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Background: Despite increasing concern regarding health problems as a result of environmental pollutants, no association of toxic heavy metals with sarcopenia has been demonstrated in the general population. We investigated the association of heavy metals, including lead, mercury and cadmium, with sarcopenia in the Korean population., Methods: Participants included 344 males and 360 females older than 65 years based on data from the fourth and fifth Korea National Health and Nutritional Examination Surveys. Measurements of blood lead, mercury and cadmium levels were performed. To evaluate the cumulative effect of the three heavy metals, subjects were categorized into quartiles. Sarcopenia was defined according to the criteria for the Asia Working Group for Sarcopenia (AWGS) (SMI<5.4 kg/m(2) in females and <7.0 kg/m(2) in males)., Results: Of 704 elderly persons (344 in males and 360 in females), prevalences of sarcopenia were 26.7% (92/344) in male and 7.5% (27/360) in female. Mean serum levels of lead in sarcopenia group were significantly higher than non-sarcopenia males (P=0.03). After adjustment for confounding factors, odds ratio for sarcopenia were increased with concentration category of lead (P=0.005 and P<0.001), mercury (P=0.001 and P<0.001) and cadmium (P=0.010 and P<0.001) in males and females, respectively., Conclusions: This study demonstrates that high levels of blood lead, mercury and cadmium increase the prevalence of sarcopenia in both genders of elderly populations.