Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Diabetes Metab J. 2013 Dec;37(6):458-64. doi: 10.4093/dmj.2013.37.6.458. Epub 2013 Dec 12.
Visceral adiposity is related to insulin resistance. Skeletal muscle plays a central role in insulin-mediated glucose disposal; however, little is known about the association between muscle mass and metabolic syndrome (MS). This study is to clarify the clinical role of skeletal muscle mass in development of MS.
A total of 1,042 subjects were enrolled. Subjects with prior MS and chronic diseases were excluded. After 24 months, development of MS was assessed using NCEP-ATP III criteria. Skeletal muscle mass (SMM; kg), body fat mass (BFM; kg), and visceral fat area (VFA; cm(2)) were obtained from bioelectrical analysis. Then, the following values were calculated as follows: percent of SMM (SMM%; %): SMM (kg)/weight (kg), skeletal muscle index (SMI; kg/m(2)): SMM (kg)/height (m(2)), skeletal muscle to body fat ratio (MFR): SMM (kg)/BFM (kg), and skeletal muscle to visceral fat ratio (SVR; kg/cm(2)): SMM (kg)/VFA (cm(2)).
Among 838 subjects, 88 (10.5%) were newly diagnosed with MS. Development of MS increased according to increasing quintiles of BMI, SMM, VFA, and SMI, but was negatively associated with SMM%, MFR, and SVR. VFA was positively associated with high waist circumference (WC), high blood pressure (BP), dysglycemia, and high triglyceride (TG). In contrast, MFR was negatively associated with high WC, high BP, dysglycemia, and high TG. SVR was negatively associated with all components of MS.
Relative SMM ratio to body composition, rather than absolute mass, may play a critical role in development of MS and could be used as a strong predictor.
内脏脂肪与胰岛素抵抗有关。骨骼肌在胰岛素介导的葡萄糖摄取中起核心作用;然而,对于肌肉量与代谢综合征(MS)之间的关系知之甚少。本研究旨在阐明骨骼肌量在 MS 发展中的临床作用。
共纳入 1042 名受试者。排除有既往 MS 和慢性疾病的患者。24 个月后,采用 NCEP-ATP III 标准评估 MS 的发展。通过生物电阻抗分析获得骨骼肌量(SMM;kg)、体脂肪量(BFM;kg)和内脏脂肪面积(VFA;cm²)。然后,计算以下值:SMM 百分比(SMM%):SMM(kg)/体重(kg)、骨骼肌指数(SMI;kg/m²):SMM(kg)/身高(m)、骨骼肌与体脂肪比值(MFR):SMM(kg)/BFM(kg)和骨骼肌与内脏脂肪比值(SVR;kg/cm²):SMM(kg)/VFA(cm²)。
在 838 名受试者中,88 名(10.5%)新诊断为 MS。随着 BMI、SMM、VFA 和 SMI 五分位的增加,MS 的发病风险增加,但与 SMM%、MFR 和 SVR 呈负相关。VFA 与高腰围(WC)、高血压(BP)、血糖异常和高甘油三酯(TG)相关。相反,MFR 与高 WC、高 BP、血糖异常和高 TG 呈负相关。SVR 与 MS 的所有成分均呈负相关。
相对于身体成分的绝对质量,相对 SMM 比值可能在 MS 的发展中起关键作用,并可作为一个强有力的预测因子。