Skip to main content

Advertisement

Log in

Optimal cutoffs for low skeletal muscle mass related to cardiovascular risk in adults: The Korea National Health and Nutrition Examination Survey 2009–2010

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

The possible association between low skeletal muscle mass and cardiovascular disease (CVD) risk factors necessitates estimation of muscle mass even in subjects with normal body mass index (BMI). This study was aimed to investigate optimal cutoffs for skeletal muscle mass reflecting CVD risk factors and to evaluate the relationship between skeletal muscle mass and CVD risk factors in the general population and in subjects with normal BMI using these cutoffs. This cross-sectional study analyzed data from the Korea National Health and Nutrition Examination Survey 2009–2010. We enrolled 5120 men and 6559 women aged ≥20 years. Skeletal muscle index (SMI) was defined as the weight-adjusted appendicular skeletal muscle mass measured by dual-energy X-ray absorptiometry. Using receiver operating characteristic curve analyses, SMI cutoffs associated with CVD risk factors were determined. Lower SMI was significantly associated with an increased prevalence of CVD risk factors. The first cutoffs in men and women were 32 and 25 %, respectively, and the second cutoffs were 30 and 23.5 %. Subjects in stage I and stage II SMI categories showed increased prevalence and risk for several CVD risk factors. These tendencies persisted in the association between cardiometabolic characteristics and SMI even in subjects with normal BMI. Using cutoffs of low skeletal muscle mass reflecting CVD risk factors, lower skeletal muscle mass was associated with increased prevalence and risk of several CVD risk factors. A higher prevalence of cardiometabolic abnormalities was observed among subjects with normal BMI but low skeletal muscle mass.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. S.S. Moon, Low skeletal muscle mass is associated with insulin resistance, diabetes, and metabolic syndrome in the Korean population: the Korea National Health and Nutrition Examination Survey (KNHANES) 2009–2010. Endocr. J. 61, 61–70 (2014)

    Article  CAS  PubMed  Google Scholar 

  2. T.N. Kim, M.S. Park, S.J. Yang, H.J. Yoo, H.J. Kang, W. Song, J.A. Seo, S.G. Kim, N.H. Kim, S.H. Baik, D.S. Choi, K.M. Choi, Prevalence and determinant factors of sarcopenia in patients with type 2 diabetes: the Korean Sarcopenic Obesity Study (KSOS). Diabetes Care 33, 1497–1499 (2010)

    Article  PubMed Central  PubMed  Google Scholar 

  3. Y.S. Kim, Y. Lee, Y.S. Chung, D.J. Lee, N.S. Joo, D. Hong, Ge Song, H.J. Kim, Y.J. Choi, K.M. Kim, Prevalence of sarcopenia and sarcopenic obesity in the Korean population based on the Fourth Korean National Health and Nutritional Examination Surveys. J. Gerontol. A 67, 1107–1113 (2012)

    Article  Google Scholar 

  4. A.J. Cruz-Jentoft, J.P. Baeyen, J.M. Bauer, Y. Boirie, T. Cederholm, F. Landi, F.C. Martin, J.P. Michel, Y. Rolland, S.M. Schneider, E. Topinková, M. Vandewoude, M. Zamboni, European Working Group on Sarcopenia in older people., Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in older people. Age Ageing 39, 412–423 (2010)

    Article  PubMed Central  PubMed  Google Scholar 

  5. H. Aleman-Mateo, R.E. Ruiz Valenzuela, Skeletal muscle mass indices in healthy young Mexican adults aged 20–40 years: implications for diagnoses of sarcopenia in the elderly population. ScientificWorldJournal 2014, 672158 (2014)

    PubMed Central  CAS  PubMed  Google Scholar 

  6. V.H. Goh, C.F. Tain, T.Y. Tong, H.P. Mok, M.T. Wong, Are BMI and other Anthropometric measures appropriate as indices for obesity? A study in an Asian population. J. Lipid Res. 45, 1892–1898 (2004)

    Article  CAS  PubMed  Google Scholar 

  7. M. Deurenberg-Yap, G. Schmidt, W.A. van Staveren, P. Deurenberq, The paradox of low body mass index and high body fat percentage among Chinese, Malays and Indians in Singapore. Int. J. Obes. Relat. Metab. Disord. 24, 1011–1017 (2000)

    Article  CAS  PubMed  Google Scholar 

  8. A. Romero-Corral, V.K. Somers, J. Sierra-Johnson, R.J. Thomas, M.L. Collazo-Clavell, J. Korinek, T.G. Allison, J.A. Batsis, F.H. Sert-Kuniyoshi, F. Lopez-Jimenez, Accuracy of body mass index in diagnosing obesity in the adult general population. Int. J. Obes. 32, 959–966 (2008)

    Article  CAS  Google Scholar 

  9. A.S. Levey, J. Coresh, T. Greene, L.A. Stevens, Y.L. Zhang, S. Hendriksen, J.W. Kusek, F. Van Lente, Chronic kidney disease epidemiology collaboration. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann. Intern. Med. 145, 247–254 (2006)

    Article  CAS  PubMed  Google Scholar 

  10. D.P. Agarwal, Cardioprotective effects of light-moderate consumption of alcohol: a review of putative mechanisms. Alcohol Alcohol. 37, 409–415 (2002)

    Article  CAS  PubMed  Google Scholar 

  11. J.Y. Oh, Y.J. Yan, B.S. Kim, J.H. Kang, Validity and reliability of Korean version of International Physical Activity Questionnaire (IPAQ) short form. J. Korean Acad. Fam. Med. 28, 532–541 (2007)

    Google Scholar 

  12. R.C. Weisell, Body mass index as an indicator of obesity. Asia. Pac. J. Clin. Nutr. 11(Suppl 8), S681–S684 (2002)

    Article  Google Scholar 

  13. S.B. Heymsfield, R. Smith, M. Aulet, B. Bensen, S. Lichtman, J. Wang, R.N. Pierson Jr, Appendicular skeletal muscle mass: measurement by dual-photon absorptiometry. Am. J. Clin. Nutr. 52, 214–218 (1990)

    CAS  PubMed  Google Scholar 

  14. I. Janssen, S.B. Heymsfield, R. Ross, Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J. Am. Geriatr. Soc. 50, 889–896 (2002)

    Article  PubMed  Google Scholar 

  15. R.N. Baumgartner, K.M. Koehler, D. Gallaqher, L. Romero, S.B. Heymsfield, R.R. Ross, P.J. Garry, R.D. Lindman, Epidemiology of sarcopenia among the elderly in New Mexico. Am. J. Epidemiol. 147, 755–763 (1998)

    Article  CAS  PubMed  Google Scholar 

  16. S. Lim, J.H. Kim, J.W. Yoon, S.M. Kang, S.H. Choi, Y.J. Park, K.W. Kim, J.Y. Lim, K.S. Park, Jang HC Sarcopenic obesity: prevalence and association with metabolic syndrome in the Korean longitudinal study on health and aging (KLoSHA). Diabetes Care 33, 1652–1654 (2010)

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. D.R. Matthews, J.P. Hosker, A.S. Rudenski, B.A. Naylor, D.F. Treacher, R.C. Turner, Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28, 412–419 (1985)

    Article  CAS  PubMed  Google Scholar 

  18. Expert Panel on Detection, Evaluation, and treatment of high blood cholesterol in adults. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA 285, 2486–2497 (2001)

    Article  Google Scholar 

  19. S.Y. Lee, H.S. Park, D.J. Kim, J.H. Han, S.M. Kim, G.J. Cho, D.Y. Kim, H.S. Kwon, S.R. Kim, C.B. Lee, S.J. Oh, C.Y. Park, H.J. Yoo, Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res. Clin. Pract. 75, 72–80 (2007)

    Article  PubMed  Google Scholar 

  20. J.L. Atkins, P.H. Whincup, R.W. Morris, L.T. Lennon, O. Papacosta, S.G. Wannamethee, Sarcopenic obesity and risk of cardiovascular disease and mortality: a population-based cohort study of older men. J. Am. Geriatr. Soc. 62, 253–260 (2014)

    Article  PubMed  Google Scholar 

  21. S.O. Chin, S.Y. Rhee, S. Chon, Y.C. Hwang, I.K. Jeong, S. Oh, K.J. Ahn, H.Y. Chung, J.T. Woo, S.W. Kim, J.W. Kim, Y.S. Kim, H.Y. Ahn, Sarcopenia is independently associated with cardiovascular disease in older Korean adults: the Korea National Health and Nutrition Examination Survey (KNHANES) from 2009. PLoS One 8, e60119 (2013)

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  22. E. Ravussin, S. Lillioja, T.E. Anderson, L. Christin, C. Boqardus, Determinants of 24-hour energy expenditure in man. Methods and results using a respiratory chamber. J. Clin. Invest. 78, 1568–1578 (1986)

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. J.P. Gumucio, C.L. Mendias, Atrogin-1, MuRF-1, and sarcopenia. Endocrine 43, 12–21 (2013)

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  24. Y. Boirie, Physiopathological mechanism of sarcopenia. J. Nutr. Health Aging 13, 717–723 (2009)

    Article  CAS  PubMed  Google Scholar 

  25. K.I. Lim, S.J. Yang, T.N. Kim, H.J. Yoo, H.J. Kang, W. Song, S.H. Baik, D.S. Choi, K.M. Choi, The association between the ratio of visceral fat to thigh muscle area and metabolic syndrome: the Korean Sarcopenic Obesity Study (KSOS). Clin. Endocrinol. 73, 588–594 (2010)

    Article  CAS  Google Scholar 

  26. S.J. Baek, G.E. Nam, K.D. Han, S.W. Choi, S.W. Jung, A.R. Bok, Y.H. Kim, K.S. Lee, B.D. Han, Kim DH Sarcopenia and sarcopenic obesity and their association with dyslipidemia in Korean elderly men: the 2008–2010 Korea National Health and Nutrition Examination Survey. J. Endocrinol. Invest. 37, 247–260 (2014)

    Article  CAS  PubMed  Google Scholar 

  27. W.C. Stephen, I. Janssen, Sarcopenic-obesity and cardiovascular disease risk in the elderly. J. Nutr. Health Aging 13, 460–466 (2009)

    Article  CAS  PubMed  Google Scholar 

  28. T.N. Kim, S.M. Park, K.I. Lim, S.J. Yang, H.J. Yoo, H.J. Kang, W. Song, J.A. Seo, S.G. Kim, N.H. Kim, S.H. Baik, D.S. Choi, K.M. Choi, Skeletal muscle mass to visceral fat area ratio is associated with metabolic syndrome and arterial stiffness: The Korean Sarcopenic Obesity Study (KSOS). Diabetes Res. Clin. Pract. 93, 285–291 (2011)

    Article  PubMed  Google Scholar 

  29. K. Kohara, Sarcopenic obesity in aging population: current status and future directions for research. Endocrine 45, 15–25 (2014)

    Article  CAS  PubMed  Google Scholar 

  30. S.C. Forbes, J.P. Little, D.G. Candow, Exercise and nutritional interventions for improving aging muscle health. Endocrine 42, 29–38 (2012)

    Article  CAS  PubMed  Google Scholar 

  31. E. Poqqioqalle, S. Migliaccio, A. Lenzi, L.M. Donini, Treatment of body composition changes in obese and overweight older adults: insight into the phenotype of sarcopenic obesity. Endocrine 17, 699–716 (2014)

    Article  Google Scholar 

  32. M.K. Kim, K. Han, H.S. Kwon, K.H. Song, H.W. Yim, W.C. Lee, Y.M. Park, Normal weight obesity in Korean adults. Clin. Endocrinol. 80, 214–220 (2014)

    Article  Google Scholar 

  33. C.H. Kim, H.S. Park, M. Park, H. Kim, C. Kim, Optimal cutoffs of percentage body fat for predicting obesity-related cardiovascular disease risk factors in Korean adults. Am. J. Clin. Nutr. 94, 34–39 (2011)

    Article  CAS  PubMed  Google Scholar 

  34. alternative definitions and associations with lower extremity function, Newman AB, Kupelian V, Visser M, Simonsick E, Goodpaster B, Nevitt M, Kritchevsky SB, Tylavsky FA, Rubin SM, Harris TB; Health ABC Study Investigators. Sarcopenia. J. Am. Geriatr. Soc. 51, 1602–1609 (2003)

    Article  Google Scholar 

  35. A.B. Newman, V. Kupelian, M. Visser, E.M. Simonsick, B.H. Goodpaster, S.B. Kritchevsky, F.A. Tylavsky, S.M. Rubin, T.B. Harris, Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J. Gerontol. A 61, 72–77 (2006)

    Article  Google Scholar 

  36. M.P. St-Onge, Z. Wang, M. Horlick, J. Wang, S.B. Heymsfield, Dual-energy X-ray absorptiometry lean soft tissue hydration: independent contributions of intra- and extracellular water. Am. J. Physiol. Endocrinol. Metab. 287, E842–E847 (2004)

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We greatly appreciate the participants in the 2009–2010 Korea National Health and Nutrition Examination Survey.

Conflict of interest

The authors declare that they have no conflict of interest or funding source.

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Byoung-Duck Han or Ga Eun Nam.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 16 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, Y., Han, BD., Han, K. et al. Optimal cutoffs for low skeletal muscle mass related to cardiovascular risk in adults: The Korea National Health and Nutrition Examination Survey 2009–2010. Endocrine 50, 424–433 (2015). https://doi.org/10.1007/s12020-015-0577-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-015-0577-y

Keywords

Navigation