Calcified Tissue International

, Volume 104, Issue 2, pp 130–136 | Cite as

Coexistence of Pre-sarcopenia and Metabolic Syndrome in Arab Men

  • Sobhy M. Yakout
  • Shaea A. Alkahtani
  • Dara Al-Disi
  • Khalid S. Aljaloud
  • Malak Nawaz Khan Khattak
  • Majed S. Alokail
  • Jean-Yves Reginster
  • Shaun Sabico
  • Nasser M. Al-DaghriEmail author
Original Research



The present single-center observational study determined the prevalence and coexistence of sarcopenia, pre-sarcopenia, and metabolic syndrome (MetS) among apparently healthy Arab men and whether having both conditions present a unique cardiometabolic profile that is distinct than having the conditions separately.


A total of 471 out of 530 Arab men aged 20–77 years old were included after screening for the presence of pre-sarcopenia (ALM/ht2 < 7.26 kg/m2), sarcopenia (presence of both low muscle mass and low function), and MetS. MetS screening was done using the definition by the NCEP-ATP III. Based on the screening results, the participants were classified as control (normal) group (N = 328), MetS only (N = 73), pre-sarcopenia only (N = 64), and MetS + pre-sarcopenia (N = 6).


Pre-sarcopenia without MetS was observed in 64 participants (13.6%), while MetS without pre-sarcopenia was observed in 73 participants (15.5%). MetS + pre-sarcopenia was observed only in 6 participants (1.3%). None of the participants had sarcopenia. Age- and BMI-adjusted comparisons showed that those with MetS + pre-sarcopenia had the highest diastolic blood pressure and triglyceride levels as compared to all groups (p values < 0.001). MetS + pre-sarcopenia group also had the highest levels of glucose and the lowest lean arms–legs/BMI ratio than control and pre-sarcopenia groups (p values < 0.001 and 0.005, respectively).


The prevalence of pre-sarcopenia + MetS is low among young adult Arab men, but shows a unique cardiometabolic profile that is worse than those having only one of the conditions. Further investigations should be done among Arab women and the elderly.


Body composition Bone mineral density Metabolic syndrome Sarcopenia 



The authors thank all participants, the Cardiovascular Laboratory, and all research assistants. Blood samples were collected by Mr. Hamza Saber and Mr. Marwan Alharbi, and DXA scan was conducted by Mr. Abdulrahman Almajrashi.

Authors’ Contributions

SMY, SAA, DA, KSA, MNKK, MSA, JYR, NMA. SMY, SAA, and NMA conceptualized the study. SAA secured the funding and ethical approval. SMY and SS drafted the manuscript. DA, KSA, MSA, and NMA contributed in the data collection, interpretation, and writing of the manuscript. SS and JYR performed the critical review and revision of the manuscript. MNKK performed data analysis and contributed in the drafting of the manuscript. All authors have read and approved the final version of the manuscript.

Availability of Data and Materials

Data are available from the corresponding author on reasonable request.


This research project was supported by a grant from the Research Centre for the Sports Science and Physical Activity, Deanship of Scientific Research at KSU.

Compliance with Ethical Standards

Conflict of interest

Sobhy M. Yakout, Shaea A. Alkahtani, Dara Al‑Disi, Khalid S. Aljaloud, Malak Nawaz Khan Khattak, Majed S. Alokail, Jean‑Yves Reginster, Shaun Sabico, Nasser M. Al‑Daghri declare that they have no conflict of interest.

Ethics Approval

Ethical approval was obtained from the ethics committee of KSU, Riyadh, KSA (IRB No. E-16-1785). All participants who expressed their interest in the study signed a consent prior to inclusion.

Human and Animal Rights and Informed Consent

The study was approved by the KSU Institutional Review Board (IRB No. E-16-1785). Written consent was obtained from all patients who were included in the study.


  1. 1.
    Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinkova E, Vandelwoude M, Zamboni M, European Working Group on Sarcopenia in Older People (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010 39(4):412–423CrossRefGoogle Scholar
  2. 2.
    Beaudart C, McCloskey E, Bruyere O, Cesari M, Rolland Y, Rizzoli R, Araujo de Carvalho I, Amuthavalli Thiyagarajan J, Bautmans I, Bertiere MC, Brandi ML, Al-Daghri NM, Burlet N, Cavalier E, Cerreta F, Cherubini A, Fielding R, Gielen E, Landi F, Petermans J, Reginster JY, Visser M, Kanis J, Cooper C (2016) Sarcopenia in daily practice: assessment and management. BMC Geriatr 16(1):170CrossRefGoogle Scholar
  3. 3.
    Buckinx F, Landi F, Cesari M, Fielding RA, Visser M, Engelke K, Maggi S, Dennison E, Al-Daghri NM, Allepaerts S, Bauer J, Bautmans I, Brandi ML, Bruyere O, Cederholm T, Cerreta F, Cherubini A, Cooper C, Cruz-Jentoft A, McCloskey E, Dawson-Hughes B, Kaufman JM, Laslop A, Petermans J, Reginster JY, Rizzoli R, Robinson S, Rolland Y, Vellas B, Kanis JA (2018) Pitfalls in the measurement of muscle mass: a need for a reference standard. J Cachexia Sarcopenia Muscle 9(2):269–278CrossRefGoogle Scholar
  4. 4.
    Shafiee G, Keshtkar A, Soltani A, Ahadi Z, Larijani B, Heshmart R (2017) Prevalence of sarcopenia in the world: a systematic review and meta-analysis of general population studies. J Diabetes Metab Disord 16:21CrossRefGoogle Scholar
  5. 5.
    Beaudart C, Zaaria M, Pasleau F, Reginster JY, Bruyere O (2017) Health outcomes of sarcopenia: a systematic review and meta-analysis. PLoS ONE 12(1):e0169548CrossRefGoogle Scholar
  6. 6.
    Rizzoli R, Reginster JY, Arnal JF, Bautmans I, Beaudart C, Bischoff-Ferrari H, Biver E, Boonen S, Brandi ML, Chines A, Cooper C, Epstein S, Fielding RA, Godpaster B, Kanis JA, Kaufman JM, Laslop A, Malafarina V, Manas LR, Mitlak BH, Oreffo RO, Petermans J, Reid K, Rolland Y, Sayer AA, Tsouderos Y, Visser M, Bruyere O (2013) Quality of life in sarcopenia and frailty. Calcif Tissue Int 93(2):101–120CrossRefGoogle Scholar
  7. 7.
    Rodriguez AJ, Scott D, Khan B, Khan N, Hodge A, English DR, Giles GG, Ebeling PR (2016) Low relative lean mass is associated with increased likelihood of abdominal aortic calcification in community-dwelling older Australians. Calcif Tissue Int 99(4):340–349CrossRefGoogle Scholar
  8. 8.
    Clynes MA, Edwards MH, Buehring B, Dennison EM, Binkley N, Cooper C (2015) Definitions of sarcopenia: associations with previous falls and fracture in a population sample. Calcif Tissue Int 97(5):445–452CrossRefGoogle Scholar
  9. 9.
    Waters DL, Hale L, Grant AM, Herbison P, Goulding A (2010) Osteoporosis and gait and balance disturbances in older sarcopenic obese New Zealanders. Osteoporos Int 21(2):351–357CrossRefGoogle Scholar
  10. 10.
    Zhang H, Lin S, Gao T, Zhong F, Cai J, Sun Y, Ma A (2018) Association between sarcopenia and metabolic syndrome in middle-aged and older non-obese adults: a systematic review and meta-analysis. Nutrients 10(3): E364CrossRefGoogle Scholar
  11. 11.
    Choi KM (2016) Sarcopenia and sarcopenic obesity. Korean J Intern Med 31(6):1054–1060CrossRefGoogle Scholar
  12. 12.
    Srikanthan P, Hevener AL, Karlamangla AS (2010) Sarcopenia exacerbates obesity-associated insulin resistance and dysglycemia: findings from the National Health and Nutrition Examination Survey III. PLoS ONE 5(5):e10805CrossRefGoogle Scholar
  13. 13.
    Al-Dokhi L (2015) Association of the new index of sarcopenic obesity with physical fitness in healthy Saudi men and women. Eur Rev Med Pharmacol Sci 19(2):328–333Google Scholar
  14. 14.
    Alkahtani SA (2017) A cross-sectional study on sarcopenia using different methods: reference values for healthy Saudi young men. BMC Musculoskeletal Disord 18(1):19CrossRefGoogle Scholar
  15. 15.
    Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, Sabico SL, Chrousos GP (2010) Decreasing prevalence of the full metabolic syndrome but a persistently high prevalence of dyslipidemia among adults Arabs. PLoS ONE 5(8):e12159CrossRefGoogle Scholar
  16. 16.
    Al-Rubeaan K, Bawazeer N, Al Farsi Y, Youssef AM, Al-Yahya AA, AlQumaidi H, Al-Malki BM, Naji KA, Al-Shehri K, Al Rumaih FI (2018) Prevalence of metabolic syndrome in Saudi Arabia – a cross-sectional study. BMC Endocr Disord 18(1):16CrossRefGoogle Scholar
  17. 17.
    Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F, American Heart Association; National Heart, Lung, and Blood Institute (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute. Circulation 112(17):2735–2752CrossRefGoogle Scholar
  18. 18.
    Khoja AT, Aljawadi MH, Al-Shammari SA, Mohamed AG, Al-Manaa HA, Morlock L, Ahmed S, Khoja TAM (2018) The health of Saudi older adults; results from the Saudi National Survey for Elderly Health (SNSEH) 2006–2015. Saudi Pharm J 26(2):292–300CrossRefGoogle Scholar
  19. 19.
    Reijnierse EM, Trappenburg MC, Leter MJ, Blauw GJ, Sipila S, Sillanpaa E, Narici MV, Hogrel JY, Butler-Browne G, McPhee JS, Gapeyeva H, Paasuke M, de van der Schueren MA, Meskers CG, Maier AB (2015) The impact of different diagnostic criteria on the prevalence of sarcopenia in healthy elderly participants and geriatric outpatients. Gerontology 61(6):491–496CrossRefGoogle Scholar
  20. 20.
    Pereira CP, Amaral DJC, Funke VAM, Borba VZC (2017) Presarcopenia and bone mineral density in adults submitted to hematopoietic stem cell transplantation. Rev Bras Hematol Hemoter 39(4):343–348CrossRefGoogle Scholar
  21. 21.
    Harada H, Kai H, Shibata R, Niiyama H, Nishiyama Y, Murohara T, Yoshida N, Katoh A, Ikeda H (2017) New diagnostic index for sarcopenia in patients with cardiovascular diseases. PLoS ONE 12(5):e0178123CrossRefGoogle Scholar
  22. 22.
    Kim TN, Yang SJ, Yoo HJ, Song W, Seo JA, Kim SG, Kim NH, Baik SH, Choi DS, Choi KM (2009) Prevalence of sarcopenia and sarcopenic obesity in Korean adults: the Korean sarcopenic obesity study. Int J Obes (Lond) 33(8):885–892CrossRefGoogle Scholar
  23. 23.
    Carroll S, Cooke CB, Butterly RJ (2000) Metabolic clustering, physical activity and fitness in nonsmoking, middle-aged men. Med Sci Sports Exerc 32(12):2079–2086CrossRefGoogle Scholar
  24. 24.
    Finley CE, LaMonte MJ, Waslien CI, Barlow CE, Blair SN, Nichaman MZ (2006) Cardiorespiratory fitness, macronutrient intake, and the metabolic syndrome: the Aerobics Center Longitudinal Study. J Am Diet Assoc 106(5):673–679CrossRefGoogle Scholar
  25. 25.
    Lakka TA, Laaksonen DE, Lakka HM, Mannikko N, Niskanen LK, Rauramaa R, Salonen JT (2003) Sedentary lifestyle, poor cardiorespiratory fitness, and the metabolic syndrome. Med Sci Sports Exerc 35(8):1279–1286CrossRefGoogle Scholar
  26. 26.
    LaMonte MJ, Barlow CE, Jurca R, Kampert JB, Church TS, Blair SN (2005) Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: a prospective study of men and women. Circulation 112(4):505–512CrossRefGoogle Scholar
  27. 27.
    Lee S, Kuk JL, Katzmarzyk PT, Blair SN, Church TS, Ross R (2005) Cardiorespiratory fitness attenuates metabolic risk independent of abdominal subcutaneous and visceral fat in men. Diabetes Care 28(4):895–901CrossRefGoogle Scholar
  28. 28.
    Ho-Pharm LT, Nguyen UD, Nguyen TV (2014) Association between fat mass, and bone mineral density: a meta-analysis. J Clin Endocrinol Metab 99(1):30–38CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Sobhy M. Yakout
    • 1
  • Shaea A. Alkahtani
    • 2
  • Dara Al-Disi
    • 3
  • Khalid S. Aljaloud
    • 2
  • Malak Nawaz Khan Khattak
    • 1
  • Majed S. Alokail
    • 1
  • Jean-Yves Reginster
    • 1
    • 4
  • Shaun Sabico
    • 1
  • Nasser M. Al-Daghri
    • 1
    Email author
  1. 1.Prince Mutaib bin Abdullah Chair for Biomarkers Research on Osteoporosis, Department of Biochemistry, College of ScienceKing Saud UniversityRiyadhSaudi Arabia
  2. 2.Department of Exercise Physiology, College of Sport Sciences and Physical ActivityKing Saud UniversityRiyadhSaudi Arabia
  3. 3.Department of Community Health Sciences, College of Applied Medical SciencesKing Saud UniversityRiyadhSaudi Arabia
  4. 4.Department of Public Health, Epidemiology and Health EconomicsUniversity of LiegeLiegeBelgium

Personalised recommendations