Insulin Resistance Is Associated With Decreased Quadriceps Muscle Strength in Nondiabetic Adults Aged ≥70 Years
- Joshua I. Barzilay, MD1,
- George A. Cotsonis, MS2,
- Jeremy Walston, MD3,
- Ann V. Schwartz, PHD4,
- Suzanne Satterfield, MD, DRPH5,
- Iva Miljkovic, MD, PHD6,
- Tamara B. Harris, MD7 and
- for the Health ABC Study
- 1Kaiser Permanente of Georgia and the Division of Endocrinology, Emory University School of Medicine, Atlanta, Georgia;
- 2Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia;
- 3Department of Geriatrics, Johns Hopkins Medical Institutions, Baltimore, Maryland;
- 4Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California;
- 5Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee;
- 6Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, Pennsylvania;
- 7Geriatric Epidemiology Section, Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland.
- Corresponding author: Joshua Barzilay, Joshua.barzilay{at}kp.org.
Abstract
OBJECTIVE Lower-limb muscle strength is reduced in many people with diabetes. In this study, we examined whether quadriceps muscle strength is reduced in relation to insulin resistance in well-functioning ambulatory nondiabetic individuals.
RESEARCH DESIGN AND METHODS Participants (age ≥70 years) underwent dual-energy X-ray absorptiometry (DEXA) scanning to ascertain muscle and fat mass, tests of quadriceps strength, computed tomography scanning of the quadriceps to gauge muscle lipid content, and fasting insulin and glucose level measurements from which homeostasis model assessment of insulin resistance (HOMA-IR) was derived.
RESULTS In regression analysis, quadriceps strength per kilogram of muscle mass was negatively associated (P < 0.0001) with HOMA-IR independent of other factors negatively associated with strength such as increased age, female sex, low-physical activity, impaired fasting glucose, and increased total body fat. Muscle lipid content was not associated with strength.
CONCLUSIONS A small decrease in quadriceps muscle force is associated with increased HOMA-IR in well-functioning nondiabetic adults, suggesting that diminished quadriceps muscle strength begins before diabetes.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received September 28, 2008.
- Accepted January 7, 2009.
- © 2009 by the American Diabetes Association.
