Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, 06351, South Korea.
Division of Endocrinology and Metabolism, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, 51524, South Korea.
Cardiovasc Diabetol. 2018 Feb 5;17(1):23. doi: 10.1186/s12933-018-0659-2.
Skeletal 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.
A 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.
During 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.
An 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.
在之前的横断面研究中，骨骼肌质量与代谢综合征的患病率呈负相关。本研究旨在通过一项大型基于人群的 7 年队列研究，调查基线骨骼肌质量和随时间变化的骨骼肌质量对代谢综合征发展的影响。
本研究共纳入了 14830 名和 11639 名分别在韩国首尔三星医疗中心健康促进中心进行体检的个体，用于分析基线骨骼肌质量和基线至 1 年内骨骼肌质量变化。通过生物电阻抗分析来评估骨骼肌质量，并以骨骼肌质量指数（SMI）表示，即体重校正的四肢骨骼肌质量值。使用 Cox 回归模型，分析基线 SMI 值或 SMI 变化与代谢综合征相关的风险比（调整后风险比 [AHR]）。
在 7 年的随访期间，20.1%的患者发生了代谢综合征。与最低性别特异性 SMI 三分位组相比，最高性别特异性 SMI 三分位组的代谢综合征风险显著降低（调整后 AHR=0.61，95%置信区间 [CI] 0.54-0.68）。此外，与 SMI 变化<1 年 0%相比，在调整了基线 SMI 和糖代谢参数后，SMI 变化 0-1%和>1%的代谢综合征发生的多变量 AHR 分别为 0.87（95%CI 0.78-0.97）和 0.67（0.56-0.79）。
随着时间的推移，相对骨骼肌质量的增加对预防代谢综合征的发生具有潜在作用，独立于基线骨骼肌质量和糖代谢参数。
