Associations of Cardiometabolic Risk Burden, Metabolic Syndrome, and Functional Exercise Capacity in Thai Older Adults: A Cross-Sectional Study

Metabolic syndrome (MetS) is highly prevalent among older adults and has been associated with impaired physical function and reduced exercise capacity. However, the relationships of binary MetS status and cumulative MetS component burden with different dimensions of functional capacity remain unclear. This cross-sectional study examined these associations and evaluated whether they were attenuated after adjustment for body mass index (BMI) among community-dwelling Thai older adults. A total of 182 participants aged ≥ 60 years were included. The outcomes represented complementary dimensions of functional capacity: lower-extremity functional performance assessed using the Five-Times Sit-to-Stand Test (5TSTS), stepping endurance assessed using the 2-Minute Step Test (2MST), cadence-derived estimated oxygen uptake, and externally paced walking capacity assessed using the Incremental Shuttle Walk Test (ISWT). Overall, 55 participants (30.2%) had MetS. Functional outcomes did not differ significantly between participants with and without MetS. After false-discovery-rate (FDR) correction, BMI was inversely correlated with ISWT distance, waist circumference was correlated with slower 5TSTS performance and shorter ISWT distance, and cumulative MetS component burden was inversely correlated with ISWT distance. Binary MetS status was not independently associated with any outcome after FDR correction. In Model 1, each additional MetS component was associated with a 0.27-s longer 5TSTS completion time (95% CI: 0.07 to 0.46; p = 0.008; q = 0.030) and a 27.80-m shorter ISWT distance (95% CI: −45.01 to −10.59; p = 0.002; q = 0.014). Both associations were attenuated and no longer statistically significant after additional adjustment for BMI. These findings suggest that cumulative MetS burden was associated with sit-to-stand and walking performance before BMI adjustment. Both associations were attenuated and no longer statistically significant after additional adjustment for BMI.