title: Novel effects of sarcopenic osteoarthritis on metabolic syndrome, insulin resistance, osteoporosis, and bone fracture: the national survey.
abstract: This study compared the effects sarcopenic osteoarthritis on metabolic syndrome, insulin resistance, osteoporosis, and bone fracture. By using national survey data, we suggest that the relationship between sarcopenia and metabolic syndrome or insulin resistance is potentiated by the severity of osteoarthritis and is independent of body weight.
  
  
  
  Sarcopenia and osteoarthritis are known risk factors for metabolic syndrome. However, their combined effects on metabolic syndrome, insulin resistance and osteoporosis remain uncertain.
  
  
  
  We used data from the fifth Korean National Health and Nutrition Examination Survey using a total of 3158 adults (age >50 years). Sarcopenia was defined as a skeletal muscle index score (appendicular skeletal muscle mass/body weight) within the fifth percentile of sex-matched younger reference participants. Radiographic knee osteoarthritis was defined as a Kellgren-Lawrence (K-L) grade of 2 or greater. Metabolic syndrome was diagnosed using the National Cholesterol Education Program criteria. Insulin resistance was evaluated using the homeostasis model assessment-estimated insulin resistance index (HOMA-IR). Osteoporosis was defined using the World Health Organization T-score criteria.
  
  
  
  In multivariable logistic regression analysis, the sarcopenic osteoarthritis group had a higher odds ratio (OR) for metabolic syndrome (OR = 11.00, 95 % confidential interval (CI) = 2.12-56.99, p = 0.013) than the non-sarcopenic osteoarthritis (OR = 1.02, 95 % CI = 0.65-1.62, p = 0.972) and sarcopenic non-osteoarthritis groups (OR = 7.15, 95 % CI = 1.57-32.53, p = 0.027). Similarly, sarcopenic osteoarthritis had a greater OR of highest HOMA-IR quartiles (OR = 8.19, 95 % CI = 2.03-33.05, p = 0.003) than the other groups. Overall, the association between the K-L grade and body mass index was significant; however, this significance was lower in individuals with sarcopenia and was lost in those with sarcopenic osteoarthritis. Additionally, osteoporosis and bone fracture were not associated to sarcopenic osteoarthritis (p > 0.05).
  
  
  
  These results suggest that the relationship between sarcopenia and metabolic syndrome or insulin resistance is potentiated by the severity of osteoarthritis and is independent of body weight.
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, Republic of Korea.
authors.forename: S M
authors.initials: SM
authors.lastname: Chung
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, Republic of Korea.
authors.forename: M H
authors.initials: MH
authors.lastname: Hyun
authors.affiliation: Department of Cardiology, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, 321, Sanbon-ro, Gunpo, Gyeonggi-province, 435-040, Republic of Korea. mdemlee@naver.com.
authors.forename: E
authors.initials: E
authors.lastname: Lee
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, Republic of Korea. mdhsseo@korea.ac.kr.|Korea Institute of Science and Technology (KU-KIST) Graduate School of Converging Science and Technology, Korea University, Seoul, Republic of Korea. mdhsseo@korea.ac.kr.
authors.forename: H S
authors.initials: HS
authors.lastname: Seo
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009749:Nutrition Surveys; D010003:Osteoarthritis / Q000503:physiopathology*; D010024:Osteoporosis / Q000453:epidemiology*; D056910:Republic of Korea; D012307:Risk Factors; D055948:Sarcopenia / Q000503:physiopathology*
keywords: Insulin resistance; Metabolic syndrome; Osteoarthritis; Sarcopenia