Body weight, skeletal muscle morphology, and enzyme activities in relation to fasting serum insulin concentration and glucose tolerance in 48-year-old men.

Tissue samples were taken from the gastrocnemius muscle of 26 randomly selected, glucose-tolerant, 48-yr-old men. Hexokinase, phosphorylase, lactate dehydrogenase (LDH), succinate dehydrogenase, and lipoprotein lipase activity (LPLA), as well as the area per fiber type and capillary density, were determined. Mean fiber area correlated positively with relative body weight (r equals 0.53, P less than 0.01), but capillary density did not. The result is that, in cases of high body weight, each capillary supplies a larger muscle fiber area. Serum insulin concentration in the fasting state correlated positively with body weight (r equals 0.77, P less than 0.001) and with mean fiber area per capillary (r equals 0.87; P less than 0.001). Only during the latter part of an oral glucose tolerance test (OGTT) did blood glucose concentrations correlate with relative body weight and mean fiber area per capillary (r equals 0.42, r equals 0.51, P less than 0.05). A stepwise multiple regression analysis showed that the different muscle morphology measurements could account for 3/4 of the variation in the fasting serum insulin concentration, the fasting insulin/glucose ratio, and the blood glucose concentration at 120 min in the OGTT. Of the intracellular enzymes, only LDH (r equals -0.71, P less than 0.001) correlated with the mean fiber area per capillary. LPLA correlated with capillary density (r equals 0.66, P less than 0.001), and, long with the muscle morphology measurements, could account for 3/4 of the variation in serum triglyceride concentrations. The results show that a large mean muscle fiber area/capillary ratio indicates a morphologic imbalance, which is related to both glucose tolerance and various degrees of insulin sensitivity.