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Diabetes Care. 2009 Apr;32(4):736-8. doi: 10.2337/dc08-1781. Epub 2009 Jan 26.

Insulin resistance is associated with decreased quadriceps muscle strength in nondiabetic adults aged >or=70 years.

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  • 1Division of Endocrinology, Kaiser Permanente of Georgia, Emory University School of Medicine, Atlanta, Georgia, USA.



Lower-limb muscle strength is reduced in many people with diabetes. In this study, we examined whether quadriceps muscle strength is reduced in relation to insulin resistance in well-functioning ambulatory nondiabetic individuals.


Participants (age >or=70 years) underwent dual-energy X-ray absorptiometry (DEXA) scanning to ascertain muscle and fat mass, tests of quadriceps strength, computed tomography scanning of the quadriceps to gauge muscle lipid content, and fasting insulin and glucose level measurements from which homeostasis model assessment of insulin resistance (HOMA-IR) was derived.


In regression analysis, quadriceps strength per kilogram of muscle mass was negatively associated (P < 0.0001) with HOMA-IR independent of other factors negatively associated with strength such as increased age, female sex, low-physical activity, impaired fasting glucose, and increased total body fat. Muscle lipid content was not associated with strength.


A small decrease in quadriceps muscle force is associated with increased HOMA-IR in well-functioning nondiabetic adults, suggesting that diminished quadriceps muscle strength begins before diabetes.

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