title: Glucose and insulin measurements from the oral glucose tolerance test and relationship to muscle mass.
abstract: BACKGROUND
  Diabetes is associated with decreased muscle mass. The effect of higher levels of glucose and insulin on muscle mass has not been studied in individuals without diabetes. We sought to determine the relationship of insulin and glucose measurements from the oral glucose tolerance test (OGTT) with muscle mass in persons without diabetes.
  
  
  METHODS
  We analyzed data from 587 participants in the Baltimore Longitudinal Study of Aging (mean age 67.3 years, range 26-95 years) without diabetes who underwent a 2-hour OGTT, including glucose and insulin measurements taken every 20 minutes and assessment of midthigh muscle cross-sectional area by computed tomography, taken as a proxy measure of muscle mass. Linear regression models and Bayesian model averaging were used to explore the independent cross-sectional association of various OGTT-derived measures and midthigh muscle cross-sectional area, independent of confounders.
  
  
  RESULTS
  Individually, fasting glucose, fasting insulin, OGTT glucose (40, 60, 80, 100, and 120 minutes), OGTT insulin (20, 60, 80, 100, and 120 minutes), homeostasis model assessment of insulin resistance, integrated glucose area, and integrated insulin area were inversely associated, and the Matsuda index was positively associated, with the midthigh muscle cross-sectional area (standardized to body weight) after adjustment for age, sex, race, height, physical activity, and peroneal motor nerve conduction velocity (all ps <.05). When considered together, the Matsuda index and fasting glucose were the strongest predictors of lower midthigh muscle cross-sectional area after covariate adjustment.
  
  
  CONCLUSIONS
  Higher fasting and OGTT values of both glucose and insulin are associated with lower muscle mass. Longitudinal studies are needed to verify whether individuals free of diabetes that have higher glucose and insulin during an OGTT are at risk for accelerated muscle mass decline with aging.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. rrastogi@jhmi.edu
authors.forename: Rita R
authors.initials: RR
authors.lastname: Kalyani
authors.forename: E Jeffrey
authors.initials: EJ
authors.lastname: Metter
authors.forename: Ramona
authors.initials: R
authors.lastname: Ramachandran
authors.forename: Chee W
authors.initials: CW
authors.lastname: Chia
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Saudek
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D005260:Female; D015577:Geriatric Assessment; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood* / Q000502:physiology; D007333:Insulin Resistance / Q000502:physiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000033:anatomy & histology* / Q000503:physiopathology; D009431:Neural Conduction / Q000502:physiology; D010543:Peroneal Nerve / Q000503:physiopathology; D013848:Thigh / Q000033:anatomy & histology / Q000503:physiopathology
chemical_list: D001786:Blood Glucose; D007328:Insulin