Hormonal
Altered muscle composition, specifically lower muscle attenuation (indicative of intramuscular fat), is a strong independent marker of insulin resistance, particularly in obese individuals.
For those who are obese, the quality of your muscle matters as much as its size. Lower muscle density (attenuation) on CT scans, which reflects higher intramuscular fat, is a strong predictor of insulin resistance. Prioritize exercises and nutrition that improve muscle quality and reduce intramuscular fat, not just increasing muscle size.
In analysis of obese subjects, muscle attenuation was the strongest single correlate of insulin resistance.
Why this rating
Gold-standard glucose clamp technique used on a large, diverse cohort (lean to obese).
Source
Subcutaneous Abdominal Fat and Thigh Muscle Composition Predict Insulin Sensitivity Independently of Visceral Fat
Bret H. Goodpaster et al. · Diabetes · 1997
DOI 10.2337/diacare.46.10.1579
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