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 (beta = -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. J Am Geriatr Soc 59: 1376-1384, 2011.