The Association of Muscle Mass Measured by D3-Creatine Dilution Method With Dual-Energy X-Ray Absorptiometry and Physical Function in Postmenopausal Women

Abstract

Background The D3-creatine (D3Cr) dilution method provides a direct measure of skeletal muscle. The aim of this study was to compare the association of D3Cr muscle mass with lean body mass (LBM) measured by dual energy x-ray absorptiometry (DXA) and examine its relation with physical function in postmenopausal women. Methods 74 community dwelling women (mean age 82.3±5.4) participated in this pilot study from the Buffalo, New York clinical site of the Women’s Health Initiative (WHI). Participants attended a clinic visit which included anthropometric measures, blood draw, DXA scan, measures of physical function, and initiated the D3Cr protocol. Physical function was evaluated using hand grip strength, short physical performance battery (SPPB), and RAND-36 physical function scale. Descriptive statistics and logistic regression models were used to examine the associations of D3Cr muscle mass with functional outcomes. Results D3Cr muscle mass was moderately correlated with DXA LBM (r = 0.50) and DXA appendicular lean mass (ALM) (r = 0.50). Individuals with high D3Cr muscle mass (%) had higher physical function compared to individuals with low muscle mass (%), indicated by high scores on SPPB (OR =5.24; 95% CI: 1.40, 19.58). We observed stronger relationships between high D3Cr and physical function than either DXA-LBM (OR=3.40; 95% CI: 0.88, 13.11) or DXA-ALM (OR=4.15; 95% CI: 1.10, 15.68) and physical function. Conclusions Our findings provide strong preliminary data for the associations of D3Cr muscle mass with measures of physical function in older women. These findings support and extend prior work on D3Cr muscle mass in older men.

Validating muscle mass cutoffs of four international sarcopenia‐working groups in Japanese people using DXA and BIA

“…Indeed, the muscle strength and physical performance are also important measurements for determining sarcopenia according to the reported guidelines 1,2,7,8 . The current methods are not satisfactory to obtain an accurate muscle mass measurement 26–30 . Furthermore, measurement of mass per se may not distinguish between muscle wasting from chronic disease or cachexia.…”

“… 1 , 2 , 7 , 8 The current methods are not satisfactory to obtain an accurate muscle mass measurement. 26 , 27 , 28 , 29 , 30 Furthermore, measurement of mass per se may not distinguish between muscle wasting from chronic disease or cachexia. In addition, we only assessed a Japanese cohort, which is not representative for all Asian countries.…”

Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition diagnosis of malnutrition

“…Although MRI 23 and deuterium and D3‐creatine dilution tests 63,64 are currently available, we consider it unlikely that they will soon be available for routine clinical practice. Some of these methods are being currently tested and validated 63–65 . In general, their relevance to the implementation of the GLIM criterion of low skeletal muscle mass for diagnosis of malnutrition in clinical practice remains limited until more widespread implementation and comparison with clinically established methods becomes possible.…”

“…Some of these methods are being currently tested and validated. [63][64][65] In general, their relevance to the implementation of the GLIM criterion of low skeletal muscle mass for diagnosis of malnutrition in clinical practice remains limited until more widespread implementation and comparison with clinically established methods becomes possible.…”

Lean body mass should not be used as a surrogate measurement of muscle mass in malnourished men and women: Comment on Compher et al.

“…A similarly poor relationship between DXA LBM and D 3 Cr muscle mass was reported in older women. 12 Although these comparisons provide important new data to help interpret surrogate estimates of muscle mass, there is still an inadequate amount of data on D 3 Cr muscle mass to base clinical decisions regarding treatment of malnutrition. This will come as data emerge that use this method to measure muscle in patients with cachexia and malnourishment.…”