National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan.
PLoS One. 2022 Oct 6;17(10):e0263213. doi: 10.1371/journal.pone.0263213. eCollection 2022.
Previous cross-sectional studies have indicated that low relative appendicular lean mass (ALM) against body weight (divided by body weight, ALM/Wt, or divided by body mass index, ALM/BMI) was negatively associated with metabolic syndrome (MetS). Conversely, previous cross-sectional studies have indicated that the absolute ALM or ALM divided by squared height (ALM/Ht2) were positively associated with MetS. The aim of this longitudinal study was to investigate the association between low absolute or relative skeletal muscle mass, leg muscle power, or percent body fat and the development of MetS in Japanese women in a 7-y prospective study. The study participants included 346 Japanese women aged 26 to 85 years. The participants were divided into low and high groups based on the median values of ALM/Wt, ALM/BMI, ALM/Ht2, absolute ALM, or leg power. The longitudinal relationship between ALM indices or leg power and MetS development was examined using Kaplan-Meier curves and Cox regression models (average follow-up duration 7 years, range 1 to 10 years). During follow-up, 24 participants developed MetS. MetS incidence was higher in the low ALM/Wt group than the high ALM/Wt group even after controlling for age, obesity, waist circumference, family history of diabetes, smoking, and physical activity [adjusted hazard ratio = 5.60 (95% CI; 1.04-30.0)]. In contrast, MetS incidence was lower in the low ALM/Ht2 group than the high ALM/Ht2 group [adjusted hazard ratio = 10.6 (95%CI; 1.27-89.1)]. MetS incidence was not significantly different between the low and high ALM/BMI, absolute ALM, and leg power groups. Both ALM/Ht2 and ALM/Wt were not significant predictive variables for MetS development when fat mass or percent body fat was taken into account in the Cox model. At the very least, the results of this study underscore the importance of body composition measurements in that percent body fat, but not ALM, is associated with MetS development.
先前的横断面研究表明，相对于体重的低肢体瘦体重（ALM）（体重除 ALM，ALM/Wt，或体重指数除 ALM，ALM/BMI）与代谢综合征（MetS）呈负相关。相反，先前的横断面研究表明，绝对 ALM 或 ALM 除以身高的平方（ALM/Ht2）与 MetS 呈正相关。本纵向研究的目的是在一项为期 7 年的前瞻性研究中，调查日本女性中绝对或相对骨骼肌质量、腿部肌肉力量或体脂百分比与 MetS 发展之间的关系。研究参与者包括 346 名年龄在 26 至 85 岁的日本女性。根据 ALM/Wt、ALM/BMI、ALM/Ht2、绝对 ALM 或腿部力量的中位数将参与者分为低分组和高分组。使用 Kaplan-Meier 曲线和 Cox 回归模型（平均随访时间 7 年，范围 1 至 10 年）检查 ALM 指数或腿部力量与 MetS 发展之间的纵向关系。在随访期间，24 名参与者发生了 MetS。即使在控制年龄、肥胖、腰围、糖尿病家族史、吸烟和体力活动后，低 ALM/Wt 组的 MetS 发生率也高于高 ALM/Wt 组[调整后的危险比=5.60（95%可信区间；1.04-30.0）]。相反，低 ALM/Ht2 组的 MetS 发生率低于高 ALM/Ht2 组[调整后的危险比=10.6（95%可信区间；1.27-89.1）]。低和高 ALM/BMI、绝对 ALM 和腿部力量组之间的 MetS 发生率无显著差异。当 Cox 模型中考虑体脂质量或体脂百分比时，ALM/Ht2 和 ALM/Wt 均不是 MetS 发展的显著预测变量。至少，这项研究的结果强调了身体成分测量的重要性，因为体脂百分比，而不是 ALM，与 MetS 发展相关。
