Insulin resistance since early adulthood and appendicular lean mass in middle-aged adults without diabetes: 20 years of the CARDIA study

Victor W. Zhong, Michael P. Bancks, Pamela J. Schreiner, Cora E. Lewis, Lyn M. Steffen, James B. Meigs, Lauren A. Schrader, Melanie Schorr, Karen K. Miller, Stephen Sidney, Mercedes R. Carnethon

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3 Scopus citations

Abstract

Aims: To determine the association between 20-year trajectories in insulin resistance (IR) since young adulthood and appendicular lean mass (ALM) at middle-age in adults without diabetes. Methods: A prospective cohort study was designed among young and middle-aged US men (n = 925) and women (n = 1193). Fasting serum glucose and insulin were measured five times in 1985–2005. IR was determined using the homeostasis model assessment (HOMA). ALM was measured in 2005 and ALM adjusted for BMI (ALM/BMI) was the outcome. Sex-specific analyses were performed. Results: Three HOMA-IR trajectories were identified. Compared to the low-stable group, the adjusted ALM/BMI difference was −0.041 (95% CI: −0.060 to −0.022) and −0.114 (−0.141 to −0.086) in men, and −0.052 (−0.065 to −0.039) and −0.043 (−0.063 to −0.023) in women, respectively, for the medium-increase and high-increase groups. Further adjusting for the treadmill test duration attenuated these estimates to −0.022 (−0.040 to −0.004) and −0.061 (−0.089 to −0.034) in men and −0.026 (−0.038 to −0.014) and −0.007 (−0.026 to 0.012) in women. Conclusions: Compared to the low-stable insulin resistance trajectory between early and middle adulthood, the high-increase trajectory was associated with lower ALM/BMI in middle-aged men, but not women, without diabetes, after adjusting for cardiorespiratory fitness.

Original languageEnglish (US)
Pages (from-to)84-90
Number of pages7
JournalJournal of Diabetes and Its Complications
Volume33
Issue number1
DOIs
StatePublished - Jan 2019

Bibliographical note

Funding Information:
Funding information: This study was supported by the postdoctoral fellowship from the American Heart Association Strategically Focused Research Networks (14SFRN20480260). MPB was supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health under Award Numbers T32HL069771 to conduct the current work. JBM was supported by K24 DK080140.The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201300025C & HHSN268201300026C), Northwestern University (HHSN268201300027C), University of Minnesota (HHSN268201300028C), Kaiser Foundation Research Institute (HHSN268201300029C), and Johns Hopkins University School of Medicine (HHSN268200900041C). CARDIA is also partially supported by the Intramural Research Program of the National Institute on Aging (NIA) and an intra-agency agreement between NIA and NHLBI (AG0005). This manuscript has been reviewed by CARDIA for scientific content.

Funding Information:
The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201300025C & HHSN268201300026C), Northwestern University (HHSN268201300027C), University of Minnesota (HHSN268201300028C), Kaiser Foundation Research Institute (HHSN268201300029C), and Johns Hopkins University School of Medicine (HHSN268200900041C). CARDIA is also partially supported by the Intramural Research Program of the National Institute on Aging (NIA) and an intra-agency agreement between NIA and NHLBI (AG0005). This manuscript has been reviewed by CARDIA for scientific content.

Keywords

  • Appendicular lean mass
  • Diabetes
  • Early prevention
  • Insulin resistance
  • Sarcopenia

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