Association of Low Muscle Mass and Isokinetic Strength with Metabolic Syndrome

Main Article Content

Hoyoun Kim
Yong Hwan Kim
Won Kim


metabolic syndrome, sarcopenia, strength, muscle mass, odds ratio


Background and objectives
Sarcopenia and metabolic syndrome (MetS) increase incidence with age. This study evaluated the prevalence of MetS in middle-age to elderly men according to knee and grip strength and muscle mass. Methods
Data from 256 males aged 40–69 years were analyzed. The impedance method was used to assess appendicular skeletal muscle mass (ASM). Muscle strength was measured grip strength with a dynamometer and 60°/s knee strength with isokinetic machine. Strength and muscle mass were divided into quartiles, and logistic regression analyses were performed.

Absolute strength was not significantly prevalent in MetS, but MetS prevalence was significantly higher in participants with lower relative strength and muscle mass values (p<0.05). The group with the lowest relative ASM showed a 3.604-fold increase in MetS prevalence compared to highest ASM. Lowest relative knee extension strength group increased by 3.308 (95% CI 1.201–8.064) and relative knee flexion strength increased by 2.390 (95% CI 1.006–5.560) in MetS prevalence compared to the highest strength group. Lowest muscle mass and extension strength group increased by 6.8-fold com-pared to the highest muscle mass and strength group.

Relative values of strength and muscle mass divided by body weight were significantly associated with MetS. Therefore, having high muscle strength and muscle mass along with low body weight will prevent MetS.


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1. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing 2018;48:16–31.
2. Anker SD, Morley JE, von Haehling S. Welcome to the ICD-10 code for sarcopenia. J Cachexia Sarcopenia Muscle 2016;7:512–514. https://doi. org/10.1002/jcsm.12147
3. Evans WJ. What is sarcopenia? J Gerontol A Biol Sci Med Sci 1995;50:5–8.
4. Cleasby ME, Jamieson PM, Atherton PJ. Insulin resistance and sarcopenia: Mechanistic links between common comorbidities. J Endocrinol 2016;229:R67–R81.
5. Sanada K, Miyachi M, Tanimoto M, et al. A cross-sectional study of sarcopenia in Japanese men and women: Reference values and association with cardiovascular risk factors. Eur J Appl Physiol 2010;110:57–65. s00421-010-1473-z
6. Stephen W, Janssen I. Sarcopenic-obesity and cardiovascular disease risk in the elderly. J Nutr Health Aging 2009;13:460–466. https://doi. org/10.1007/s12603-009-0084-z
7. Atkins JL, Whincup PH, Morris RW, et al. Sarcopenic obesity and risk of cardiovascular dis-ease and mortality: A population-based cohort study of older men. J Am Geriatr Soc 2014;62: 253–260.
8. Grundy SM. Metabolic syndrome: Connecting and reconciling cardiovascular and diabetes worlds. J Am Coll Cardiol 2006;47:1093–1100.
9. Kim YH, Cho KK, Kim YH. Association of fitness, body circumference, muscle mass, and exercise habits with metabolic syndrome. J Mens Health 2019;15:e46–e55.
10. Kawamoto R, Ninomiya D, Kasai Y, et al. Handgrip strength is associated with metabolic syndrome among middle-aged and elderly community-dwelling persons. Clin Exp Hypertens 2016;38:245–251. 63.2015.1081232
11. Yang EJ, Lim S, Lim J-Y, et al. Association between muscle strength and metabolic syndrome in older Korean men and women: The Korean lon-gitudinal study on health and aging. Metabolism 2012;61:317–324. 2011.07.005
12. Kannus P. Isokinetic evaluation of muscular performance. Int J Sports Med 1994;15:S11–S18.
13. Royer M, Castelo-Branco C, Blümel J, et al. The US National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III): Prevalence of the metabolic syndrome in post-menopausal Latin American women. Climacteric 2007;10:164–170. 30701258895
14. Khang Y-H, Yun S-C. Trends in general and abdominal obesity among Korean adults: Findings from 1998, 2001, 2005, and 2007 Korea National Health and Nutrition Examination Surveys. J Korean Med Sci 2010;25:1582–1588.
15. CSMi. Humac norm users guide. Stoughton, MA: Computer Sports Medicine, Inc.; 2019.
16. Stenholm S, Harris TB, Rantanen T, et al. Sarcopenic obesity-definition, etiology and consequences. Curr Opin Clin Nutr Metabol Care 2008;11:693. e328312c37d
17. Lee J, Hong Y-p, Shin HJ, et al. Associations of sarcopenia and sarcopenic obesity with metabolic syndrome considering both muscle mass and muscle strength. J Prev Med Public Health 2016;49(1):35– 44.
18. Atlantis E, Martin SA, Haren MT, et al. Inverse associations between muscle mass, strength, and the metabolic syndrome. Metabolism 2009;58:1013– 1022.
19. Keller K, Engelhardt M. Strength and muscle mass loss with aging process. Age and strength loss. Muscles Ligaments Tendons J 2013;3:346.
20. Goodpaster BH, Park SW, Harris TB, et al. The loss of skeletal muscle strength, mass, and quality in older adults: The health, aging and body composition study. J Gerontol A: Biol Sci Med Sci 2006;61:1059–1064. 61.10.1059
21. Hurley BF. Age, gender, and muscular strength. J Gerontol Biol Sci Med Sci 1995;50:41–44. https://
22. Yi D, Khang AR, Lee HW, et al. Relative handgrip strength as a marker of metabolic syndrome: The Korea National Health and Nutrition Examination Survey (KNHANES) VI (2014–2015). Diabetes Metab Syndr Obes Targets Ther 2018;11:227.
23. Ploutz-Snyder LL, Manini T, Ploutz-Snyder RJ, et al. Functionally relevant thresholds of quadriceps femoris strength. J Gerontol A Biol Sci Med Sci 2002;57:B144–B152. gerona/57.4.B144
24. Hamner SR, Seth A, Delp SL. Muscle contributions to propulsion and support during running. J  Biomech 2010;43:2709–2716. 10.1016/j.jbiomech.2010.06.025
25. Abe T, Sakamaki M, Yasuda T, et al. Age-related, site-specific muscle loss in 1507 Japanese men and women aged 20 to 95 years. J Sports Sci Med 2011;10:145.
26. Trappe T, Lindquist D, Carrithers J. Muscle-specific atrophy of the quadriceps femoris with aging. J Appl Physiol 2001;90:2070–2074. https://
27. Artero EG, Lee D-c, Lavie CJ, et al. Effects of muscular strength on cardiovascular risk factors and prognosis. J Cardiopulm Rehabil Prev 2012;32:351. e3182642688
28. Srikanthan P, Karlamangla AS. Muscle mass index as a predictor of longevity in older adults. Am J Med 2014;127:547–553. https://doi. org/10.1016/j.amjmed.2014.02.007
29. Larsson L, Degens H, Li M, et al. Sarcopenia: Aging-related loss of muscle mass and function. Physiol Rev 2018;99:427–511. 10.1152/physrev.00061.2017
30. Hong JY, Oak JS. Effects of 12 weeks aerobic. Anaerobic combined exercise training on fitness, body composition, skeletal muscle index and blood lipid profiles in obese elderly women. Korean J Obes 2013;22:30–38. kjo.2013.22.1.30
31. Evans WJ. Exercise training guidelines for the elderly. Med Sci Sports Exerc 1999;31:12–17.