Metabolic Syndrome Is Associated with Altered Gait Biomechanics but Demonstrates Limited Predictive Performance in Young Adults

Background/Objectives: Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors that increases the risk for cardiovascular disease. Although gait impairments are documented in older adults with MetS, few studies have examined gait biomechanics or the potential for gait-related measures to differentiate metabolic syndrome status in young adults. This study examined whether gait biomechanics, functional gait performance, and muscle strength are associated with MetS risk factors in young adults, and whether these measures predict MetS classification. Methods: Twenty-four young adults meeting criteria for metabolic syndrome (MetS+) and 24 participants without MetS (MetS−) completed cardiometabolic assessments, gait analysis, functional gait testing, and lower extremity isometric strength testing. Multiple linear regression examined associations between gait velocity and MetS risk factors, and binary logistic regression assessed the ability of biomechanical, functional, and strength variables to differentiate MetS status. Results: Compared with matched controls, MetS+ participants demonstrated slower gait velocity, longer stance time, and lower propulsive ground reaction forces. Regression models examining MetS risk factors did not significantly explain variance in gait velocity. Logistic regression indicated that spatiotemporal gait parameters and GRF variables could differentiate MetS classification with fair predictive ability, whereas functional gait performance and strength measures showed limited classification performance. Conclusions: Young adults with MetS demonstrated modest differences in select gait variables, but the MetS risk factors did not show strong relationships with gait velocity in regression analyses. Spatiotemporal gait parameters differentiated MetS+ and MetS− groups but offered limited predictive value. These findings suggest that subtle biomechanical differences may be present early in the progression of MetS, although stronger functional impairments may not yet be detectable in young adults.