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. 2025 Jan-Feb;39(1):381-389.
doi: 10.21873/invivo.13839.

Metabolic Syndrome and Somatic Composition: A Large Cross-sectional Analysis

Masahiro Matsui  1 , Akira Fukuda  2 , Saori Onishi  1 , Kosuke Ushiro  1 , Tomohiro Nishikawa  1 , Akira Asai  1 , Soo Ki Kim  3 , Hiroki Nishikawa  4
Affiliations

Metabolic Syndrome and Somatic Composition: A Large Cross-sectional Analysis

Masahiro Matsui et al. In Vivo. 2025 Jan-Feb.

Abstract

Background/aim: To elucidate the relationship between metabolic syndrome (Mets) and somatic composition [fat mass, fat-free (FF) mass, and fat to fat-free (F-FF) ratio] among health checkup recipients (7,776 males and 10,121 females).

Patients and methods: We classified study subjects into four types considering Japanese criteria for Mets; Type A is for males with waist circumference (WC) <85 cm and females with WC <90 cm, Type B is for males with WC ≥85 cm and females with WC ≥90 cm, but without any metabolic abnormalities, Type C is for males with WC ≥85 cm and females with WC ≥90 cm and one metabolic disorder (pre-Mets), and Type D is Mets. We compared baseline characteristics among types of A, B, C, and D.

Results: F index, FF index, and F-FF ratio showed an increasing trend with increasing risk factors for Mets in both sexes.

Conclusion: This study demonstrates a clear correlation between somatic composition and the severity of metabolic syndrome (Mets). As Mets risk factors increase, fat mass, fat-free mass, and the fat-to-fat-free ratio also rise, indicating that body composition shifts with disease progression. These findings emphasize the need for early intervention, such as exercise and diet, to manage somatic composition imbalances and reduce complications like insulin resistance.

Keywords: Metabolic syndrome; fat mass; fat mass to fat-free mass ratio; fat-free mass; somatic composition.

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Conflict of interest statement

The Authors have no conflicts of interest to declare in relation to this study.

Figures

Figure 1
Figure 1
Comparison of age (A), ALT (B) and eGFR (C) among types of A, B, C, and D in males (n=7776). Type A: WC <85 cm, Type B: WC ≥85 cm and no metabolic abnormalities, Type C: pre-metabolic syndrome, and Type D: Mets. (A) p-Values: comparison of A and B, p<0.0001; A and C, p<0.0001; A and D, p<0.0001; B and C, p<0.0001; B and D, p<0.0001; C and D, p<0.0001; overall p<0.0001. (B) p-Values: comparison of A and B, p<0.0001; A and C, p<0.0001; A and D, p<0.0001; B and C, p=0.0162; B and D, p<0.0001; C and D, p<0.0001; overall p<0.0001. (C) p-Values: comparison of A and B, p=0.1764; A and C, p<0.0001; A and D, p<0.0001; B and C, p<0.0001; B and D, p<0.0001; C and D, p<0.0001; overall p<0.0001.
Figure 2
Figure 2
Comparison of F index (A), FF index (B) and F-FF ratio (C) among types of A, B, C, and D in males (n=7,776). Type A: WC <85 cm, Type B: WC ≥85 cm and no metabolic abnormalities, Type C: pre-metabolic syndrome, and Type D: Mets. (A) p-Values: comparison of A and B, p<0.0001; A and C, p<0.0001; A and D, p<0.0001; B and C, p<0.0001; B and D, p<0.0001; C and D, p<0.0001; overall p<0.0001. (B) p-Values: comparison of A and B, p<0.0001; A and C, p<0.0001; A and D, p<0.0001; B and C, p<0.0001; B and D, p<0.0001; C and D, p<0.0001; overall p<0.0001. (C) p-Values: comparison of A and B, p<0.0001; A and C, p<0.0001; A and D, p<0.0001; B and C, p<0.0001; B and D, p<0.0001; C and D, p<0.0001; overall p<0.0001.
Figure 3
Figure 3
Comparison of the percentage decrease in BMI and FF index among types of A, B, C, and D in males. (A) Comparison of percentage of BMI <23 kg/m2 among types of A, B, C, and D in males. (B) Comparison of percentage of FF index <18 kg/m2 (skeletal muscle mass loss) among types of A, B, C, and D in males. Type A: WC <85 cm, Type B: WC ≥85 cm and no metabolic abnormalities, Type C: pre-metabolic syndrome, and Type D: Mets. (A) p-Values: comparison of A and B, p<0.0001; A and C, p<0.0001; A and D, p<0.0001; B and C, p=0.0027; B and D, p<0.0001; C and D, p=0.0066; overall p<0.0001. (B) p-Values: comparison of A and B, p<0.0001; A and C, p<0.0001; A and D, p<0.0001; B and C, p=0.2065; B and D, p=0.2979; C and D, p=0.8235; overall p<0.0001.
Figure 4
Figure 4
Comparison of age (A), ALT (B) and eGFR (C) among types of A, B, C, and D in females (n=10121). Type A: WC <90 cm, Type B: WC ≥90 cm and no metabolic abnormalities, Type C: pre-metabolic syndrome, and Type D: Mets. (A) p-Values: comparison of A and B, p=0.3364; A and C, p<0.0001; A and D, p<0.0001; B and C, p<0.0001; B and D, p<0.0001; C and D, p<0.0001; overall p<0.0001. (B) p-Values: comparison of A and B, p<0.0001; A and C, p<0.0001; A and D, p<0.0001; B and C, p<0.0001; B and D, p<0.0001; C and D, p<0.0001; overall p<0.0001. (C) p-Values: comparison of A and B, p=0.6041; A and C, p=0.4239; A and D, p=0.0066; B and C, p=0.3505; B and D, p=0.0214; C and D, p=0.1228; overall p=0.0410.
Figure 5
Figure 5
Comparison of F index (A), FF index (B) and F-FF ratio (C) among types of A, B, C, and D in females (n=10121). Type A: WC <90 cm, Type B: WC ≥90 cm and no metabolic abnormalities, Type C: pre-metabolic syndrome, and Type D: Mets. (A) p-Values: comparison of A and B, p<0.0001; A and C, p<0.0001; A and D, p<0.0001; B and C, p=0.0007; B and D, p=0.0003; C and D, p=0.6849; overall p<0.0001. (B) p-Values: comparison of A and B, p<0.0001; A and C, p<0.0001; A and D, p<0.0001; B and C, p=0.4011; B and D, p=0.7635; C and D, p=0.6580; overall p<0.0001. (C) p-Values: comparison of A and B, p<0.0001; A and C, p<0.0001; A and D, p<0.0001; B and C, p<0.0001; B and D, p<0.0001; C and D, p=0.6245; overall p<0.0001.
Figure 6
Figure 6
Comparison of the percentage decrease in BMI and FF index among types of A, B, C, and D in females. (A) Comparison of percentage of BMI <23 kg/m2 among types of A, B, C, and D in females. (B) Comparison of percentage of FF index <15 kg/m2 (skeletal muscle mass loss) among types of A, B, C, and D in females. Type A: WC <90 cm, Type B: WC ≥90 cm and no metabolic abnormalities, Type C: pre-metabolic syndrome, and Type D: Mets. (A) p-Values: comparison of A and B, p<0.0001; A and C, p<0.0001; A and D, p<0.0001; B and C, p=0.3777; B and D, p=0.3561; C and D, p=0.0264; overall p<0.0001. (B) p-Values: comparison of A and B, p<0.0001; A and C, p<0.0001; A and D, p<0.0001; B and C, p=0.3731; B and D, p=0.0908; C and D, p=0.3404; overall p<0.0001.
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