Association of Sarcopenia with Lower Adiponectin Levels and Reduced Estimated Appendicular Lean Mass in Patients with Metabolic Syndrome: A Cross-Sectional Study

<b>Background:</b> Sarcopenia is a progressive muscle disorder associated with metabolic syndrome (MS), in which early impairments in muscle strength and quality precede muscle mass loss. Simple, non-invasive measures such as handgrip strength, estimated appendicular skeletal muscle mass (eASM), and phase angle (PA) may aid early detection, while adipokines link muscle dysfunction to metabolic regulation. <b>Objective:</b> In the present study, we aimed to evaluate the association between sarcopenia markers and PA in patients with MS. <b>Methods:</b> A cross-sectional study was conducted in patients with MS, at a third-level hospital in Mexico City. Sarcopenia was assessed by handgrip strength and eASM; body composition and PA were measured using bioelectrical impedance; and plasma adipokines were quantified by ELISA. <b>Results:</b> Seventy-four (mean age, 57.7 years; 75% female; BMI, 32.5 kg/m²) participants with MS were included. Handgrip strength correlated with eASM (r = 0.64; <i>p</i> < 0.01) and PA (rho = 0.43; <i>p</i> < 0.01), and eASM also correlated with PA (rho = 0.40; <i>p</i> < 0.01) and predicted higher PA values (OR = 2.74; <i>p</i> = 0.042). The sarcopenic subgroup had lower brachial circumference and plasma adiponectin. <b>Conclusions:</b> Sarcopenia is frequent in MS and associated with lower adiponectin, suggesting a vulnerable condition. Functional/structural markers of sarcopenia showed significant correlation with PA, whereas combined methods may enhance the early detection and management of muscle deterioration in metabolic disease.