Appendicular Skeletal Muscle Mass and Insulin Resistance in an Elderly Korean Population: The Korean Social Life, Health and Aging Project-Health Examination Cohort

Background Increasing evidence supports an association between age-related loss of muscle mass and insulin resistance. However, the association has not been fully investigated in the general population. Thus, we investigated the association between appendicular skeletal muscle mass (ASM) and insulin resistance in an elderly Korean population. Methods This cross-sectional study included 158 men (mean age, 71.8) and 241 women (mean age, 70.6) from the Korean Social Life, Health and Aging Project, which started in 2011. In this study, ASM was measured by bioelectrical impedance analysis and was analyzed in three forms: ASM (kg), ASM/height2 (kg/m2), and ASM/weight (%). The homeostasis model assessment of insulin resistance (HOMA-IR) was used as a measure of insulin resistance. The relationships between the ASM values and the HOMA-IR were investigated by multiple linear regression models. Results The HOMA-IR was positively associated with ASM (β=0.43, P<0.0001) and ASM/height2 (β=0.36, P<0.0001) when adjusted for sex and age. However, after additional adjustment for body weight, HOMA-IR was inversely associated with ASM (β=-0.43, P<0.001) and ASM/height2 (β=-0.30, P=0.001). Adjustment for other potential confounders did not change these associations. Conversely, HOMA-IR was consistently and inversely associated with ASM/weight before and after adjustment for other potential confounders. Conclusion Our results support the idea that lower skeletal muscle mass is independently associated with insulin resistance in older adults. When evaluating sarcopenia or muscle-related conditions in older adults, their whole body sizes also need to be considered.

[1]  H. Astiazarán-García,et al.  Association between insulin resistance and low relative appendicular skeletal muscle mass: evidence from a cohort study in community-dwelling older men and women participants. , 2014, The journals of gerontology. Series A, Biological sciences and medical sciences.

[2]  N. H. Cho,et al.  Assessment of appendicular skeletal muscle mass by bioimpedance in older community-dwelling Korean adults. , 2014, Archives of gerontology and geriatrics.

[3]  L. Peng,et al.  Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. , 2014, Journal of the American Medical Directors Association.

[4]  Chia-Wen Lu,et al.  Sarcopenic obesity is closely associated with metabolic syndrome. , 2013, Obesity research & clinical practice.

[5]  O. Beauchet,et al.  Low skeletal muscle mass and risk of functional decline in elderly community-dwelling women: the prospective EPIDOS study. , 2013, Journal of the American Medical Directors Association.

[6]  H. J. Yoo,et al.  Relationships between sarcopenic obesity and insulin resistance, inflammation, and vitamin D status: the Korean Sarcopenic Obesity Study , 2013, Clinical endocrinology.

[7]  R. Westendorp,et al.  Diagnostic criteria for sarcopenia relate differently to insulin resistance , 2013, AGE.

[8]  Yong-jun Choi,et al.  Prevalence of sarcopenia and sarcopenic obesity in the Korean population based on the Fourth Korean National Health and Nutritional Examination Surveys. , 2012, The journals of gerontology. Series A, Biological sciences and medical sciences.

[9]  T. Abe,et al.  Relationship between site-specific loss of thigh muscle and gait performance in women: the HIREGASAKI study. , 2012, Archives of gerontology and geriatrics.

[10]  N. Paik,et al.  Association between muscle strength and metabolic syndrome in older Korean men and women: the Korean Longitudinal Study on Health and Aging. , 2012, Metabolism: clinical and experimental.

[11]  G. Paolisso,et al.  Discovering pathways of sarcopenia in older adults: A role for insulin resistance on mitochondria dysfunction , 2011, The journal of nutrition, health & aging.

[12]  A. Karlamangla,et al.  Relative muscle mass is inversely associated with insulin resistance and prediabetes. Findings from the third National Health and Nutrition Examination Survey. , 2011, The Journal of clinical endocrinology and metabolism.

[13]  Sandrine Andrieu,et al.  Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. , 2011, Journal of the American Medical Directors Association.

[14]  K. Kohara,et al.  Arterial stiffness is associated with low thigh muscle mass in middle-aged to elderly men. , 2010, Atherosclerosis.

[15]  M. Roden,et al.  Mitochondrial Function and Insulin Resistance during Aging – A Mini-Review , 2010, Gerontology.

[16]  A. Hevener,et al.  Sarcopenia Exacerbates Obesity-Associated Insulin Resistance and Dysglycemia: Findings from the National Health and Nutrition Examination Survey III , 2010, PloS one.

[17]  K. Park,et al.  Sarcopenic Obesity: Prevalence and Association With Metabolic Syndrome in the Korean Longitudinal Study on Health and Aging (KLoSHA) , 2010, Diabetes Care.

[18]  H. J. Yoo,et al.  Prevalence of sarcopenia and sarcopenic obesity in Korean adults: the Korean sarcopenic obesity study , 2009, International Journal of Obesity.

[19]  F. Toledo,et al.  Physical Inactivity and Obesity Underlie the Insulin Resistance of Aging , 2009, Diabetes Care.

[20]  G. Jensen.  Inflammation: roles in aging and sarcopenia. , 2008, JPEN. Journal of parenteral and enteral nutrition.

[21]  R. Ross,et al.  Whole-body skeletal muscle mass is not related to glucose tolerance or insulin sensitivity in overweight and obese men and women. , 2008, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[22]  C. Gazzaruso,et al.  Nutritional supplements with oral amino acid mixtures increases whole-body lean mass and insulin sensitivity in elderly subjects with sarcopenia. , 2008, The American journal of cardiology.

[23]  R. Roubenoff.  Physical activity, inflammation, and muscle loss. , 2007, Nutrition reviews.

[24]  L. Ferrucci,et al.  Oxidative stress and severe walking disability among older women. , 2007, The American journal of medicine.

[25]  W. Ambrosius,et al.  Sarcopenia, obesity, and inflammation--results from the Trial of Angiotensin Converting Enzyme Inhibition and Novel Cardiovascular Risk Factors study. , 2005, The American journal of clinical nutrition.

[26]  S. Kritchevsky,et al.  Leg Muscle Mass and Composition in Relation to Lower Extremity Performance in Men and Women Aged 70 to 79: The Health, Aging and Body Composition Study , 2002, Journal of the American Geriatrics Society.

[27]  I. Rosenberg,et al.  Sarcopenia: origins and clinical relevance. , 1997, The Journal of nutrition.

[28]  R. Turner,et al.  Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man , 1985, Diabetologia.

[29]  R. DeFronzo,et al.  The Effect of Insulin on the Disposal of Intravenous Glucose: Results from Indirect Calorimetry and Hepatic and Femoral Venous Catheterization , 1981, Diabetes.

[30]  S. Moon.  Low skeletal muscle mass is associated with insulin resistance, diabetes, and metabolic syndrome in the Korean population: the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2010. , 2014, Endocrine journal.

[31]  E. Ravussin,et al.  Ectopic lipid accumulation and reduced glucose tolerance in elderly adults are accompanied by altered skeletal muscle mitochondrial activity. , 2012, The Journal of clinical endocrinology and metabolism.

[32]  J. E. Morley,et al.  The I.A.N.A. task force on frailty assessment of older people in clinical practice , 2008, The journal of nutrition, health & aging.

[33]  Z. Redzic,et al.  Current Topics in Developmental Biology, Volume 71 , 2005 .

[34]  K. Nair,et al.  Sarcopenia of aging and its metabolic impact. , 2005, Current topics in developmental biology.

[35]  S. Kritchevsky,et al.  Research hypotheses on muscle wasting, aging, loss of function and disability. , 1998, The journal of nutrition, health & aging.