Yonsei Med J.  2019 Aug;60(8):742-750. 10.3349/ymj.2019.60.8.742.

Determinants of Bone Mass and Insulin Resistance in Korean Postmenopausal Women: Muscle Area, Strength, or Composition?

• Park HS
• Lim JS
• Lim SK

• KMID: 2452955
• DOI: http://doi.org/10.3349/ymj.2019.60.8.742

Abstract

PURPOSE
Muscle mass, strength, and composition determine muscle quantity and quality. However, data on muscle properties in relation to bone mass or insulin resistance are limited in Asian populations. This study aimed to investigate the relative importance of muscle measurements in regards to their relationship with lower bone mass and insulin resistance.
MATERIALS AND METHODS
In this study, 192 postmenopausal women (age, 72.39±6.07 years) were enrolled. We measured muscle cross-sectional area (CSA) and attenuation at the gluteus maximus and quadriceps muscles through quantitative computed tomography. Muscle strength and physical performance were evaluated with the hand grip test and Short Physical Performance Battery (SPPB). Pearson correlation analysis and linear regression were performed to evaluate the relationship between muscle properties and homeostatic model assessment-insulin resistance (HOMA-IR) or bone mineral density (BMD).
RESULTS
Muscle CSA, hand grip strength, and SPPB score held positive correlations with spine and hip BMDs, but not with insulin resistance. In contrast, muscle attenuation of the gluteus maximus or quadriceps was inversely related to HOMA-IR (r=−0.194, p=0.018 and r=−0.292, p<0.001, respectively), but not BMD. Compared with the control group, muscle CSA was significantly decreased in patients with osteoporosis; however, decreased muscle attenuation, indicating high fat infiltration, was found only in patients with diabetes.
CONCLUSION
Muscle mass, strength, and physical performance were associated with low bone mass, and accumulation of intramuscular fat, a histological hallmark of persistently damaged muscles, may play a major role in the development of insulin resistance in Korean postmenopausal women.

Keyword

Muscle; sarcopenia; bone mass; insulin resistance

MeSH Terms

Asian Continental Ancestry Group
Bone Density
Female
Hand
Hand Strength
Hip
Humans
Insulin Resistance*
Insulin*
Linear Models
Muscle Strength
Muscles
Osteoporosis
Quadriceps Muscle
Sarcopenia
Spine
Insulin

Figure

• 

  Fig. 1 Scatterplot analysis of BMD with muscle CSA (A and B), hand grip strength (C), SPPB score (D), and muscle attenuation (E and F). Spine BMD and hip BMD according to SPPB score (G and H). BMD, bone mineral density; CSA, cross-sectional area; SPPB, Short Physical Performance Battery.

• 

  Fig. 2 Scatterplot analysis of HOMA-IR with muscle CSA (A and B), hand grip strength (C), SPPB score (D), and muscle attenuation (E and F). HOMA-IR, homeostatic model assessment-insulin resistance; CSA, cross-sectional area; SPPB, Short Physical Performance Battery.

• 

  Fig. 3 Muscle parameters in subjects with osteoporosis (A, B, and C) and diabetes (E, E, and F). Muscle CSA is shown in (A) and (D), physical performance in (B) and (E), and muscle composition in (C) and (F). *p≤0.05 versus non-osteoporotic (A, B, and C) or non-diabetic group (D, E, and F). CSA, cross-sectional area; HGT, hand grip test; SPPB, Short Physical Performance Battery.

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