Strong Relation Between Muscle Mass Determined by D3-creatine Dilution, Physical Performance, and Incidence of Falls and Mobility Limitations in a Prospective Cohort of Older Men

Cawthon, Peggy M.; Orwoll, Eric S.; Peters, Katherine W.; Ensrud, Kristine E.; Cauley, Jane A.; Kado, Deborah M.; Stefanick, Marcia L.; Shikany, James M.; Strotmeyer, Elsa S.; Glynn, Nancy W.; Caserotti, Paolo; Shankaran, Mahalakshmi; Hellerstein, Marc K.; Cummings, Steven R.; Evans, William J.

doi:10.1093/gerona/gly129

Cited by 179 publications

(180 citation statements)

References 39 publications

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“…The D 3 ‐creatine (D 3 Cr) dilution method is a direct assessment of muscle mass . We found that low D 3 Cr muscle mass is strongly related to poor physical performance and subsequent falls and mobility problems in older men, but these relationships were not observed using DXA measures of lean body mass .…”

Section: Introductionmentioning

confidence: 90%

Association of change in muscle mass assessed by D₃‐creatine dilution with changes in grip strength and walking speed

Duchowny

Peters

Cummings

et al. 2019

J cachexia sarcopenia muscle

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Background Muscle mass declines with age. However, common assessments used to quantify muscle mass are indirect. The D3‐creatine (D3Cr) dilution method is a direct assessment of muscle mass; however, longitudinal changes have not been examined in relation to changes in other measures of muscle mass, strength, and performance. Methods A convenience sample of 40 men from the Osteoporotic Fractures in Men Study (mean age = 83.3 years, standard deviation = 3.9) underwent repeat assessment of D3Cr muscle mass, dual‐energy X‐ray absorptiometry (DXA) lean mass, grip strength, and walking speed at two time points approximately 1.6 years apart (2014–2016). One‐sample t‐tests and Pearson correlations were used to examine changes in DXA total body lean mass, DXA appendicular lean mass/height2, DXA appendicular lean mass/weight, D3Cr muscle mass, D3Cr muscle mass/weight, grip strength, walking speed, and weight. Results D3‐creatine muscle mass, D3Cr muscle mass/weight, grip strength, and walking speed all significantly declined (all P < 0.01). The change in DXA measures of lean mass was moderately correlated with changes in D3Cr muscle mass. There was no significant correlation between the change in DXA measures of lean mass and change in walking speed (all P > 0.05). The change in D3Cr muscle mass/weight was moderately correlated with change in walking speed (r = 0.33, P < .05). The change in grip strength was weakly correlated with the change in DXA measures of lean mass and D3Cr muscle mass (r = 0.19–0.32). Conclusions The results of our study provide new insights regarding the decline in muscle strength and D3Cr muscle mass. The D3Cr method may be a feasible tool to measure declines in muscle mass over time.

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Section: Introductionmentioning

confidence: 90%

Association of change in muscle mass assessed by D₃‐creatine dilution with changes in grip strength and walking speed

Duchowny

Peters

Cummings

et al. 2019

J cachexia sarcopenia muscle

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“…While each component of body composition varies by age, sex, and medical condition, muscle mass is about 50% of lean mass. The non‐muscle components of lean mass is termed residual lean mass …”

Section: Lean Body Mass (Also Referred To As Fat Free Mass)mentioning

confidence: 99%

“…Newly published data from the ongoing MrOS study demonstrate that in older men, those with the lowest muscle mass/weight by D 3 ‐Cr dilution have the highest risk of incident mobility limitation and injurious falls, and much worse physical performance and lower strength than those with higher muscle mass. These associations were not explained by confounding factors such as age, co‐morbidities, or activity level.…”

Section: Lean Body Mass (Also Referred To As Fat Free Mass)mentioning

confidence: 99%

“…A particular value of D 3 ‐creatine dilution is that it can be assessed in large number of subjects with very little subject burden. A subject simply swallows a capsule and produces a fasting urine sample later . This ease of use may allow the D 3 ‐creatine dilution method to be used in large subject and patient populations including many where CT or MRI cannot be used, such as paediatric or international studies in malnourished populations.…”

Section: Lean Body Mass (Also Referred To As Fat Free Mass)mentioning

confidence: 99%

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D₃‐Creatine dilution and the importance of accuracy in the assessment of skeletal muscle mass

Evans

Hellerstein

Orwoll

et al. 2019

J cachexia sarcopenia muscle

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137

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Sarcopenia has been described as the age‐associated decrease in skeletal muscle mass. However, virtually every study of sarcopenia has measured lean body mass (LBM) or fat free mass (FFM) rather than muscle mass, specifically. In a number of published sarcopenia studies, LBM or FFM is referred to as muscle mass, leading to an incorrect assumption that measuring LBM or FFM is an accurate measure of muscle mass. As a result, the data on the effects of changes in LBM or FFM in older populations on outcomes such as functional capacity, disability, and risk of injurious falls have been inconsistent resulting in the conclusion that muscle mass is only weakly related to these outcomes. We review and describe the assumptions for the most commonly used measurements of body composition. Dual‐energy X‐ray absorptiometry (DXA) has become an increasingly common tool for the assessment of LBM or FFM and appendicular lean mass as a surrogate, but inaccurate, measurement of muscle mass. Other previously used methods (total body water, bioelectric impedance, and imaging) also have significant limitations. D 3 ‐Creatine (D 3 ‐Cr) dilution provides a direct and accurate measurement of creatine pool size and skeletal muscle mass. In a recent study in older men (MrOS cohort), D 3 ‐Cr muscle mass was associated with functional capacity and risk of injurious falls and disability, while assessments of LBM or appendicular lean mass by DXA were only weakly or not associated with these outcomes. Inaccurate measurements of muscle mass by DXA and other methods have led to inconsistent results and potentially erroneous conclusions about the importance of skeletal muscle mass in health and disease. The assessment of skeletal muscle mass using the D 3 ‐Cr dilution method in prospective cohort studies may reveal sarcopenia as a powerful risk factor for late life disability and chronic disease.

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“…Practically, there seems little point in spending up to 10 minutes acquiring a DXA whole body scan in addition to a 30 second hip assessment, when it will add no additional risk information. Other modalities of muscle assessment, such as peripheral quantitative computed tomography,[16] or labeled creatine dilution,[17] might contribute to prediction of fracture independently of DXA BMD, and investigations of the value of these indices in large cohorts, considering also DXA BMD and FRAX probability, are warranted.…”

Section: Editorialmentioning

confidence: 99%

Appendicular lean mass and fracture risk assessment: implications for FRAX® and sarcopenia

et al. 2019

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The vast majority of current sarcopenia definitions use DXA-derived appendicular lean mass (DXA ALM) as an approximation of muscle mass. However, there is increasing evidence that ALM is poorly predictive of incident fractures. In this editorial, we describe findings from several cohorts suggesting that DXA ALM gives only limited information on the risk of incident fracture, and that in the US MrOS, WHI and Health ABC cohorts, accounting for femoral neck bone mineral density may entirely remove ALM-fracture associations. These observations raise important questions about the role of DXA ALM both in sarcopenia definitions and as a potential input variable for FRAX. We conclude that DXA ALM is unlikely to be a useful addition to the FRAX tool, but that other means of estimating muscle mass, such as those derived from creatine dilution or peripheral quantitative CT, might offer more value for fracture risk assessment.

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Strong Relation Between Muscle Mass Determined by D3-creatine Dilution, Physical Performance, and Incidence of Falls and Mobility Limitations in a Prospective Cohort of Older Men

Abstract: Unlike DXA lean mass, low D3Cr muscle mass/body mass is strongly related to physical performance, mobility and incident injurious falls in older me.

Cited by 179 publications

References 39 publications

Association of change in muscle mass assessed by D₃‐creatine dilution with changes in grip strength and walking speed

Association of change in muscle mass assessed by D₃‐creatine dilution with changes in grip strength and walking speed

D₃‐Creatine dilution and the importance of accuracy in the assessment of skeletal muscle mass

Appendicular lean mass and fracture risk assessment: implications for FRAX® and sarcopenia

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Strong Relation Between Muscle Mass Determined by D3-creatine Dilution, Physical Performance, and Incidence of Falls and Mobility Limitations in a Prospective Cohort of Older Men

Abstract: Unlike DXA lean mass, low D3Cr muscle mass/body mass is strongly related to physical performance, mobility and incident injurious falls in older me.

Cited by 179 publications

References 39 publications

Association of change in muscle mass assessed by D3‐creatine dilution with changes in grip strength and walking speed

Association of change in muscle mass assessed by D3‐creatine dilution with changes in grip strength and walking speed

D3‐Creatine dilution and the importance of accuracy in the assessment of skeletal muscle mass

Appendicular lean mass and fracture risk assessment: implications for FRAX® and sarcopenia

Contact Info

Product

Resources

About

Association of change in muscle mass assessed by D₃‐creatine dilution with changes in grip strength and walking speed

Association of change in muscle mass assessed by D₃‐creatine dilution with changes in grip strength and walking speed

D₃‐Creatine dilution and the importance of accuracy in the assessment of skeletal muscle mass