Background: Sarcopenia is strongly linked to impaired metabolic health. However, sarcopenia might be omitted in patients (pts) with metabolic syndrome which is commonly predominated by obesity. We seek to identify associates of low muscle mass in regard metabolic health and obesity. Methods: Consecutive pts who presented to internal medicine outpatient clinics of a tertiary hospital for regular follow-up were included in this study. Those with comorbidities that are known to cause secondary sarcopenia such as chronic liver and kidney disease, inflammatory diseases and cancers were excluded. SMI was measured by bioelectrical impedance analysis (TANITA MC780) Pts with at least two components of metabolic syndrome were considered metabolically unhealthy. SMI values of metabolic healthy (MH) and unhealthy (MUH) patient groups were compared across obese and non-obese adults. Multivariate regression analysis was performed to identify factors related to low muscle mass. Results: Amongst 200 pts (M:F 97:103) included in this study, median age was 49,9 ± 8. Mean SMI was 8.9±0.6 (F:M 8.3:9.5) The MUH phenotype was more frequent in pts with low muscle mass compared to those with normal muscle mass (p=0.048) Obesity was not associated with low muscle mass regardless of MH (p=0.345) Mean SMI was lower in MUH pts regardless of presence of obesity. After controlling the mentioned variables, multivariate analysis didn’t demonstrate an independent effect of MUH phenotype on low SMI but a trend towards effect was observed (Odds ratioOR:1.09 Confidence IntervalCI 95% 0.95-9.51 p=0.062). High waist to hip ratio was the factor independently associated with low SMI (OR: 8.328, CI 95% 8.23-20.43 p=0.009). Conclusion: Our results identify an association between impaired metabolical health and low muscle mass regardless of the presence of obesity. Most interestingly we observed an interplay between central obesity and impaired muscle mass that warrants further exploration in larger samples. Disclosure Y. Onal-Tastan: None. N. Dizman: None. E. Ertur: None. B. Cakir-Guney: None. M. Sargin: None. A. Oguz: None.