Metabolic Syndrome and Osteoporosis in Relation to Muscle Mass

Abstract

This study aimed to examine the relationship between metabolic syndrome (MetS) and osteoporosis according to muscle mass levels and the joint relationship of MetS and muscle mass with osteoporosis in a representative population-based sample from the Korea National Health and Nutrition Examination Survey in 2010-2011. In 1654 men and 1979 women aged 50-93 years, body composition and bone mineral density at the femur and lumbar spine were measured using dual-energy X-ray absorptiometry. Low- and high-muscle mass groups were identified using the mean sex-specific muscle mass of appendicular muscle mass/height(2). The covariates were age, health behaviors, serum 25-OH vitamin D and parathyroid hormone, calcium intake, and hormone replacement therapy for women. Men and women with MetS (defined by the Adult Treatment Panel III) had 43 and 31% lower odds for osteoporosis, respectively, compared with their MetS-free counterparts after adjusting for muscle mass and covariates. When stratified by muscle mass, MetS was not associated with osteoporosis in men, while associated in women with higher muscle mass (OR 0.65, 95% CI 0.46-0.91). Compared with MetS-free men and women with lower muscle mass, the odds for osteoporosis were 45% and 23, 52 and 15%, and 72 and 46% lower among those with low muscle mass and MetS, high muscle mass without MetS, and high muscle mass and MetS, respectively (P for trend <0.001). Combination of high muscle mass and MetS was associated with lower prevalence of osteoporosis in Korean men and women.

Increased odds of having the metabolic syndrome with greater fat‐free mass: counterintuitive results from the National Health and Nutrition Examination Survey database

“…Applying this method led to the second main finding of this study: the ORs of having the MetS increased in younger and older men and women with larger FFMi, independently of multiple covariables. Although it opposes the widespread belief that FFM has a protective effect on metabolic health, this conclusion is in line with previous counterintuitive observations from multiple published studies 4,15,17,18,20,23,24,28–31 . The authors of these studies, however, have not always put forward, if discussed, their results.…”

The Relationship between Metabolic Syndrome and Osteoporosis: A Review

“…There was a significant relationship between muscle mass and MetS and prevalence of osteoporosis among Koreans (1654 men and 1979 women, aged 50–93 years). Body composition and BMD were determined using dual-energy X-ray absorptiometry (DEXA) and findings showed that higher muscle mass and MetS were associated with a lower prevalence of osteoporosis in men and women (OR 0.65, 95% CI 0.46–0.91) [ 53 ].…”

Effects of metabolic syndrome on bone mineral density, histomorphometry and remodelling markers in male rats

“…Recently, there is a debate concerning whether MetS is associated with osteoporosis. Many studies involving animals and humans have been performed to investigate the relationship between MetS and osteoporosis but the findings were heterogeneous [ 9 – 14 ]. Human observational studies revealed that individual with MetS had either higher [ 9 , 12 ] or lower bone mineral density (BMD) [ 10 , 15 – 17 ].…”

“…Many studies involving animals and humans have been performed to investigate the relationship between MetS and osteoporosis but the findings were heterogeneous [ 9 – 14 ]. Human observational studies revealed that individual with MetS had either higher [ 9 , 12 ] or lower bone mineral density (BMD) [ 10 , 15 – 17 ]. Animal studies also yielded inconsistent results, whereby MetS decreased [ 18 ] or had no effect [ 19 ] on BMD in animals.…”