Association Between Locomotive Syndrome and N-Terminal Pro B-Type Natriuretic Peptide Concentration in a Health Screening Cohort　― A Retrospective Cross-Sectional Study ―

Q: What are the key findings of this study?

Locomotive syndrome stage 3 was independently associated with a 3.51-fold higher odds of elevated NT-proBNP compared to individuals without locomotive syndrome.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: General health screening population (n=8593). Intervention: Locomotive syndrome stage 3 vs. Non-locomotive syndrome. Primary outcome: Elevated NT-proBNP (≥125 pg/mL) (OR 3.51, 95% CI 2.02-6.12, p=<0.001).

Q: What does this research mean for the field?

Locomotive syndrome stages 2 and 3 are independently associated with elevated NT-proBNP concentrations, indicating increased myocardial stress in asymptomatic adults. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To investigate the association between locomotive syndrome severity and concentrations of N-terminal pro B-type natriuretic peptide, a biomarker of myocardial stress, in a general health screening population.

Chiaki Mizuno; Hiroaki Hiraiwa; SHINYA YOKOYAMA; Takanori Ito; K. Sahara; Takashi Honda; Taku Tanaka; Tetsuhito Kojima; Naoyoshi Kariya; Ryota Ito; Shingo Kazama; Torû Kondô; Ryota Morimoto; Hiroki Kawashima; T MUROHARA

doi:10.1253/circrep.cr-25-0323

March 6, 2026Circulation ReportsOpen Access

Association Between Locomotive Syndrome and N-Terminal Pro B-Type Natriuretic Peptide Concentration in a Health Screening Cohort　― A Retrospective Cross-Sectional Study ―

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Key result

Advanced locomotive syndrome linked to ~251% higher odds of elevated NT-proBNP in asymptomatic adults.

OR 3.51
95% CI 2.02-6.12
P<0.001
n=8,593

Figures

Why the study?

Locomotive syndrome is an early predictor of physical frailty evaluated during health screenings, but its relationship with early cardiac dysfunction remains unclear.

Does locomotive syndrome severity correlate with elevated NT-proBNP in asymptomatic adults undergoing routine health screening?

Key Points

To investigate the association between locomotive syndrome severity and concentrations of N-terminal pro B-type natriuretic peptide, a biomarker of myocardial stress, in a general health screening population.
Conducted a retrospective cross-sectional analysis of 8,593 individuals aged 20–94 years who underwent routine health checkups with complete locomotive syndrome and NT-proBNP data.
Assessed locomotive syndrome using the stand-up test, two-step test, and the 25-question Geriatric Locomotive Function Scale, staging severity from stage 1 to stage 3.
Used univariate and multivariate logistic regression models adjusting for potential confounders to evaluate associations with elevated NT-proBNP (defined as ≥125 pg/mL).
Elevated NT-proBNP (≥125 pg/mL) was observed in 4.3% (366/8,593) of participants, and 2,080 individuals were classified as having locomotive syndrome.
Locomotive syndrome was independently associated with elevated NT-proBNP in multivariate analysis (OR 1.67, 95% CI 1.31–2.13; P<0.001).
Multivariate odds of elevated NT-proBNP increased progressively with locomotive syndrome severity: stage 1 (OR 1.50; P=0.002), stage 2 (OR 2.24; P=0.002), and stage 3 (OR 3.51; P<0.001).

Study Design

Type

Cross-Sectional (n=8,593)

Multicenter

No

Structured PICO

Does locomotive syndrome severity correlate with elevated NT-proBNP in asymptomatic adults undergoing routine health screening?

P

Population

8,593 asymptomatic adults aged 20 to 94 years undergoing routine health checkups in Japan, assessed for locomotive syndrome and NT-proBNP levels.

E

Exposure

Locomotive syndrome (LS) severity (stages 1-3) assessed by the Short Test Battery for LS (stand-up test, 2-step test, and GLFS-25 questionnaire).

C

Comparator

Non-LS (individuals without locomotive syndrome).

O

Outcome

Elevated NT-proBNP concentration (≥125 pg/mL).surrogate

Main Result

Odds Ratio: 3.51 (95% CI 2.02–6.12)

p-value: p=<0.001

Locomotive syndrome severity is independently associated with elevated NT-proBNP in asymptomatic adults, suggesting physical function decline may reflect early subclinical myocardial stress.

Limitations

Large number of exclusions due to missing data may have introduced selection bias.
Voluntary participation in health examinations may represent a more health-conscious subgroup, limiting generalizability.
Possibility of residual or unmeasured confounding such as physical activity level, medication use, and undiagnosed comorbidities.
Cross-sectional design precludes establishing causal relationships between locomotive syndrome and cardiac dysfunction.
Large number of exclusions due to missing data (only 8,593 of 38,035 included)
Voluntary participation may represent a more health-conscious subgroup (selection bias)
Cross-sectional design cannot establish causality

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Implication

Should not yet change screening in asymptomatic adults; hypothesis-generating for physical decline as marker of myocardial stress needing prospective validation.

Abstract

Background: Locomotive syndrome (LS), an early predictor of physical frailty, is frequently evaluated during health screenings in Japan. However, its relationship with early cardiac dysfunction remains unclear. We investigated the association between LS severity and N-terminal pro B-type natriuretic peptide (NT-proBNP) concentration, a myocardial stress biomarker, in a general health screening population.

Discussion

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Cite This Study

Mizuno et al. (2026) conducted a cross-sectional in General health screening population (n=8,593). Locomotive syndrome stage 3 vs. Non-locomotive syndrome was evaluated on Elevated NT-proBNP (≥125 pg/mL) (OR 3.51, 95% CI 2.02-6.12, p=<0.001). Locomotive syndrome stage 3 was independently associated with a 3.51-fold higher odds of elevated NT-proBNP compared to individuals without locomotive syndrome.

synapsesocial.com/papers/69af23813eac3accde8a1764 https://doi.org/10.1253/circrep.cr-25-0323

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Association Between Locomotive Syndrome and N-Terminal Pro B-Type Natriuretic Peptide Concentration in a Health Screening Cohort　― A Retrospective Cross-Sectional Study ―

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Association Between Locomotive Syndrome and N-Terminal Pro B-Type Natriuretic Peptide Concentration in a Health Screening Cohort　― A Retrospective Cross-Sectional Study ―

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

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Implication

Abstract

Discussion

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Association Between Locomotive Syndrome and N-Terminal Pro B-Type Natriuretic Peptide Concentration in a Health Screening Cohort ― A Retrospective Cross-Sectional Study ―

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Association Between Locomotive Syndrome and N-Terminal Pro B-Type Natriuretic Peptide Concentration in a Health Screening Cohort ― A Retrospective Cross-Sectional Study ―

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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Association Between Locomotive Syndrome and N-Terminal Pro B-Type Natriuretic Peptide Concentration in a Health Screening Cohort　― A Retrospective Cross-Sectional Study ―

Association Between Locomotive Syndrome and N-Terminal Pro B-Type Natriuretic Peptide Concentration in a Health Screening Cohort　― A Retrospective Cross-Sectional Study ―