Association between Sarcopenia and Metabolic Syndrome on the Obese Status in Korean Elderly: KNHANES 2010–2010

Research Article

Austin J Obes & Metab Synd. 2020; 4(2): 1019.

Association between Sarcopenia and Metabolic Syndrome on the Obese Status in Korean Elderly: KNHANES 2010–2010

Cho Rong Oh*

Department of Food and Nutrition, Kyungsung University, Korea

*Corresponding author: Cho Rong Oh, Department of Food and Nutrition, Kyungsung University, 309, Suyeong-ro, Nam-gu, Busan 608-736, Korea

Received: June 15, 2020; Accepted: July 07, 2020; Published: July 14, 2020


Background: The aim of this study was to determine relationship between sarcopenia and the risk of Metabolic Syndrome (MS) on the obese status in Korean elderly and to compare the general characteristics include METs (Metabolic Equivalent), and dietary patterns among subjects for better understand to prevent strategy of MS.

Methods: The collected subjects (n=4,452) were =60 years and included 1,929 males and 2,523 females who was completed using dual energy X-Ray Absorptiometry (DXA) and both health condition and dietary intake data. MET was used to express Physical Activity (PA) intensity and the three dietary patterns using cluster analysis were identified.

Results: The Non-Obese Sarcopenic Group (NOS) showed a significantly increased MS risk than with obese sarcopenic group. The MS risk in non-obese group, NOS showed a 3.21% increased of abdominal obesity (2.525-4.212, P=0.000), 1.285 % increased of Hypertriglyceridemia (1.012-1.632, P=0.040), 1.314% increased of Low-HDL-cholesterol (1.054-1.638, P=0.015), 1.439 % increased of High fasting blood glucose (1.164-1,780, P=0.001). There is 2.269% increased MS risk in with sarcopenia group (1.430-3.600, p=0.001) in non- obese group and increased a 1.463% (0.999-2.142, p=0.050) in obese group comparing without sarcopenia group.

Conclusions: In Korea, old people-onset MS may be considering toward more sarcopenia status than obese status. We should consider obese include sarcopenia or not when we understand the general strategy for the MS in the Korean elderly.

Keywords: Sarcopenia; Obese; MS; Exercise; Dietary Patterns; Elderly


In aging, the prevalence of Metabolic Syndrome (MS) referred to the previous stage of geriatric disease is increased rapidly in Korean elderly [1]. It is a cluster of independent factors such as Insulin Resistance (IR), abdominal obesity, dyslipidemia, and hypertension [2]. According to a research by Oh, there have been the association between body composition such as obese or sarcopenia phenomenon of aging and increased risk of the MS in the Korean elderly [3].

In general, obese is one of worldwide health problems as a cause of chronic disease as well as MS among all age people. However, just obese status can’t be the indicator of healthy aging. Recent studies have reported the risk of disease among non-obese elderly individuals [4]. There are associations between body composition changes and IR and/or inflammations are fundamental to MS [5,6]. Specially with aging, less producing cytokines and myokines by skeletal muscle is caused IR and increased fat mass [5].

As muscle functions are revealed, sarcopenia status might be most important factor when defining obesity in the elderly. There is report that Non-Obese with Sarcopenia (NOS) elderly has been clearly demonstrated to have an adverse effect on physical performance due to frailty syndrome [7]. Furthermore, it should be different the way of approaching on the strategy of MS for the elderly, compared with the young people. Insufficient understanding of obesity for the elderly leads to body composition degradation and accelerates body function for the elderly. Therefore, it is not appropriate to apply knowledge that non-obese is to be healthy in the elderly without considering sarcopenia status.

Life style could control muscle synthesis in epigenetic perspective [2,8]. Their unbalanced diet status and physical activity behaviors are reflected in leading to obesity include sarcopenia [9-12]. Up to this date, many studies have focused on the MS and obese or sarcopenia but a few studies have investigated focused on the nonobese sarcopenia. [3,13,14]. This study assessed and compared the risk of MS and the general characteristics include METs and dietary patterns on sarcopenia and obese status in Korean elderly. The principal objective of this study is to elucidate that sarcopenia might be a specific intervention for the improvement of MS than obese for the Korean elderly.


Study population

Data for this cross-sectional studies was obtained from the Korean National Health and Nutrition Examination Survey 2009 to 2011 (KNHANES) by using a stratified, complex multistage, cluster random survey method of a representative sample of the noninstitutionalized civilian Korean population. In brief, the KNHANES consisted of the following four sections: the first section is a health interview survey, the second section is a health behaviors survey, the third section is a health examination survey and the fourth section is a nutrition examination survey. Total population of 1,929 men and 2,523 women (aged≥60 y of age or older) participated in body composition measuring by using bone densitometry, DXA and completed both the health and dietary surveys. Everyone who participated in this survey signed a consent form. All collected blood sample tested in 24 hours. Height, weight, and waist circumference related anthropometric predictors were measured.9 VV [15].

Assessment for obese and the non- obese with sarcopenia or not

We used Appendicular Skeletal Muscle mass (ASM) after weight adjusted ASM, ASM/Wt % more than 1 Standard Deviations (1 SDs) below the mean for the gender-age based reference group this research, because (ASM/Wt) (%) is more applicable than ASM/Height2 for Korean populations [13,14,16]. The reference group included 2,824 men and 3,732 women, who were all healthy adulthood aged of 20 to 40 age. We used BMI (kg/m²) calculator=Weight (kg) /Height (m²) to classify obesity; BMI ≥ 25 kg/m² was considered obese [17].

Assessment for the Metabolic Equivalent Task (MET score)

The International Physical Activity Questionnaire (IPAQ) has been measured for epidemiological study and for physical health. It was defined as moderate-intense activity for five days per week or walks for 30 min a day; vigorous PA, defined as three days of vigorous exercise over 20 min per day; and inactivity within a previous 7-day reference period [18,19]. An average MET score was calculated for measuring IPAQ data: Walking score=3.3, Moderate PA score=4.0, Vigorous PA score=8.0. There are 4 different METs defined as Walking METs, Moderate METs, Vigorous METs and total PA METs=sum of Walking + Moderate + Vigorous METs [20].

Assessment of dietary patterns

The 24 h dietary recall (24HR) was used to express the foods and beverages consumed yesterday by trained staff with food models, bowls, cups and spoons to estimating. The food data were grouped into 20 food items based on the Korean Nutrient Data, and total energy intake (%) was calculated from every food groups. Kimchi was grouped into a Korean traditional side dish. The die intake patterns were grouped by efficient K-mean cluster analysis. We classified three patterns (the Mix group, White rice group, and Meat group) with the based on the central food groups. ‘White rice group’ was showed by an increased consumption of white rice and kimchi. The other subjects were applied to a ‘Meat group’ because they had a high intake of meat and alcohol.

Statistical analysis

Statistics were carried out with SPSS 20.0 (SPSS, IBM, NY, USA). Chi-square test was used to examine difference in the sociodemographic factors according to non-obese and obese groups with or without sarcopenia. The diet intake was grouped by k-means cluster analysis. A generalized linear was tested for physical activity according to non-obese and obese groups with or without sarcopenia and a logistic regression model was calculated as odds ratios (95% CI) for association between sarcopenia within obese status and metabolic syndrome risk factors. All data were adjusted for ages, sexes, and diabetes. Statistical significances were accepted at P< 0.05.

Ethics statement

The study methods were confirmed by the Korea Centers for Disease Control and Prevention (IRB No: 2012-02 CON-06-C).


The socio-demographic factors of obese and the non- obese group with sarcopenia or not.

In Table 1, the significant difference between gender and sarcopenia in the obese group and the prevalence of sarcopenia is shown to be higher in female than male (male, 59.2%; female, 67.1%. (p=0.01)). There is no significant difference between gender and sarcopenia in the non-obese group and the prevalence of sarcopenia is shown to be lower in both gender in the non-obese group (male, 24.5%; female, 25.4%). In the non-obsess group, subjects with sarcopenia had significantly higher precursor signs of diabetes and diabetes than subjects with non-sarcopenia. There is no significant difference between diabetes status and sarcopenia in the obese group.

Citation: Cho Rong Oh. Association between Sarcopenia and Metabolic Syndrome on the Obese Status in Korean Elderly: KNHANES 2010–2010. Austin J Obes & Metab Synd. 2020; 4(2): 1019.