Muscle mass assessed by the D3-creatine dilution method and incident self-reported disability and mortality in a prospective observational study of community-dwelling older men
Open accessAbstract
BACKGROUND: Whether low muscle mass is a risk factor for disability and mortality is unclear. Associations between approximations of muscle mass (including lean mass from dual-energy x-ray absorptiometry [DXA]), and these outcomes are inconsistent. METHODS: Muscle mass measured by deuterated creatine (D3Cr) dilution and appendicular lean mass (ALM, by DXA) were assessed at the Year 14 Visit (2014-2016) of the prospective Osteoporotic Fractures in Men study (N = 1,425, age 77-101 years). Disability in activities of daily living (ADLs), instrumental ADLs, and mobility tasks was self-reported at the Year 14 visit and 2.2 years later; deaths were centrally adjudicated over 3.3 years. Relative risks and 95% confidence intervals (CI) were estimated per standard deviation decrement with negative binomial, logistic regression, or proportional hazards models. RESULTS: In age- and clinical center-adjusted models, the relative risks per decrement in D3Cr muscle mass/wgt was 1.9 (95% CI: 1.2, 3.1) for incident self-reported ADL disability; 1.5 (95% CI: 1.3, 1.9) for instrumental ADL disability; and 1.8 (95% CI: 1.5, 2.2) for mobility disability. In age-, clinical center-, and weight-adjusted models, the relative risks per decrement in D3Cr muscle mass was 1.8 (95% CI: 1.5, 2.2) for all-cause mortality. In contrast, lower DXA ALM was not associated with any outcome. Associations of D3Cr muscle mass with these outcomes were slightly attenuated after adjustment for confounding factors and the potentially mediating effects of strength and physical performance. CONCLUSIONS: Low muscle mass as measured by D3Cr dilution is a novel risk factor for clinically meaningful outcomes in older men.
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When using D3-Creatine Dilution Method, the association between muscle mass and disability is significant.
“In fact, when using D3-Creatine Dilution Method the association between muscle mass and disability is signi fi cant [105].”
From Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement (2022) · cites this paper as [105]
The reason for the shift in focus is heterogeneity in the association of lean mass with mortality, muscle function, and mobility limitations.
“The reason for the shift in focus is the aforementioned heterogeneity in the association of lean mass with mortality, muscle function, and mobility limitations.[48][49][50][51][52]”
From Changes in lean body mass with <scp>glucagon‐like peptide</scp> ‐1‐based therapies and mitigation strategies (2024) · cites this paper as [51]
Some studies suggest that the predictive value of lean mass is limited and focus should be on muscle strength and function; others recognize a link between amount of active muscle tissue and adverse outcomes, but this relationship is obscured because lean mass is too confounded and does not accurately measure muscle mass.
“Some studies suggest that the predictive value of lean mass is limited and the focus should be on muscle strength and function instead; whereas others recognize a link between the amount of active muscle tissue and adverse outcomes, but that this relationship is obscured by the fact that lean mass is too confounded and does not accurately measure muscle mass.49,51,53”
From Changes in lean body mass with <scp>glucagon‐like peptide</scp> ‐1‐based therapies and mitigation strategies (2024) · cites this paper as [51]
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- Authors
- Cawthon, P. M., Blackwell, T., Cummings, S. R., Orwoll, E. S., Duchowny, K. A., Kado, D. M., Stone, K. L., Ensrud, K. E., Cauley, J. A., & Evans, W. J.
- Affiliations
- University of California, San Francisco (US)
- California Pacific Medical Center (US)
- Oregon Health & Science University (US)
- University of California San Diego (US)
- University of Minnesota (US)
- University of Pittsburgh (US)
- Duke University (US)
- Corresponding author
- Cawthon, Peggy M
- ORCID
- Venue
- The Journals of Gerontology: Series A
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-05-22
- Volume
- 76
- Issue
- 1
- Pages
- 123-130
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- PMC
- PMC7756711
- OpenAlex
- W3026577928
- Cited by
- 105
- References
- 35
- Citations by year
- 2026: 6 · 2025: 16 · 2024: 20 · 2023: 24 · 2022: 18 · 2021: 14 · 2020: 7
- FWCI
- 9.46
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging
- National Center for Advancing Translational Sciences
- NIH Roadmap for Medical Research (U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, UL1 TR000128)
- NIAMS (R01 AR065268)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- muscle mass, appendicular lean mass, dual-energy X-ray absorptiometry, disability, activities of daily living, instrumental activities of daily living, mobility impairment, all-cause mortality, older men, sarcopenia, Osteoporotic Fractures in Men Study
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Creatine, Deuterium, Disability Evaluation, Humans, Indicator Dilution Techniques, Male, Organ Size, Prospective Studies, Muscle, Skeletal, Sarcopenia, Independent Living, Diagnostic Self Evaluation
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