Furthermore, myokines secreted by skeletal muscle have been found to prevent inflammation and insulin resistance, thus counteracting the pro-inflammatory and metabolic effects of adipokines produced in adipose tissue; the Perindopril Erbumine relative paucity of myokines relative to adipokines in sarcopenic Dapoxetine hydrochloride obesity may increase the risk of metabolic and cardiovascular disease. Consistent with this, Stephen et al. found a positive association between sarcopenic obesity and cardiovascular disease in the older adults from the Cardiovascular Health Study. However, since type II muscle fibers, described as glycolytic and insulin resistant, are lost to a greater extent than type I fibers in age-related muscle atrophy, sarcopenia could theoretically also increase insulin sensitivity and cause some beneficial alterations in glucose metabolism in older adults. Accordingly, we hypothesize that sarcopenic obese individuals have more insulin resistance and higher prevalence of dysglycemia, than individuals with neither sarcopenia nor obesity, those with obesity alone, and those with sarcopenia alone. We further hypothesize that this association will be stronger in young and middle aged adults than in older adults, in whom sarcopenia may mean a preferential reduction in insulinresistant fibers. To test this hypothesis, we assessed the level of insulin resistance and dysglycemia in sarcopenic obese individuals, obese individuals without sarcopenia, sarcopenic individuals without obesity, and in those with neither sarcopenia nor obesity, in a nationally representative sample, and tested for effect modification by age. As hypothesized, sarcopenic obesity was strongly associated with increased insulin resistance and dysglycemia. In addition, sarcopenia was associated with increased insulin resistance in both non-obese and obese individuals, and also associated with higher levels of HbA1C in obese individuals. Thus, sarcopenic obese individuals had significantly higher HOMA-IR and HbA1C levels than obese individuals without sarcopenia, confirming our hypothesis that the combination of sarcopenia and obesity leads to more severe insulin resistance and dysglycemia.