Metabolic syndrome and physical performance in elderly men: The osteoporotic fractures in men study

Objectives: To examine the association between metabolic syndrome (MetS) and objective measures of physical performance. Design: Cross-sectional analysis of the cohort study, the Osteoporotic Fractures in Men Study. Setting: Six clinical sites in the United States. Participants: Five thousand four hundred fifty-seven ambulatory men (mean age 73.6 ± 5.9). Measurements: Physical performance assessed according to grip strength, narrow walk speed, walking speed, and time to complete five repeated chair stands. Individual scores were converted to quintiles (worst=1 to best=5; unable to complete=0) and summed for an overall score (mean 11.6 ± 4.3, range, 1-20). MetS was defined according to World Health Organization criteria that include evidence of glucose dysregulation (insulin resistance, diabetes mellitus, or hyperinsulinemia) and at least two additional characteristics: high blood pressure, low high-density lipoprotein cholesterol, high triglycerides, obesity. Results: More than one-quarter (26.3%) of participants met criteria for MetS. In separate linear regression models, four of five MetS components were related to performance (P<.001); only high blood pressure was unrelated. Men with MetS had a 1.1-point lower performance score (mean 10.8, 95% confidence interval (CI)=10.6-11.0) than men without MetS (mean 11.9, 95% CI=11.8-12.0) (P<.001), adjusting for age, race, education, and site. With further covariate adjustment, this difference was reduced but remained significant (β=-0.78, P<.001). A graded association was observed between number of MetS components (0, 1, 2, or ≥3) and performance (P for trend <.001). Findings were similar excluding men with diabetes mellitus or obese men. Conclusion: Metabolic dysregulation is related to objectively assessed poorer physical performance in relatively healthy older men.