Associations between visceral adiposity and cardiometabolic risk indicators vary across skeletal muscle levels: The Tromso Study 2015-2016

Background and Aims We aimed to investigate whether different levels of appendicular lean mass (ALM) modify the association between visceral adipose tissue (VAT) and cardiometabolic risk indicators in community-dwelling adults. Methods and Results We included 3350 participants (58% women, age 40-84 years) from the seventh survey of the Tromsø Study (2015-2016), with data on ALM, VAT, glycated haemoglobin, triglycerides, and C-reactive protein. Sex-specific tertiles of relative VAT and ALM were grouped into nine body composition profiles. Multivariate logistic regression models were used to analyse associations between the different profiles and hyperglycaemia, hypertriglyceridemia, and low-grade inflammation. Fully adjusted models revealed lower likelihood of hyperglycaemia only in participants with concurrent high VAT and high ALM (OR 0.10, 95% CI 0.01-0.73) and with concurrent moderate VAT and moderate ALM (OR 0.39, 95% CI 0.16-0.94), compared to low ALM. Only participants with low VAT and high ALM expressed lower likelihood of hypertriglyceridemia (OR 0.25, 95% CI 0.07-0.96), compared with low ALM participants. Moderate and high ALM levels were consistently and significantly associated with 40-80% lower odds of low-grade inflammation, regardless of VAT level, when compared with low ALM levels. Conclusions We consistently found lower presence of low-grade inflammation in adults with moderate and high amounts of ALM in all three VAT categories. Similar although less consistent patterns were observed for hyperglycaemia, but not for hypertriglyceridemia. This study indicates that higher muscle mass levels may protect against low-grade inflammation and hyperglycaemia typically associated with abdominal obesity, although longitudinal and experimental studies should verify these findings.