Association of muscle mass measured by D 3 -Creatine (D 3 Cr), sarcopenic obesity, and insulin-glucose homeostasis in postmenopausal women

• Published in: PloS one 2022-12, Vol.17 (12)
• Main Authors: Banack, Hailey, LaMonte, Michael, Manson, JoAnn, Zhu, Kexin, Evans, William, Shankaran, Mahalakshmi, Wactawski-Wende, Jean
• Format: Article
• Language: English
• Subjects: Blood pressure; Body fat; Body weight; Consent; Creatine; Creatinine; Diabetes; Dilution; Fasting; Glucose; Hemoglobin; Homeostasis; Hyperglycemia; Insulin; Insulin resistance; Laboratories; Muscles; Musculoskeletal system; Obesity; Older people; Post-menopause; Regression analysis; Regression models; Sarcopenia; Skeletal muscle; Urine; Womens health
• ISSN: 1932-6203
• DOI: 10.1371/journal.pone.0278723

The D 3 -Creatine (D 3 Cr) dilution method is a direct and accurate measure of skeletal muscle mass. In this study, we examined the association of D 3 Cr muscle mass with measures of insulin-glucose homeostasis in community dwelling postmenopausal women. Additionally, we examined association of sarcopenic obesity, defined as low D 3 Cr muscle mass and high percent body fat, with fasting plasma glucose, insulin, hemoglobin A1c and insulin resistance. Insulin resistance was measured by the homeostatic measure of insulin resistance (HOMA-IR). This pilot study included 74 participants (mean age = 82.3 years) from the Women’s Health Initiative-Buffalo site. The D 3 Cr method was initiated at a clinic visit and used to measure muscle mass via remote urine sample collection. Descriptive and graphical approaches and age-adjusted linear regression models were used to analyze study data. We examined muscle mass as an absolute value (kg) and scaled to body weight (D 3 Cr muscle mass/kg). There was an inverse relationship between skeletal muscle mass, and impaired insulin-glucose homeostasis. Women with low muscle mass had higher levels of insulin (uIU/mL; β = -0.40; 95% CI: -0.79, -0.01), fasting plasma glucose (mg/dL; β = -0.1; 95% CI: -0.2, 0.03), HbA1c (%; β = -2.30; 95% CI: -5.7, 1.1), and calculated homeostatic model of insulin resistance, HOMA-IR, (β = -1.49; 95% CI: -2.9, -0.1). Sarcopenic obesity was common in this population of women; 41% of participants were categorized as having low muscle mass and high percent body fat. Results demonstrate that D 3 Cr muscle mass is independently associated with measures of insulin-glucose homeostasis, but obesity is a stronger predictor of insulin resistance than muscle mass.