Fat‐to‐muscle ratio as a predictor of insulin resistance and metabolic syndrome in Korean adults

Abstract

Background The present study evaluated the associations of the fat‐to‐muscle ratio (FMR) with metabolic syndrome (MetS) and insulin resistance (IR) in Korean adults using nationally representative survey data. Methods A two‐stage stratified sampling method was reflected in a cross‐sectional study involving a total of 13 032 participants aged ≥ 19 years who participated in the fourth and fifth Korea National Health and Nutrition Examination Surveys. The homeostasis model assessment for IR (HOMA‐IR) was used to evaluate IR and was calculated as follows: [fasting plasma glucose level (mg/dL) × fasting plasma insulin level (uIU/mL)]/405. MetS was defined using the 2006 International Diabetes Federation criteria, and FMR was measured using whole‐body dual‐energy X‐ray absorptiometry and calculated as follows: total fat mass (kg) divided by total lean mass (kg). In addition, the optimal FMR cut‐off values for detecting MetS and the odds ratios (ORs) for MetS risk were determined according to the FMR quartile and sex. Results Among all participants, the proportion of women was 58.4%, and the mean age was 44.22 ± 0.26 years. The FMR significantly differed between men and women (0.30 ± 0.002 vs. 0.53 ± 0.003, respectively, P < 0.001), and the prevalence of MetS and IR gradually increased as FMR increased (P for trend: <0.001). The optimal FMR cut‐off value for detecting MetS was higher in women than in men (0.555 vs. 0.336, respectively). The negative predictive value was the highest in normal‐weight participants (0.9992 in women and 0.9986 in men), while the positive predictive value was the highest in obese participants (0.5994 in women and 0.5428 in men). Based on the derived cut‐off FMR, a high FMR was associated with poor outcomes in terms of cardiometabolic risk markers (P < 0.001). The multivariable‐adjusted ORs for MetS, abdominal obesity, and IR (HOMA‐IR ≥ 3) were 5.35 [95% confidence interval (CI): 4.39–6.52], 7.67 (95% CI: 6.33–9.30), and 3.25 (95% CI: 2.70–3.92), respectively, in men and 5.59 (95% CI: 4.66–6.72), 7.48 (95% CI: 6.35–8.82), and 2.55 (95% CI: 2.17–3.00), respectively, in women. Conclusions In the present study, a high FMR was significantly associated with the prevalence of MetS and IR. The present findings also showed that FMR can be a novel indicator for detecting the absence or presence of MetS, particularly in metabolically healthy normal‐weight individuals and metabolically obese obese‐weight individuals.

<p>Sarcopenia Coexisting with High Adiposity Exacerbates Insulin Resistance and Dyslipidemia in Saudi Adult Men</p>

“…Therefore, during skeletal muscle aging there will be an increase in insulin resistance that leads to T2DM. An interesting study by Seo et al 28 reported relationship of fat to skeletal muscle mass ratio with insulin resistance indices and MetS. Similar to our observations there was a significant association of this ratio with insulin resistance and it could be a novel marker for detecting MetS, both in normal weight and obese people.…”

Fat mass to fat-free mass ratio and the risk of non-alcoholic fatty liver disease and fibrosis in non-obese and obese individuals

“…Besides, studies have linked sarcopenia obesity with insulin resistance, dyslipidemia, and T2D, which all implicated in the development of NAFLD [ 34 ]. Meanwhile, it has been reported that the FM/FFM ratio was positively associated with insulin resistance in the general population and liver fat accumulation, which was an important pathological feature of NAFLD, in patients with T2D directly [ 18 , 35 ]. Besides, studies also suggested that the FM/FFM ratio was capable to be regarded as a novel predictor of metabolic syndrome and glucose metabolic disorder, which both were associated closely with NAFLD [ 18 – 20 , 36 ].…”

“…Meanwhile, it has been reported that the FM/FFM ratio was positively associated with insulin resistance in the general population and liver fat accumulation, which was an important pathological feature of NAFLD, in patients with T2D directly [ 18 , 35 ]. Besides, studies also suggested that the FM/FFM ratio was capable to be regarded as a novel predictor of metabolic syndrome and glucose metabolic disorder, which both were associated closely with NAFLD [ 18 – 20 , 36 ]. Combined these studies with the findings of our study, the FM/FFM ratio could be a useful predictor of the risk of developing NAFLD among different obesity status.…”

“…There were several studies that investigated the associations of FM/FFM with health outcomes and found that the ratio was associated with insulin resistance, liver fat accumulation, glucose metabolic disorders, and metabolic syndrome [ 18 – 20 ]. However, the association of the FM/FFM ratio with the risk of incident NAFLD and fibrosis remained unclear, especially whether it could predict the NAFLD risk in non-obese individuals has not been estimated.…”

Оптимизация Вторичной Профилактики Переломов Костей При Остеопорозе У Менопаузальных Женщин И Роль Коморбидного Метаболического Синдрома

“…Развитие ОП у женщин с наcтуплением периода менопаузы тесно связано с метаболическим синдромом Оригінальні дослідження / Original Researches (МС), или синдромом инсулинорезистентности Х [6,7], при котором накопление конечных продуктов гликирования приводит к усилению ломкости костей [8,9]. МС не только ухудшает течение ОП у неменструирующих женщин, но и снижает эффективность мероприятий по вторичной профилактике остеофрактур, что требует совершенствования лечебных мероприятий у таких больных [10].…”