Metabolic Syndrome and Physical Performance in Elderly Men: The Osteoporotic Fractures in Men Study

Authors

  • Susan A. Everson-Rose PhD, MPH,

    1. From the Departments of *Medicine and Epidemiology, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Medical Center, Minneapolis, Minnesota; §Department of Medicine, Columbia University, New York, New York; Research Institute, California Pacific Medical Center, San Francisco, California; #Department of Medicine, Oregon Health & Science University, Portland, Oregon; **Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; ††Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, California; and ‡‡Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California.
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  • Misti Paudel MPH,

    1. From the Departments of *Medicine and Epidemiology, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Medical Center, Minneapolis, Minnesota; §Department of Medicine, Columbia University, New York, New York; Research Institute, California Pacific Medical Center, San Francisco, California; #Department of Medicine, Oregon Health & Science University, Portland, Oregon; **Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; ††Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, California; and ‡‡Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California.
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  • Brent C. Taylor PhD, MPH,

    1. From the Departments of *Medicine and Epidemiology, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Medical Center, Minneapolis, Minnesota; §Department of Medicine, Columbia University, New York, New York; Research Institute, California Pacific Medical Center, San Francisco, California; #Department of Medicine, Oregon Health & Science University, Portland, Oregon; **Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; ††Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, California; and ‡‡Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California.
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  • Tien Dam MD,

    1. From the Departments of *Medicine and Epidemiology, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Medical Center, Minneapolis, Minnesota; §Department of Medicine, Columbia University, New York, New York; Research Institute, California Pacific Medical Center, San Francisco, California; #Department of Medicine, Oregon Health & Science University, Portland, Oregon; **Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; ††Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, California; and ‡‡Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California.
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  • Peggy Mannen Cawthon PhD, MPH,

    1. From the Departments of *Medicine and Epidemiology, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Medical Center, Minneapolis, Minnesota; §Department of Medicine, Columbia University, New York, New York; Research Institute, California Pacific Medical Center, San Francisco, California; #Department of Medicine, Oregon Health & Science University, Portland, Oregon; **Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; ††Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, California; and ‡‡Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California.
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  • Erin LeBlanc MD, MPH,

    1. From the Departments of *Medicine and Epidemiology, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Medical Center, Minneapolis, Minnesota; §Department of Medicine, Columbia University, New York, New York; Research Institute, California Pacific Medical Center, San Francisco, California; #Department of Medicine, Oregon Health & Science University, Portland, Oregon; **Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; ††Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, California; and ‡‡Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California.
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  • Elsa S. Strotmeyer PhD, MPH,

    1. From the Departments of *Medicine and Epidemiology, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Medical Center, Minneapolis, Minnesota; §Department of Medicine, Columbia University, New York, New York; Research Institute, California Pacific Medical Center, San Francisco, California; #Department of Medicine, Oregon Health & Science University, Portland, Oregon; **Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; ††Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, California; and ‡‡Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California.
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  • Jane A. Cauley DrPH,

    1. From the Departments of *Medicine and Epidemiology, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Medical Center, Minneapolis, Minnesota; §Department of Medicine, Columbia University, New York, New York; Research Institute, California Pacific Medical Center, San Francisco, California; #Department of Medicine, Oregon Health & Science University, Portland, Oregon; **Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; ††Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, California; and ‡‡Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California.
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  • Marcia L. Stefanick PhD,

    1. From the Departments of *Medicine and Epidemiology, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Medical Center, Minneapolis, Minnesota; §Department of Medicine, Columbia University, New York, New York; Research Institute, California Pacific Medical Center, San Francisco, California; #Department of Medicine, Oregon Health & Science University, Portland, Oregon; **Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; ††Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, California; and ‡‡Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California.
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  • Elizabeth Barrett-Connor MD,

    1. From the Departments of *Medicine and Epidemiology, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Medical Center, Minneapolis, Minnesota; §Department of Medicine, Columbia University, New York, New York; Research Institute, California Pacific Medical Center, San Francisco, California; #Department of Medicine, Oregon Health & Science University, Portland, Oregon; **Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; ††Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, California; and ‡‡Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California.
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  • Kristine E. Ensrud MD,

    1. From the Departments of *Medicine and Epidemiology, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Medical Center, Minneapolis, Minnesota; §Department of Medicine, Columbia University, New York, New York; Research Institute, California Pacific Medical Center, San Francisco, California; #Department of Medicine, Oregon Health & Science University, Portland, Oregon; **Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; ††Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, California; and ‡‡Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California.
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  • for the Osteoporotic Fractures in Men Research Group

    1. From the Departments of *Medicine and Epidemiology, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Medical Center, Minneapolis, Minnesota; §Department of Medicine, Columbia University, New York, New York; Research Institute, California Pacific Medical Center, San Francisco, California; #Department of Medicine, Oregon Health & Science University, Portland, Oregon; **Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; ††Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, California; and ‡‡Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California.
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Address correspondence to Susan A. Everson-Rose, Program in Health Disparities Research, University of Minnesota, 717 Delaware St SE, Room 166, Minneapolis, MN 55414. E-mail: saer@umn.edu

Abstract

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.

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