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Zhang Y, Zhang K, Huang S, Li W, He P. A review on associated factors and management measures for sarcopenia in type 2 diabetes mellitus. Medicine (Baltimore) 2024; 103:e37666. [PMID: 38640276 PMCID: PMC11029968 DOI: 10.1097/md.0000000000037666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 01/28/2024] [Accepted: 02/29/2024] [Indexed: 04/21/2024] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease characterized by hyperglycemia, insulin resistance, and insufficient insulin secretion. Sarcopenia, as a new complication of diabetes, is characterized by the loss of muscle mass and the progressive decline of muscle strength and function in T2DM patients, which has a serious impact on the physical and mental health of patients. Insulin resistance, mitochondrial dysfunction, and chronic inflammation are common mechanisms of diabetes and sarcopenia. Reasonable exercise training, nutrition supplement, and drug intervention may improve the quality of life of patients with diabetes combined with sarcopenia. This article reviews the relevant factors and management measures of sarcopenia in T2DM patients, in order to achieve early detection, diagnosis, and intervention.
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Affiliation(s)
- Yi Zhang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kemeng Zhang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sui Huang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenhan Li
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping He
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Qiu S, Cai X, Zhou X, Xu J, Sun Z, Guo H, Wu T. Muscle Quality in Relation to Prediabetes Phenotypes: A Population-Based Study With Mediation Analysis. J Clin Endocrinol Metab 2024; 109:e1151-e1158. [PMID: 37878955 DOI: 10.1210/clinem/dgad630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/05/2023] [Accepted: 10/20/2023] [Indexed: 10/27/2023]
Abstract
CONTEXT Prediabetes is associated with an increased risk of physical disability, yet no studies have assessed the extent to which muscle quality, a measure reflecting muscle functionality, was altered in prediabetes and its specific phenotype. OBJECTIVE We evaluated their associations in a general US population with mediation analysis. METHODS This was a cross-sectional study based on the National Health and Nutrition Examination Survey 2011-2014. Participants with prediabetes were stratified as having an isolated defect (impaired fasting glucose [IFG], impaired glucose tolerance [IGT], or impaired hemoglobin A1c [IA1c]), 2 defects (IFG + IGT, IFG + IA1c, or IGT + IA1c), or all defects (IFG + IGT + IA1c). Muscle quality was calculated as dominant grip strength divided by dominant arm muscle mass measured by dual-energy X-ray absorptiometry. RESULTS We included 2351 participants (938 with prediabetes and 1413 with normoglycemia). Despite higher grip strength and larger arm muscle mass, arm muscle quality was lower in prediabetes and all prediabetes phenotypes (except for IGT) than normoglycemia (all P < .04), and was unrelated to prediabetes awareness. Arm muscle quality was decreased and the odds of low arm muscle quality was increased in prediabetes with increasing numbers of glucometabolic defects (both P < .001), with insulin resistance being the predominant mediator. HbA1c-defined prediabetes (IA1c) had lower arm muscle quality and higher odds of low arm muscle quality than blood glucose-defined prediabetes (IFG, IGT, or IFG + IGT). CONCLUSION Muscle quality was impaired in prediabetes and its specific phenotype. Relative to blood glucose, elevated HbA1c might be a better predictor of reduced muscle quality.
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Affiliation(s)
- Shanhu Qiu
- Department of General Practice, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing 210009, China
- Research and Education Centre of General Practice, Zhongda Hospital, Southeast University, Nanjing 210009, China
| | - Xue Cai
- Department of Nursing Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Xiaoying Zhou
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing 210009, China
| | - Jinshui Xu
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210000, China
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing 210009, China
| | - Haijian Guo
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210000, China
| | - Tongzhi Wu
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide 5000, Australia
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Norris T, Johnson W, Cooper R, Pereira SMP. Associations between diabetes status and grip strength trajectory sub-groups in adulthood: findings from over 16 years of follow-up in the MRC National Survey of Health and Development. BMC Geriatr 2023; 23:213. [PMID: 37016329 PMCID: PMC10074704 DOI: 10.1186/s12877-023-03871-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/03/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Cross-sectional studies suggest a relationship between diabetes status and weaker grip strength (GS) in adulthood and limited evidence from longitudinal studies has focussed on the association with average change in GS. We aimed to investigate whether diabetes status was related to membership of distinct GS trajectories in mid-to-late adulthood in 2,263 participants in the Medical Research Council National Survey of Health and Development. METHODS Grip strength (kg) was measured at 53, 60-64 and 69 years. Pre-/diabetes was defined at 53 years based on HbA1c > 5.6% and/or doctor-diagnosis of diabetes. Sex-specific latent class trajectory models were developed and multinomial logistic regression was used to investigate the association between pre-/diabetes status and membership into GS trajectory classes. RESULTS For both males and females, a 3-class solution ('High', 'Intermediate', 'Low') provided the best representation of the GS data and the most plausible solution. There was no evidence that pre-/diabetes status was associated with class membership in either sex: e.g., adjusted odds ratios of being in the 'Low' class (vs. 'High') for males with pre-/diabetes (vs. no-diabetes) was 1.07 (95% CI:0.45,2.55). CONCLUSION Using a flexible data-driven approach to identify GS trajectories between 53 and 69 years, we observed three distinct GS trajectories, all declining, in both sexes. There was no association between pre-/diabetes status at 53 years and membership into these GS trajectories. Understanding the diabetes status-GS trajectories association is vital to ascertain the consequences that projected increases in pre-/diabetes prevalence's are likely to have.
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Affiliation(s)
- T Norris
- Institute of Sport, Exercise and Health, Division of Surgery & Interventional Science, University College London, London, UK
| | - W Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - R Cooper
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - S M Pinto Pereira
- Institute of Sport, Exercise and Health, Division of Surgery & Interventional Science, University College London, London, UK.
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Chang CY, Chu NF, Lin MH, Wang SC, Wu DM, Tsai MK, Lu CH. Association between Grip Strength, Obesity, and Cardiometabolic Risk Factors among the Community-Dwelling Elderly Population in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11359. [PMID: 36141648 PMCID: PMC9517202 DOI: 10.3390/ijerph191811359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to evaluate the association between grip strength, obesity, and cardiometabolic risk factors among elderly individuals with different grip strength statuses and weight statuses in Taiwan. We conducted a series of community-based health surveys among the elderly population in Chiayi County, Taiwan from 2017 to 2019. This is a cross-sectionally designed health check-up program that was conducted by the local public health bureau. Anthropometric characteristics, handgrip strength, diabetes, and cardiometabolic risk profiles were measured using standard methods. This study recruited 3739 subjects (1600 males and 2139 females). The non-obese subjects had lower blood glucose (BG) levels compared to the obese subjects. The BG levels of non-obese and obese subjects were 102.7 ± 25.6 mg/dL vs. 109.1 ± 34.3 mg/dL for males; and 102.8 ± 30.1 mg/dL vs. 112.5 ± 40.3 mg/dL for females (both p < 0.001). The grip strength was negatively associated with BG in both sexes (β = -0.357, p < 0.001 for males and β = -0.385, p < 0.05 for females). The relationship between the grip strength and the risk of diabetes showed that for every 1 kg increase in the grip strength, there was a 4.1% and 4.5% decrease in the risk for developing diabetes for males and females, respectively (OR = 0.959, 95% CI = 0.940-0.979 for males and OR = 0.955, 95% CI = 0.932-0.978 for females). A higher handgrip strength is associated with a lower BG level and a lower risk for diabetes mellitus in the elderly Taiwanese subjects. Additional health promotion should focus on the obese and sarcopenic population to prevent cardiometabolic comorbidities in later life.
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Affiliation(s)
- Chun-Yung Chang
- Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung City 802, Taiwan
| | - Nain-Feng Chu
- Division of Occupational Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City 813, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei 114, Taiwan
| | - Ming-Hsun Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei 114, Taiwan
| | - Shu-Chuan Wang
- Division of Performance Management, Kaohsiung Veterans General Hospital, Kaohsiung City 813, Taiwan
| | - Der-Min Wu
- School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
| | - Ming-Kai Tsai
- Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung City 802, Taiwan
| | - Chieh-Hua Lu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei 114, Taiwan
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Formiga F, Moreno-González R, Corsonello A, Carlsson A, Ärnlöv J, Mattace-Raso F, Kostka T, Weingart C, Roller-Wirnsberger R, Tap L, Guligowska A, Sieber C, Wirnsberger G, Artzi-Medvedik R, Yehoshua I, Giuli C, Lattanzio F, Corbella X, Formiga F, Moreno-González R, Corbella X, Martínez Y, Polo C, Cruzado JM, Corsonello A, Bustacchini S, Bolognini S, D’Ascoli P, Moresi R, Stefano GD, Giammarchi C, Bonfigli AR, Galeazzi R, Lenci F, Bella SD, Bordoni E, Provinciali M, Giacconi R, Giuli C, Postacchini D, Garasto S, Cozza A, Firmani R, Nacciariti M, Rosa MD, Fabbietti P, Ärnlöv J, Carlsson A, Feldreich T, Mattace-Raso F, Tap L, Ziere G, Goudzwaard J, Kostka T, Guligowska A, Kroc Ł, Sołtysik BK, Smyj K, Fife E, Kostka J, Pigłowska M, Wójcik A, Chrząstek Z, Sosowska N, Telążka A, Weingart C, Freiberger E, Sieber C, Wirnsberger GH, Roller-Wirnsberger RE, Herzog C, Lindner S, Artzi-Medvedik R, Melzer Y, Clarfield M, Melzer I, Yehoshua I, Gregorio PG, Martínez SL, Alonso MG, Calvo JAH, Molina FT, Fuentes LG, García PC, Pérez MM, Bernabei R, Bula C, Haller H, Zoccali C, Jager K, Biesen WV, Stevens PE. Diabetes, sarcopenia and chronic kidney disease; the Screening for CKD among Older People across Europe (SCOPE) study. BMC Geriatr 2022; 22:254. [PMID: 35346078 PMCID: PMC8962249 DOI: 10.1186/s12877-022-02916-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/04/2022] [Indexed: 02/06/2023] Open
Abstract
Background Sarcopenia may be more present in older adults with diabetes (DM). Accordingly, we evaluated the prevalence of sarcopenia and its associated risk factors among community-dwelling older adults with DM. Methods A cross-sectional analysis of older people living in the community was carried out. Participants (aged 75 years and more) came from an European multicenter prospective cohort (SCOPE study). Global geriatric assessment including short physical performance battery, handgrip strength test and bioelectrical impedance analysis was performed. Sarcopenia was defined by the updated criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Estimated glomerular filtration rate (eGFR) was calculated using Berlin Initiative Study (BIS) to define the stages of chronic kidney disease (CKD). Previous known DM was defined as physician-diagnosed DM registered in the patient's medical record or the use of DM-related medications. Hemoglobin A1c levels and specific DM therapies administered were collected. Time elapsed from the first diagnosis of DM was not collected and, therefore, was not included in the analyses. Results A total of 1,420 subjects were evaluated with a median age of 79.0 (6.0) years, of which 804 (56.6%) were women and 615 (43.3%) men; 315 (22.2%) participants had prior DM diagnosis, with a median age of 80.0 (6.0), 146 (46.3%) were women. Using EWGSOP2 definition, 150 (10.6%) participants in the SCOPE study met diagnostic criteria for sarcopenia. Participants without diabetes had more often normal results in the 3 sarcopenia components than participants with diabetes [887 (80.31%) vs. 227 (72.1%), p = 0.002], highlighting higher percentages of severe sarcopenia in participants with diabetes [27 (8.6%) vs. 58 (5.2%), p = 0.028]. Confirmed or severe sarcopenia was detected in 41 (13%) participants with diabetes and 109 (9.8%) participants without diabetes (p = 0.108). According to BIS equation, sarcopenia was not significantly more prevalent in the more advanced stages of CKD (p = 0.845). In multivariate analyses, older age (odds ratios [OR], 1.17; 95% confidence interval [CI], 1.08–1.27), and lower body mass index (OR, 0.79; 95% CI, 0.71–0.89 were associated with the presence of sarcopenia. Conclusions One tenth of all older community-dwelling subjects have sarcopenia. Older age and being thinner, but not worse renal function, were associated with higher prevalence of sarcopenia in older older adults with diabetes.
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Hamasaki H. What can hand grip strength tell us about type 2 diabetes?: mortality, morbidities and risk of diabetes. Expert Rev Endocrinol Metab 2021; 16:237-250. [PMID: 34402694 DOI: 10.1080/17446651.2021.1967743] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Hand grip strength (HGS) has been determined as a simple and cost effective method for evaluating overall skeletal muscle strength and quality. It has been used in numerous clinical studies to examine the association between skeletal muscle and type 2 diabetes (T2D). Previous studies have shown that HGS is significantly associated with mortality and cardiovascular disease (CVD) in patients with T2D. As the prevalence of T2D has seen a steady increase globally, HGS measurement can be useful and essential in managing T2D. AREAS COVERED This narrative review summarizes the current evidence regarding the association between HGS and T2D. HGS has been considered a useful tool for identifying risks for T2D, CVD, and mortality and evaluating skeletal muscle strength and quality. OPINION HGS should be measured in all patients with T2D together with height, weight, and waist circumference. However, there is yet no standard method used in measuring for HGS. T2D patients with a low HGS can engage in resistance training more effectively with appropriate advice based on HGS. Future studies clarifying the genetic association between skeletal muscle and T2D are needed to provide individualized exercise therapy.
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