title: Association between insulin resistance and low relative appendicular skeletal muscle mass: evidence from a cohort study in community-dwelling older men and women participants.
abstract: BACKGROUND
  It has been hypothesized that insulin resistance plays a role in the development of the loss of skeletal muscle; however, no cohort studies on insulin resistance and low relative appendicular skeletal muscle mass (ASM) have been published to date. Thus, we examined whether insulin resistance is associated with low relative ASM after a 4.6-year follow-up period among apparently healthy older men and women participants.
  
  
  METHODS
  This is a combined retrospective-prospective cohort study, which includes 147 community-dwelling older men and women participants. ASM was measured by dual-energy x-ray absorptiometry at baseline and follow-up. Participants with a relative change in ASM below the sex-specific 15th value were classified as the low relative ASM group. Homeostatic model assessment was used to quantify insulin resistance. Logistic regression calculated odds ratios and 95% confidence intervals for development of low relative ASM, adjusted for covariates.
  
  
  RESULTS
  The loss of ASM in the low relative ASM and normal groups was -1.8kg and -0.35kg, respectively (p ≤ .05). The low relative ASM group was older and had higher insulin and homeostatic model assessment of insulin resistance values at baseline. The risk of developing low relative ASM at 4.6-year follow-up was 2.9 times higher (95% CI, 1.00-7.8; p = .04) among the participants with homeostatic model assessment of insulin resistance levels more than 2.3. After adjusting for age, the risk increased to 3.9 times higher (95% CI, 1.3-11.5; p = .03).
  
  
  CONCLUSIONS
  Insulin resistance was associated with low relative ASM at 4.6-year follow-up after accounting for several covariates in a cohort of apparently healthy, well-functioning young older men and women.
authors: Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo A.C., Hermosillo, Sonora, México. helio@ciad.mx.
authors: Heliodoro
authors: H
authors: Alemán-Mateo
authors: Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo A.C., Hermosillo, Sonora, México.
authors: Miriam T
authors: MT
authors: López Teros
authors: Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo A.C., Hermosillo, Sonora, México.
authors: Fátima A
authors: FA
authors: Ramírez
authors: Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo A.C., Hermosillo, Sonora, México.
authors: Humberto
authors: H
authors: Astiazarán-García
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000375:Aging / Q000378:metabolism* / Q000473:pathology*; D001823:Body Composition; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology*; D011446:Prospective Studies; D012189:Retrospective Studies; D055948:Sarcopenia / Q000209:etiology / Q000378:metabolism / Q000473:pathology
keywords: Insulin resistance; Low relative appendicular skeletal muscle mass; Older adults.