, Volume 35, Issue 6, pp 2367–2375 | Cite as

Diagnostic criteria for sarcopenia relate differently to insulin resistance

  • A. Y. Bijlsma
  • C. G. M. Meskers
  • D. van Heemst
  • R. G. J. Westendorp
  • A. J. M. de Craen
  • A. B. MaierEmail author


Skeletal muscle is important in insulin-stimulated glucose uptake. Sarcopenia is, therefore, a possible risk factor for insulin resistance. Currently, different diagnostic criteria for sarcopenia include low muscle mass, muscle strength, and walking speed. We assessed these muscle characteristics in relation to insulin resistance in nondiabetics. This cross-sectional study included 301 nondiabetics, mean age 65.9 years. Area under curve (AUC) calculations of insulin and glucose from a 2-h oral glucose tolerance test (OGTT) and homeostasis model assessment of insulin resistance (HOMA-IR) were used as measures of insulin resistance. Muscle characteristics were relative muscle mass (total or appendicular lean mass (ALM) as percentage of body mass), absolute muscle mass (ALM/height2 and total lean mass), handgrip strength, and walking speed. All muscle characteristics were standardized and analyzed in linear regression models, stratified by gender. For both males and females, relative muscle mass was inversely associated with AUC insulin, AUC glucose, and HOMA-IR (ALM percentage all p ≤ 0.004). Absolute muscle mass was positively associated with AUC insulin and HOMA-IR (ALM/height2 all p < 0.001) but not with AUC glucose. Adjustments for fat mass attenuated aforementioned associations. There were no associations between handgrip strength and insulin resistance. Walking speed was inversely associated with AUC insulin in males (p = 0.032). The association between muscle characteristics and insulin resistance was strongest for relative muscle mass. Diagnostic criteria for sarcopenia relate differently to insulin resistance. The role of muscle tissue as an internal glucose-regulating organ is better reflected by relative muscle mass than by absolute muscle mass, muscle strength, or walking speed.


Sarcopenia Muscle characteristics Insulin resistance Body composition Aging 



This study was supported by an unrestricted grant from the Netherlands Organization of Scientific Research (ZonMw); the Ministry of Health, Welfare and Sports; the Netherlands Genomics Initiative/Netherlands Organization for Scientific Research (NGI/NWO; 05040202 and 050-060-810 Netherlands Consortium for Healthy Aging (NCHA)); the European Commission funded project MYOAGE (FP7, HEALTH-2007-2.4.5-10); and Switchbox (FP7, Health-F2-2010-259772).


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Copyright information

© American Aging Association 2013

Authors and Affiliations

  • A. Y. Bijlsma
    • 1
    • 2
  • C. G. M. Meskers
    • 3
  • D. van Heemst
    • 2
  • R. G. J. Westendorp
    • 2
    • 4
  • A. J. M. de Craen
    • 2
    • 4
  • A. B. Maier
    • 1
    • 4
    Email author
  1. 1.Department of Internal Medicine, Section of Gerontology and GeriatricsVU University Medical CenterAmsterdamThe Netherlands
  2. 2.Department of Gerontology and GeriatricsLeiden University Medical CentreLeidenThe Netherlands
  3. 3.Department of Rehabilitation MedicineLeiden University Medical CentreLeidenThe Netherlands
  4. 4.Netherlands Consortium for Healthy AgingLeiden University Medical CentreLeidenThe Netherlands

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