BACKGROUND AND AIMS: Metabolic syndrome is the concurrent presentation of 
multiple cardiovascular risk factors, including obesity, insulin resistance, 
hyperglycemia, dyslipidemia and hypertension. It has been suggested that some of 
these risk factors can have detrimental effects on the skeletal muscle while 
others can be a direct result of skeletal muscle abnormalities, showing a 
two-way directionality in the pathogenesis of the condition. This review aims to 
explore this bidirectional correlation by discussing the impact of metabolic 
syndrome on skeletal muscle tissue in general and will also discuss ways in 
which skeletal muscle alterations may contribute to the pathogenesis of 
metabolic syndrome.
METHODS: Literature searches were conducted with key words (e.g. metabolic 
syndrome, skeletal muscle, hyperglycemia) using PubMed, EBSCOhost, Science 
Direct and Google Scholar. All article types were included in the search.
RESULTS: The pathological mechanisms associated with metabolic syndrome, such as 
hyperglycemia and inflammation, have been associated with changes in skeletal 
muscle fiber composition, metabolism, insulin sensitivity, mitochondrial 
function, and strength. Additionally, some skeletal muscle alterations, 
particularly mitochondrial dysfunction and insulin resistance, are suggested to 
contribute to the development of metabolic syndrome. For example, the suggested 
underlying mechanisms of sarcopenia development are also contributors to 
metabolic syndrome pathogenesis.
CONCLUSION: Whilst numerous studies have identified a relationship between 
metabolic syndrome and skeletal muscle abnormalities, further investigation into 
the underlying mechanisms is needed to elucidate the best prevention and 
management strategies for these conditions.