Tanaka Muhei, Okada Hiroshi, Hashimoto Yoshitaka, Kumagai Muneaki, Nishimura Hiromi, Oda Yohei, Fukui Michiaki
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Department of Internal Medicine, Matsushita Memorial Hospital, Osaka, Japan.
Clin Nutr. 2020 Jun;39(6):1818-1825. doi: 10.1016/j.clnu.2019.07.021. Epub 2019 Aug 6.
BACKGROUND & AIMS: Metabolic syndrome is a cluster of metabolic abnormalities. Skeletal muscle attenuation and area evaluated by computer tomography (CT) may provide valuable information about patients with metabolic disorder. Therefore, we examined the association between skeletal muscle characteristics and metabolic syndrome, and investigated the combined effect of quantitative and qualitative muscle parameters.
In this cross-sectional study, we analyzed 808 middle-aged Japanese subjects. The cross-sectional area of skeletal muscle was evaluated based on CT at the third lumbar vertebrae. The subjects were divided into four groups according to the median levels of skeletal muscle index (SMI) and density (SMD).
Eighty-five men and twenty-two women had metabolic syndrome. In the adjusted model, SMI and SMD had an interaction effect on the number of metabolic syndrome components (p = 0.0398 in men and p = 0.0306 in women). When SMI and SMD were considered as independent variables for multiple regression analysis, SMI (β = -0.155, p = 0.0019 in men and β = -0.295, p < 0.0001 in women) and SMD (β = -0.355, p < 0.0001 in men and β = -0.324, p < 0.0001 in women) were both independently associated with the number of metabolic syndrome components. The subgroup with presence of low SMI and low SMD levels had a significantly higher prevalence of metabolic syndrome than that observed in other groups.
Therefore, we suggest that not only muscle quantity but also quality is independently associated with metabolic syndrome.
代谢综合征是一组代谢异常。通过计算机断层扫描（CT）评估的骨骼肌衰减和面积可为代谢紊乱患者提供有价值的信息。因此，我们研究了骨骼肌特征与代谢综合征之间的关联，并探讨了定量和定性肌肉参数的联合作用。
在这项横断面研究中，我们分析了808名日本中年受试者。基于第三腰椎水平的CT评估骨骼肌的横截面积。根据骨骼肌指数（SMI）和密度（SMD）的中位数水平将受试者分为四组。
八十五名男性和二十二名女性患有代谢综合征。在调整模型中，SMI和SMD对代谢综合征组分数量有交互作用（男性中p = 0.0398，女性中p = 0.0306）。当将SMI和SMD作为多元回归分析的自变量时，SMI（男性中β = -0.155，p = 0.0019；女性中β = -0.295，p < 0.0001）和SMD（男性中β = -0.355，p < 0.0001；女性中β = -0.324，p < 0.0001）均与代谢综合征组分数量独立相关。SMI和SMD水平均低的亚组代谢综合征患病率显著高于其他组。
因此，我们认为不仅肌肉量而且肌肉质量均与代谢综合征独立相关。
