期刊
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
卷 59, 期 7, 页码 1217-1224出版社
WILEY
DOI: 10.1111/j.1532-5415.2011.03472.x
关键词
older men; lean mass; fat mass; insulin resistance; body composition
资金
- National Institutes of Health [P30DK17047]
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
- National Institute on Aging (NIA)
- National Center for Research Resources (NCRR)
- NIH Roadmap for Medical Research [U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01 AG027810, UL1 RR024140]
- American Diabetes Association [1-04-JF-46]
OBJECTIVES: To examine the associations between insulin resistance and changes in body composition in older men without diabetes mellitus. DESIGN: Longitudinal cohort study of older men participating in the Osteoporotic Fractures in Men (MrOS) study. SETTING: Six U.S. clinical centers. PARTICIPANTS: Three thousand one hundred thirty-two ambulatory men aged 65 and older at baseline. MEASUREMENTS: Baseline insulin resistance was calculated for men without diabetes mellitus using the homeostasis model assessment of insulin resistance (HOMA-IR). Total lean, appendicular lean, total fat, and truncal fat mass were measured using dual energy X-ray absorptiometry scans at baseline and 4.6 perpendicular to 0.3 years later in 3,132 men with HOMA-IR measurements. RESULTS: There was greater loss of weight, total lean mass, and appendicular lean mass and less gain in total fat mass and truncal fat mass with increasing quartiles of HOMA-IR (P<.001 for trend). Insulin-resistant men in the highest quartile had higher odds of 5% or more loss of weight (odds ratio (OR) = 1.88, 95% confidence interval (CI) = 1.46-2.43), total lean mass (OR = 2.09, 95% CI = 1.60-2.73) and appendicular lean mass (OR = 1.57, 95% CI = 1.27-1.95) and lower odds of 5% or more gain in total fat mass (OR = 0.56, 95% CI = 0.45-0.68) and truncal fat mass (OR = 0.52, 95% CI = 0.42-0.64) than those in the lowest quartile. These findings remained significant after accounting for age, site, baseline weight, physical activity, and change in physical activity. These associations were also independent of other metabolic syndrome features and medications. CONCLUSION: Greater lean mass loss and lower fat mass gain occurred in insulin-resistant men without diabetes mellitus than in insulin-sensitive men. Insulin resistance may accelerate age-related sarcopenia. J Am Geriatr Soc 59:1217-1224, 2011.
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