{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:49:25Z","timestamp":1785761365417,"version":"3.56.0"},"reference-count":37,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: The cardiometabolic consequences of sarcopenic obesity (SO) remain poorly characterized in Latin America. We hypothesized that SO uniquely concentrates aortic stiffness, metabolic syndrome, and vitamin D deficiency in older Mexican adults, and that handgrip strength exhibits a dose\u2013response relationship with cardiometabolic risk independent of adiposity. Methods: We conducted a cross-sectional analysis of 2087 adults \u2265 50 years from the Mexican Health and Aging Study (MHAS) 2012. Four phenotypes were defined using EWGSOP2 criteria: lean\u2013fit, lean\u2013sarcopenic, obese\u2013non-sarcopenic, and obese\u2013sarcopenic (BMI \u2265 30 kg\/m2). Outcomes were pulse pressure (PP, aortic stiffness proxy), metabolic syndrome (modified IDF criteria), and serum 25(OH)D. Normality tests confirmed non-normal distribution (p &lt; 0.001). Given heteroscedasticity (Breusch\u2013Pagan p &lt; 0.001), HC3 robust standard errors were used. Regression models were sex-adjusted and sex-stratified. Results: The sample showed high cardiometabolic burden: mean HbA1c 6.91% (35.3% \u2265 6.5%); metabolic syndrome 57.6%; mean PP 60.7 \u00b1 17.9 mmHg; mean gait speed 0.708 m\/s (70.4% slow). Phenotype distribution: lean\u2013fit 12.3%; lean\u2013sarcopenic 47.3%; obese\u2013non-sarcopenic 8.7%; obese\u2013sarcopenic 31.7%. In multivariable models, handgrip strength was an independent protective predictor of PP (beta = \u22120.09 per kg; 95% CI: \u22120.17 to \u22120.01; p = 0.033), with a sex-specific effect in women (beta = \u22120.13; p = 0.010). Conclusions: SO is highly prevalent in older Mexican adults and associates with an adverse cardiometabolic profile. Handgrip strength shows a protective dose\u2013response association with cardiometabolic risk independent of adiposity, identifying muscle function as a candidate modifiable factor that warrants confirmation in longitudinal and interventional studies. The obese\u2013non-sarcopenic phenotype exhibited the lowest PP, unveiling the sarcopenic obesity paradox: adiposity without muscle function loss does not promote arterial stiffening.<\/jats:p>","DOI":"10.3390\/jcm15156006","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:50:21Z","timestamp":1785757821000},"page":"6006","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Muscle Strength as a Key Independent Predictor of Arterial Stiffness and Metabolic Syndrome in Aging Mexicans: Unveiling the Sarcopenic Obesity Paradox"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6190-938X","authenticated-orcid":false,"given":"Exal","family":"Garcia-Carrillo","sequence":"first","affiliation":[{"name":"Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Cat\u00f3lica del Maule, Talca 3480112, Chile"},{"name":"Department of Physical Activity Sciences, Universidad de Los Lagos, Osorno 5290000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7063-5728","authenticated-orcid":false,"given":"Paz","family":"Pezoa-Fuentes","sequence":"additional","affiliation":[{"name":"Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Cat\u00f3lica del Maule, Talca 3480112, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7001-9004","authenticated-orcid":false,"given":"Eduardo","family":"Guzm\u00e1n-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Escuela de Pedagog\u00eda en Educaci\u00f3n F\u00edsica, Facultad de Educaci\u00f3n, Universidad Aut\u00f3noma de Chile, Talca 3460000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7013-3894","authenticated-orcid":false,"given":"Yeny","family":"Concha-Cisternas","sequence":"additional","affiliation":[{"name":"Escuela de Kinesiolog\u00eda, Facultad de Salud, Universidad Santo Tom\u00e1s, Talca 3460000, Chile"},{"name":"Vicerrector\u00eda de Investigaci\u00f3n e Innovaci\u00f3n, Universidad Arturo Prat, Iquique 1100000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0004-3089","authenticated-orcid":false,"given":"Felipe","family":"Montalva-Valenzuela","sequence":"additional","affiliation":[{"name":"Escuela de Entrenador en Actividad F\u00edsica y Deporte, Facultad de Ciencias Humanas, Universidad Bernardo O\u2019Higgins, Santiago 8370040, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Olivares-Arancibia","sequence":"additional","affiliation":[{"name":"AFySE Group, Research in Physical Activity and School Health, School of Physical Education, Faculty of Education, Universidad de las Am\u00e9ricas, Santiago 7500975, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2926-1103","authenticated-orcid":false,"given":"Joaqu\u00edn","family":"Gonz\u00e1lez-Aroca","sequence":"additional","affiliation":[{"name":"Escuela de Kinesiolog\u00eda, Facultad de Salud, Universidad Santo Tom\u00e1s, La Serena 1720236, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8033-4777","authenticated-orcid":false,"given":"Guillermo","family":"Cort\u00e9s-Roco","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Vida, Mag\u00edster en Evaluaci\u00f3n y Planificaci\u00f3n del Entrenamiento Deportivo, Universidad Vi\u00f1a del Mar, Vi\u00f1a del Mar 2520000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9311-6576","authenticated-orcid":false,"given":"Rodrigo","family":"Y\u00e1\u00f1ez-Sep\u00falveda","sequence":"additional","affiliation":[{"name":"Escuela de Ciencias del Deporte, Facultad de Educaci\u00f3n y Humanidades, Universidad Andres Bello, Vi\u00f1a del Mar 2200055, Chile"},{"name":"School of Medicine, Universidad Esp\u00edritu Santo, Samborond\u00f3n 092301, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0140-6736(19)32472-9","article-title":"The double burden of malnutrition: Aetiological pathways and consequences for 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