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

 Hye-Sun Park  ;  Jung Soo Lim  ;  Sung-Kil Lim 
 Yonsei Medical Journal, Vol.60(8) : 742-750, 2019 
Journal Title
 Yonsei Medical Journal 
Issue Date
Aged ; Body Mass Index ; Bone Density/physiology ; Bone and Bones/anatomy & histology* ; Cross-Sectional Studies ; Diabetes Mellitus/physiopathology ; Female ; Hand Strength/physiology ; Humans ; Insulin Resistance* ; Muscle Strength/physiology* ; Muscle, Skeletal/anatomy & histology* ; Muscle, Skeletal/physiology* ; Organ Size ; Osteoporosis/physiopathology ; Postmenopause/physiology* ; Republic of Korea
Muscle ; bone mass ; insulin resistance ; sarcopenia
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lim, Sung Kil(임승길)
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