ESPE Abstracts

Introduction: Skeletal muscle plays a crucial role in glucose disposal, and studies have shown a positive relationship between muscle mass and insulin sensitivity. However, an elevated lean mass has also been associated with metabolically adverse outcomes. This study aimed to evaluate the association between the risk of metabolic syndrome (MetS) and lean mass using dual-energy X-ray absorptiometry (DXA) in a nationally representative sample from the Korea National Health and Nutrition Examination Survey.

Methods: DXA was used to measure total body lean mass (LM) and fat mass (FM), as well as trunk LM and FM. Fat mass index (FMI) and lean mass index (LMI) were calculated using the following equations: FMI = (total FM in kg) ÷ (height in m)2, LMI = (total LM in kg) ÷ (height in m)2. The standard deviation score (SDS) for FMI and LMI was determined using age- and sex-specific LMS reference values.

Results: The prevalence of MetS was 5% in the study population, with a significantly higher prevalence in boys than in girls (6.5% vs. 3.0%). LMI was significantly associated with an increased odds of MetS. Odds ratios (OR) of LMI were statistically significant with waist circumference (OR; 3.0, 95% CI; 2.5-3.5), elevated triglyceride concentration (OR; 1.3, 95% CI; 1.2-1.4), and decreased HDL-C (OR; 1.4, 95% CI; 1.3-1.5) among the MetS components. The odds of MetS were greatest with FMI SDS (OR; 4.9, 95% CI; 3.5-6.7). The odds of LMI were 1.8, the best among the crude values (BMI, total mass index, FMI, and LMI itself), and had the best sensitivity. BMI showed the lowest odds ratio but had the best performance.

Conclusions: This study suggests that lean mass is positively associated with MetS, particularly with lipid metabolism. A parameter that reflects both muscle content and fat component may enhance the prediction of metabolic risk in children and adolescents.