Abstract
BACKGROUND: This study was conducted to examine the association of body mass index (BMI)-adjusted body cell mass (BCM; BCM(bmi)) and lean body mass (LBM; LBM(bmi)) with metabolic markers, metabolic syndrome (MetS), and insulin resistance (IR) in middle-aged and older Korean adults. METHODS: This cross-sectional study included 9,522 adults (4,456 males and 5,066 females) without a history of myocardial infarction, stroke, or cancer from the Ansan-Ansung Study of the Korean Genome and Epidemiology Study. Multivariable linear regression was conducted to evaluate the association of BCM(bmi) and LBM(bmi) with metabolic markers. Logistic regression analyses were conducted to evaluate the association of BCM(bmi) and LBM(bmi) with metabolic abnormalities, including MetS and IR. MetS diagnosis followed National Cholesterol Education Program Adult Treatment Panel III criteria, and IR was assessed using the homeostatic model assessment index of insulin resistance (HOMA-IR). RESULTS: BCM(bmi) and LBM(bmi) were negatively associated with fasting glucose, fasting insulin, HOMA-IR, triglycerides, alanine/aspartate aminotransferase, uric acid, and high-sensitivity C-reactive protein, while they were positively associated with high-density lipoprotein cholesterol. The magnitudes of regression coefficients were generally greater for BCM(bmi) than for LBM(bmi). A total of 3,590 (37.7%) and 3,490 (36.7%) participants were categorized as having MetS and IR. Compared to the lowest tertile of BCM(bmi), the highest tertiles were associated with lower odds ratio of MetS (males: 0.36 [95% confidence interval, CI, 0.30 to 0.42], females: 0.23 [95% CI, 0.20 to 0.27]) and IR (males: 0.34 [95% CI, 0.30 to 0.40], females: 0.33 [95% CI, 0.28 to 0.38]), all with significant trends (P for trend <0.001). CONCLUSION: The results suggest that BCM(bmi) is independently associated with metabolic markers and demonstrate comparable predictive power to LBM(bmi) for MetS and IR, particularly in males.