The Correlations between Extremity Circumferences with Total and Regional Amounts of Skeletal Muscle and Muscle Strength in Obese Women with Type 2 Diabetes

Abstract

Background: Insulin resistance is related to central obesity and the amount of skeletal muscle. A simple and practical anthropometric marker for muscle mass is not known, although waist circumference (WC) is used as an indicator of abdominal obesity. The aims of this study were to investigate whether arm (AC) and thigh circumferences (TC) can be used as an indicator of muscle mass and if they are related to muscle strength. Methods: A total of 110 obese (body mass index [BMI]≥25 kg/m 2 ) women with type 2 diabetes were enrolled, and WC, AC, and TC were measured. Abdominal visceral fat (AVF), subcutaneous fat (ASF), and total fat (ATF) were assessed by computed tomography, regional muscle (MM), and fat mass by dual-energy X-ray absorptiometry, muscle strength by one repetition maximum (1RM) of both extremities (chest and leg press) and insulin resistance by KITT. Results: The mean age was 56.2±7.3 years, duration of diabetes was 4.2±4.4 years, and BMI was 27.2±2.8 kg/m 2 . WC was correlated with ATF, AVF, and ASF (r=0.728, P<0.001; r=0.515, P<0.001; r=0.608, P<0.001, respectively). Arm MM was correlated with AC (r=0.500, P<0.001), and leg MM with TC (r=0.291, P=0.002). Upper 1RM was related to AC/WC ratio (r=0.359, P<0.001), and lower 1RM was to TC/WC ratio (r=0.286, P=0.003). Insulin resistance had significant relations with AVF, WC, and total MM (r=-0.262, P=0.008; r=-0.217, P=0.029; r=0.160, P=0.031, respectively). Conclusion: The muscle mass was related to extremity circumferences, and muscle strength was to extremity/waist circumference ratio in obese women with type 2 diabetes.

Relationship of calf circumference with bone mineral density and hip geometry: a hospital-based cross-sectional study

“…The inconsistent association of TC compared to CC may be due to higher fat content of thigh muscles. The findings of our study is supported by previous study by Kwon et al which showed that TC has significant but poor correlations with total muscle mass compared to mid arm circumference [28].…”

“…There is good correlation of all circumference measures with muscle mass, and the correlation is independent of weight, height, and BMI [26][27][28]. Several previous studies have shown significantly strong positive association of lean muscle mass with BMD at hip and spine in both genders and hip geometry in male.…”

“…Similar to lean muscle mass, muscle strength and physical activity are associated with BMD and proximal hip strength [24,25] and muscle mass correlates significantly with extremity circumferences and muscle strength [26][27][28]. Calf circumference also is a known predictor of fall [29].…”

Creatine kinase in the U.S. population

“…Waist circumference correlates with fat mass, and mid-upper arm circumference correlates more strongly with muscle mass. [13,14] …”

Diabetes Mellitus tipo 2: caracterização da assistência à saúde, parâmetros clínicos e estado nutricional de idosos em uma Unidade Básica de Saúde, em dois períodos de acompanhamento

“…Kwon et al (2011) salientam a associação da circunferência da coxa ao metabolismo da glicose e resistência à insulina.…”