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Laura A Schaap, D3-Creatine Dilution to Assess Muscle Mass, The Journals of Gerontology: Series A, Volume 74, Issue 6, June 2019, Pages 842–843, https://doi.org/10.1093/gerona/gly180
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In this issue of the Journal of Gerontology, Cawthon and colleagues (1) report on D3-creatine dilution, a novel method to assess muscle mass in human populations, finding a more robust association with function in older men in the osteoporosis in men (MrOs) cohort study than has been seen with dual-energy x-ray absorptiometry (DXA). Previous studies have relied on DXA to assess sarcopenia. Health ABC used both DXA and cross-sectional thigh and abdominal computed tomography (CT) scanning to determine how body composition relates to disability. Using various analytic approaches, fat mass and muscle strength were found to be most strongly related to physical function (2), and strength was more strongly related to mortality than muscle mass (3). Though muscle mass clearly declines with age in longitudinal analysis (4,5) it has been difficult to identify an independent association of a single measure of lean mass with health outcomes. Although limited to a study in older men, this report by Cawthon illustrates the issues with the ability of DXA to quantify muscle mass and validates the D3-creatine approach.