Hyperglycemia in non-obese patients with type 2 diabetes is associated with low muscle mass: The Multicenter Study for Clarifying Evidence for Sarcopenia in Patients with Diabetes Mellitus - PubMed (original) (raw)

Multicenter Study

. 2019 Nov;10(6):1471-1479.

doi: 10.1111/jdi.13070. Epub 2019 Jun 1.

Yasuharu Tabara 2, Hiroshi Ikegami 3, Yasunori Takata 4, Kei Kamide 5, Tome Ikezoe 6, Eri Kiyoshige 5, Yukako Makutani 3, Hiroshi Onuma 7, Yasuyuki Gondo 8, Kazunori Ikebe 9, Noriaki Ichihashi 6, Tadao Tsuboyama 6 10, Fumihiko Matsuda 2, Katsuhiko Kohara 11, Mai Kabayama 5, Masahiro Fukuda 12, Tomohiro Katsuya 13 14, Haruhiko Osawa 4, Yoshihisa Hiromine 3, Hiromi Rakugi 1

Affiliations

Multicenter Study

Hyperglycemia in non-obese patients with type 2 diabetes is associated with low muscle mass: The Multicenter Study for Clarifying Evidence for Sarcopenia in Patients with Diabetes Mellitus

Ken Sugimoto et al. J Diabetes Investig. 2019 Nov.

Abstract

Aims/introduction: Hyperglycemia is a risk factor for sarcopenia when comparing individuals with and without diabetes. However, no studies have investigated whether the findings could be extrapolated to patients with diabetes with relatively higher glycemic levels. Here, we aimed to clarify whether glycemic control was associated with sarcopenia in patients with type 2 diabetes.

Materials and methods: Study participants consisted of patients with type 2 diabetes (n = 746, the average age was 69.9 years) and an older general population (n = 2,067, the average age was 68.2 years). Sarcopenia was defined as weak grip strength or slow usual gait speed and low skeletal mass index.

Results: Among patients with type 2 diabetes, 52 were diagnosed as having sarcopenia. The frequency of sarcopenia increased linearly with glycated hemoglobin (HbA1c) level, particularly in lean individuals (HbA1c <6.5%, 7.0%, ≥6.5% and <7.0%: 18.5%; HbA1c ≥7.0% and <8.0%: 20.3%; HbA1c ≥8.0%: 26.7%). The linear association was independent of major covariates, including anthropometric factors and duration of diabetes (HbA1c <6.5%: reference; ≥6.5% and <7.0%: odds ratio [OR] 4.38, P = 0.030; HbA1c ≥7.0% and <8.0%: 4.29, P = 0.024; HbA1c ≥8.0%: 7.82, P = 0.003). HbA1c level was specifically associated with low skeletal mass index (HbA1c ≥8.0%: OR 5.42, P < 0.001) rather than weak grip strength (OR 1.89, P = 0.058) or slow gait speed (OR 1.13, P = 0.672). No significant association was observed in the general population with a better glycemic profile.

Conclusions: Poor glycemic control in patients with diabetes was associated with low muscle mass.

Keywords: Sarcopenia; Skeletal muscle mass; Type 2 diabetes.

© 2019 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

PubMed Disclaimer

Figures

Figure 1

Figure 1

Association between glycated hemoglobin (HbA1c) levels and sarcopenia in patients with type 2 diabetes. The frequency of sarcopenia by body mass index and plasma HbA1c levels. Study participants were subdivided at a body mass index (BMI) of 25 kg/m2, a criterion of obesity in Japan, and 23.3 kg/m2, which corresponds to the median among the remaining non‐obese participants. The numbers of participants in each BMI subgroup are shown in the columns and parentheses.

Figure 2

Figure 2

Adjusted odds ratio for sarcopenia in non‐obese patients. (a) General population (the Nagahama study). (b) Patients with type 2 diabetes. Patients whose body mass index was >25 kg/m2 were excluded from the analysis. The odds ratio adjusted for age, sex and body mass index was calculated using the (a) intermediate or (b) lowest glycated hemoglobin (HbA1c) subgroup as a reference. T2DM, type 2 diabetes.

Similar articles

Cited by

References

    1. Chen LK, Liu LK, Woo J, et al Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 2014; 15: 95–101. - PubMed
    1. Ali S, Garcia JM. Sarcopenia, cachexia and aging: diagnosis, mechanisms and therapeutic options ‐ a mini‐review. Gerontology 2014; 60: 294–305. - PMC - PubMed
    1. Park SW, Goodpaster BH, Strotmeyer ES, et al Decreased muscle strength and quality in older adults with type 2 diabetes: the health, aging, and body composition study. Diabetes 2006; 55: 1813–1818. - PubMed
    1. Volpato S, Bianchi L, Lauretani F, et al Role of muscle mass and muscle quality in the association between diabetes and gait speed. Diabetes Care 2012; 35: 1672–1679. - PMC - PubMed
    1. Kalyani RR, Tra Y, Yeh HC, et al Quadriceps strength, quadriceps power, and gait speed in older U.S. adults with diabetes mellitus: results from the National Health and Nutrition Examination Survey, 1999‐2002. J Am Geriatr Soc 2013; 61: 769–775. - PMC - PubMed

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources