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Insulin Resistance and Muscle Strength in Older Persons

¹ Department of Geriatric Medicine and Metabolic Diseases II, University of Naples, Italy.
² Laboratory of Clinical Epidemiology, Istituto Nazionale Riposo e Cura Anziani (INRCA), Geriatrics Department, Florence, Italy.
³ Longitudinal Studies Section, National Institute on Aging, Baltimore, Maryland.
⁴ Geriatrics Department, University of Parma, Italy.

Address correspondence to Giuseppe Paolisso, MD, Department of Geriatric Medicine and Metabolic Diseases, VI Divisione di Medicina Interna, Piazza Miraglia 2, I-80138 Napoli, Italy. E-mail:giuseppe.paolisso{at}unina2.it

Background. The functional consequences of an age-related insulin resistance (IR) state on muscle functioning are unknown. Because insulin is needed for adequate muscle function, an age-related insulin-resistant state may also be a determining factor. We evaluated the relationship between IR and handgrip muscle strength in men and women from a large population-based study (n = 968).

Methods. The degree of IR was evaluated by the homeostasis model assessment (HOMA) and muscle strength was assessed using handgrip.

Results. Simple sex-stratified correlations demonstrated that, in men, body mass index-adjusted handgrip strength correlated positively with physical activity (r = 0.321; p <.001), muscle area (r = 0.420; p <.001), muscle density (r = 0.263; p =.001), plasma albumin (r = 0.156; p =.001), insulin-like growth factor-1 (r = 0.258; p <.001), calcium (r = 0.140; p =.006), and testosterone (r = 0.325; p <.001) concentrations, whereas a negative association was found for age (r = –0.659; p <.001) and myoglobin plasma levels (r = –0.164; p =.001). In women, body mass index-adjusted handgrip strength correlated positively with physical activity (r = 0.280; p <.001), muscle area (r = 0.306; p <.001), muscle density (r = 0.341; p =.001), plasma albumin (r = 0.140; p =.001), and insulin-like growth factor-1 (r = 0.300; p <.001), whereas a negative association was found for age (r = –0.563; p <.001), myoglobin levels (r = –0.164; p =.001), and IR (r = –0.130; p =.04).

Conclusions. Sex-stratified analyses adjusted for multiple confounders showed that the relationship between IR and handgrip strength was found significant in women, whereas it was negligible and not significant in men.