90.CrossRefPubMedPubMedCentral

35.

Delmonico MJ, Harris TB, Visser M, Park SW, Conroy MB, Velasquez-Mieyer P, Boudreau R, Manini TM, Nevitt M, Newman AB, et al. Longitudinal study of muscle strength, quality, and adipose tissue infiltration. Am J Clin Nutr. 2009;90(6):1579–85.CrossRef

36.

Vieira DC, Tibana RA, Tajra V, Nascimento Dda C, de Farias DL, Silva Ade O, Teixeira TG, Fonseca RM, de Oliveira RJ, Mendes FA, Martins WR, Funghetto SS, Karnikowski MG, Navalta JW, Prestes J. Decreased functional capacity and muscle strength in elderly women with metabolic syndrome. Clin Interv Aging. 2013;8:1377–86. https://doi.org/10.2147/CIA.S50333.CrossRefPubMedPubMedCentral

37.

Beavers KM, Hsu FC, Houston DK, Beavers DP, Harris TB, Hue TF, Kim LJ, Koster A, Penninx BW, Simonsick EM, Strotmeyer ES, Kritchevsky SB, Nicklas BJ, Health ABC Study. The role of metabolic syndrome, adiposity, and inflammation in physical performance in the health ABC study. J Gerontol A Biol Sci Med Sci. 2013;68(5):617–23. https://doi.org/10.1093/gerona/gls213.CrossRefPubMed

38.

Gottlieb MG, Closs VE, Rosemberg LS, Borges CA, Baptista RR, Tavares GM, Gomes I, Schneider RH, Schwanke CH. Lack of association of body composition and functionality variables with metabolic syndrome in the elderly. Metab Syndr Relat Disord. 2014;12(7):397–401. https://doi.org/10.1089/met.2014.0012.CrossRefPubMed

39.

Tieland M, Trouwborst I, Clark BC. Skeletal muscle performance and ageing. J Cachexia Sarcopenia Muscle. 2018;9(1):3–19. https://doi.org/10.1002/jcsm.12238.CrossRefPubMed

40.

Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M, Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(4):601. https://doi.org/10.1093/ageing/afz046.CrossRefPubMedPubMedCentral

41.

Kim KM, Jang HC, Lim S. Differences among skeletal muscle mass indices derived from height-, weight-, and body mass index-adjusted models in assessing sarcopenia. The Korean J Internal Med. 2016;31(4):643–50. https://doi.org/10.3904/kjim.2016.015.CrossRef

42.

Katz LD, Glickman MG, Rapoport S, Ferrannini E, DeFronzo RA. Splanchnic and peripheral disposal of oral glucose in man. Diabetes. 1983;32(7):675–9. https://doi.org/10.2337/diab.32.7.675.CrossRefPubMed

43.

Jans A, Konings E, Goossens GH, Bouwman FG, Moors CC, Boekschoten MV, Afman LA, Müller M, Mariman EC, Blaak EE. PUFAs acutely affect triacylglycerol-derived skeletal muscle fatty acid uptake and increase postprandial insulin sensitivity. Am J Clin Nutr. 2012;95(4):825–36. https://doi.org/10.3945/ajcn.111.028787.CrossRefPubMed

44.

Pedersen BK, Febbraio MA. Muscle as an endocrine organ: focus on muscle-derived interleukin-6. Physiol Rev. 2008;88(4):1379–406. https://doi.org/10.1152/physrev.90100.2007.CrossRefPubMed

45.

Perakakis N, Triantafyllou GA, Fernández-Real JM, Huh JY, Park KH, Seufert J, Mantzoros CS. Physiology and role of irisin in glucose homeostasis. Nat Rev Endocrinol. 2017;13(6):324–37. https://doi.org/10.1038/nrendo.2016.221.CrossRefPubMedPubMedCentral

Title: Muscle mass rather than muscle strength or physical performance is associated with metabolic syndrome in community-dwelling older Chinese adults
Authors: Peiyu Song
Peipei Han
Yinjiao Zhao
Yuanyuan Zhang
Liyan Wang
Zhuoying Tao
Zhengxing Jiang
Shijing Shen
Yunxiao Wu
Jiajie Wu
Xiaoyu Chen
Xing Yu
Yong Zhao
Qi Guo
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Sarcopenia
Published in: BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/s12877-021-02143-8

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Associations between objectively measured physical activity, sedentary behaviour and time in bed among 75+ community-dwelling Danish older adults

Longitudinal association between physical activity and health-related quality of life among community-dwelling older adults: a longitudinal study of Urban Health Centres Europe (UHCE)

General health, healthcare costs and dental care use of elderly with a natural dentition, implant-retained overdenture or conventional denture: an 8-year cohort of Dutch elderly (aged 75 and over)

Polypharmacy and severe potential drug-drug interactions among older adults with cardiovascular disease in the United States

The prognostic role of functional dependency in older inpatients with COVID-19

High-dose versus low-dose ergocalciferol for correcting hypovitaminosis D after fragility hip fracture: a randomized controlled trial

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage