Association Between Skeletal Muscle Mass, Physical Activity, and Metabolic Syndrome: the Korean National Health and Nutrition Examination Survey 2008-2011.

Background: Skeletal muscle mass (SM) and physical activity (PA) are major modifiable factors that can moderate and prevent the occurrence of metabolic syndrome (MetS). However, the joint association between SM and PA guidelines in MetS remains unclear. Therefore, we aimed to examine the relationship between SM and PA with MetS among Korean adults. Methods: This cross-sectional study analyzed 18,090 adults from the Korean National Health and Nutrition Examination Survey 2008-2011. We used the value of appendicular skeletal muscle mass divided by body mass index as SM. We decided on the PA guidelines using the American College of Sports Medicine guidelines. After adjusting for confounding factors, we performed logistic regression analysis to calculate the odds ratio and 95% confidence interval of MetS associated with SM and PA guidelines. Results: Participants from the highest SM quartile showed a decreased MetS risk of 58%-75%. Those who met both aerobic and resistance exercise guidelines were more likely to have lower MetS risk than those who neither. In addition, even with the same PA guideline status, participants with the highest muscle mass decreased MetS risk by 29%-81% compared with participants with the lowest muscle mass. Conclusions: Our results showed that increased SM and meeting PA guidelines are significantly associated with a decreased risk of MetS. To prevent MetS, customized strategies are needed for improving muscle mass and PA according to age and gender.