Associations Between Triglycerides and Walking Capacity in Community-Dwelling Older Adults with Metabolic Syndrome

Background and Objectives: Metabolic syndrome (MetS) has been associated with reduced physical function in older adults, but the relative contributions of metabolic components, physiological responses, and functional performance to walking capacity remain unclear. Materials and Methods: This cross-sectional study included 116 community-dwelling adults aged ≥60 years (mean age 68.5 ± 5.5 years; 65.5% female). Walking capacity was evaluated using the six-minute walk test (6MWT) with associated physiological responses. Functional performance was assessed using the five-times-sit-to-stand test (FTSST), timed-up-and-go (TUG), and handgrip strength. Associations with six-minute walk distance (6MWD) were examined using hierarchical regression analyses, and discriminatory performance was evaluated using receiver operating characteristic analysis. Results: Participants with MetS demonstrated shorter 6MWD, slower FTSST and TUG performance, and higher dyspnea ratings compared to those without MetS (p < 0.05). Triglycerides were inversely associated with 6MWD in intermediate models (β = -0.33, p < 0.001), but after full adjustment, only ΔSBP (β = 0.76, p = 0.008) and FTSST (β = -24.45, p < 0.001) remained significant. The FTSST and TUG demonstrated excellent discriminatory ability, with AUC values of 0.956 (cut-off ≥ 15.5 s) and 0.925 (cut-off ≥ 13.7 s), respectively, whereas triglycerides showed moderate accuracy (AUC = 0.709) with a cut-off of ≥143 mg/dL. Conclusions: Walking capacity was more strongly associated with physiological and functional measures than with metabolic biomarkers. The FTSST and TUG showed strong discriminatory performance for low walking capacity, whereas metabolic markers provided complementary contextual information.