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Du X, Yao Z, Wang D, Dong X, Bai J, Gu Y, Yu Y, Zhang W, Qi Q, Gu S. An insight into the causal relationship between sarcopenia-related traits and venous thromboembolism: A mendelian randomization study. PLoS One 2024; 19:e0303148. [PMID: 38753690 PMCID: PMC11098320 DOI: 10.1371/journal.pone.0303148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 04/20/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND As a geriatric syndrome, sarcopenia has a high prevalence in the old population and represents an impaired state of health with adverse health outcomes. A strong clinical interest in its relationship with venous thromboembolism (VTE), which is a complex trait disease with a heterogeneous annual incidence rate in different countries, has emerged. The relationship between sarcopenia and venous thromboembolism has been reported in observational studies but the causality from sarcopenia to VTE remained unclarified. We aimed to assess the causal effect of sarcopenia on the risk of VTE with the two-sample Mendelian randomization (MR) method. METHODS Two sets of single-nucleotide polymorphisms (SNPs), derived from two published genome-wide association study (GWAS) meta-analyses and genetically indexing muscle weakness and lean muscle mass separately, were pooled into inverse variance weighted (IVW), weighted median and MR-Egger analyses. RESULTS No evidence was found for the causal effect of genetically predicted muscle weakness (IVW: OR = 0.90, 95% CI = 0.76-1.06, p = 0.217), whole body lean mass (IVW: OR = 1.01, 95% CI = 0.87-1.17, p = 0.881) and appendicular lean mass (IVW: OR = 1.13, 95% CI = 0.82-1.57, p = 0.445) on the risk of VTE. However, both genetically predicted whole-body lean mass and appendicular lean mass can causally influence diabetes mellitus (IVW of whole-body lean mass: OR = 0.87, 95% CI = 0.78-0.96, p = 0.008; IVW of appendicular lean mass: OR = 0.71, 95% CI = 0.54-0.94, p = 0.014) and hypertension (IVW of whole-body lean mass: OR = 0.92, 95% CI = 0.87-0.98, p = 0.007; IVW of appendicular lean mass: OR = 0.84, 95% CI = 0.73-0.96, p = 0.013). CONCLUSIONS Genetically predicted sarcopenia does not causally influence VTE directly, but it might still have an indirect effect on VTE incidence via diabetes mellitus and hypertension.
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Affiliation(s)
- Xinchao Du
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Zhiwei Yao
- Department of Thyroid Surgery, The Affiliated Taian City Central Hospital of Qingdao University, Taian, Shandong, China
| | - Dongwei Wang
- Department of Cardiac Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Xinwei Dong
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Juncai Bai
- Department of Cardiac Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Yingchun Gu
- Department of Cardiac Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Yaohua Yu
- Department of Respiratory Medicine and Pulmonary Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Weifeng Zhang
- Department of Rheumatism and Immunology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Qingxia Qi
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Shengyuan Gu
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
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Xu K, Feng X, Xu Z, Pan Y, Zhang P, Zhu H. Association of sarcopenia with osteoporosis in Chinese patients with type 2 diabetes. BMC Musculoskelet Disord 2024; 25:226. [PMID: 38509497 PMCID: PMC10956338 DOI: 10.1186/s12891-024-07323-2] [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: 03/08/2023] [Accepted: 02/28/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND People with type 2 diabetes mellitus (T2DM) present a higher tendency to develop sarcopenia and osteoporosis compared with the normal population. Currently, osteoporosis screening has been frequently performed among T2DM patients, but sarcopenia screening is relatively less, and the association between the two diseases remains unclear. Herein, this study aims to determine the association between sarcopenia and osteoporosis in Chinese T2DM patients. METHODS This was a retrospective study of 678 patients with T2DM in the First Affiliated Hospital of Wenzhou Medical University. The bone mineral density (BMD) and muscle mass were measured by using dual-energy X-ray absorptiometry scanning. The diagnostic criteria of sarcopenia referred to the consensus by the Asia Working Group for Sarcopenia (AWGS). RESULT Among T2DM patients, the proportion of the sarcopenia population complicated with osteoporosis was higher than that of the non-sarcopenia (30.9% vs. 8.6% in men and 46.9% vs. 33.9% in women), but only significantly in men. The BMD of the hip and femoral neck was positively correlated with skeletal muscle mass index (SMI), grip strength, and gait speed (P < 0.01). After adjusting all covariates, the association between sarcopenia and BMD showed odds ratios of 0.43 (95% CI:0.28-0.66) for the femoral neck and 0.49 (95% CI:0.32-0.73) for the hip. CONCLUSIONS The BMD of the hip and femoral neck in T2DM patients is related to sarcopenia-related indicators and represents an independent protective factor for sarcopenia. To reduce the risk of falls, fractures, and weakness, it is necessary to take sarcopenia assessment in people with T2DM and osteopenia/osteoporosis.
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Affiliation(s)
- Ke Xu
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Xiaozhen Feng
- Department of Health Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Zeru Xu
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Yang Pan
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Ping Zhang
- Department of Endocrinology, Xining Second People's Hospital, Xining, 810000, China
| | - Hong Zhu
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
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Rentflejsz J, Wojszel ZB. Diabetes Mellitus Should Be Considered While Analysing Sarcopenia-Related Biomarkers. J Clin Med 2024; 13:1107. [PMID: 38398421 PMCID: PMC10889814 DOI: 10.3390/jcm13041107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/02/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
Sarcopenia is a chronic, progressive skeletal muscle disease characterised by low muscle strength and quantity or quality, leading to low physical performance. Patients with type 2 diabetes mellitus (T2DM) are more at risk of sarcopenia than euglycemic individuals. Because of several shared pathways between the two diseases, sarcopenia is also a risk factor for developing T2DM in older patients. Various biomarkers are under investigation as potentially valuable for sarcopenia diagnosis and treatment monitoring. Biomarkers related to sarcopenia can be divided into markers evaluating musculoskeletal status (biomarkers specific to muscle mass, markers of the neuromuscular junction, or myokines) and markers assuming causal factors (adipokines, hormones, and inflammatory markers). This paper reviews the current knowledge about how diabetes and T2DM complications affect potential sarcopenia biomarker concentrations. This review includes markers recently proposed by the expert group of the European Society for the Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) as those that may currently be useful in phase II and III clinical trials of sarcopenia: myostatin (MSTN); follistatin (FST); irisin; brain-derived neurotrophic factor (BDNF); procollagen type III N-terminal peptide (PIIINP; P3NP); sarcopenia index (serum creatinine to serum cystatin C ratio); adiponectin; leptin; insulin-like growth factor-1 (IGF-1); dehydroepiandrosterone sulphate (DHEAS); C-reactive protein (CRP); interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α). A better understanding of factors influencing these biomarkers' levels, including diabetes and diabetic complications, may lead to designing future studies and implementing results in clinical practice.
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Affiliation(s)
- Justyna Rentflejsz
- Doctoral School, Medical University of Bialystok, 15-089 Bialystok, Poland
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland;
| | - Zyta Beata Wojszel
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland;
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Bjørnsbo KS, Brøns C, Aadahl M, Kampmann FB, Friis Bryde Nielsen C, Lundbergh B, Wibaek R, Kårhus LL, Madsen AL, Hansen CS, Nørgaard K, Jørgensen NR, Suetta C, Kjaer M, Grarup N, Kanters J, Larsen M, Køber L, Kofoed KF, Loos R, Hansen T, Linneberg A, Vaag A. Protocol for the combined cardiometabolic deep phenotyping and registry-based 20-year follow-up study of the Inter99 cohort. BMJ Open 2024; 14:e078501. [PMID: 38286704 PMCID: PMC10826573 DOI: 10.1136/bmjopen-2023-078501] [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: 08/04/2023] [Accepted: 01/03/2024] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION The population-based Inter99 cohort has contributed extensively to our understanding of effects of a systematic screening and lifestyle intervention, as well as the multifactorial aetiology of type 2 diabetes (T2D) and cardiovascular disease. To understand causes, trajectories and patterns of early and overt cardiometabolic disease manifestations, we will perform a combined clinical deep phenotyping and registry follow-up study of the now 50-80 years old Inter99 participants. METHODS AND ANALYSIS The Inter99 cohort comprises individuals aged 30-60 years, who lived in a representative geographical area of greater Copenhagen, Denmark, in 1999. Age-stratified and sex-stratified random subgroups were invited to participate in either a lifestyle intervention (N=13 016) or questionnaires (N=5264), while the rest served as a reference population (N=43 021). Of the 13 016 individuals assigned to the lifestyle intervention group, 6784 (52%) accepted participation in a baseline health examination in 1999, including screening for cardiovascular risk factors and prediabetic conditions. In total, 6004 eligible participants, who participated in the baseline examination, will be invited to participate in the deep phenotyping 20-year follow-up clinical examination including measurements of anthropometry, blood pressure, arterial stiffness, cardiometabolic biomarkers, coronary artery calcification, heart rate variability, heart rhythm, liver stiffness, fundus characteristics, muscle strength and mass, as well as health and lifestyle questionnaires. In a subsample, 10-day monitoring of diet, physical activity and continuous glucose measurements will be performed. Fasting blood, urine and faecal samples to be stored in a biobank. The established database will form the basis of multiple analyses. A main purpose is to investigate whether low birth weight independent of genetics, lifestyle and glucose tolerance predicts later common T2D cardiometabolic comorbidities. ETHICS AND DISSEMINATION The study was approved by the Medical Ethics Committee, Capital Region, Denmark (H-20076231) and by the Danish Data Protection Agency through the Capital Region of Denmark's registration system (P-2020-1074). Informed consent will be obtained before examinations. Findings will be disseminated in peer-reviewed journals, at conferences and via presentations to stakeholders, including patients and public health policymakers. TRIAL REGISTRATION NUMBER NCT05166447.
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Affiliation(s)
- Kirsten Schroll Bjørnsbo
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | | | - Mette Aadahl
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Freja Bach Kampmann
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Camilla Friis Bryde Nielsen
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Bjørn Lundbergh
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | | | - Line Lund Kårhus
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Anja Lykke Madsen
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | | | - Kirsten Nørgaard
- Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Charlotte Suetta
- Institute of Sports Medicine, Department of Orthopedic Surgery and Department of Geriatrics and Palliative Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Michael Kjaer
- Institute of Sports Medicine, Department of Orthopedic Surgery and Department of Geriatrics and Palliative Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Jørgen Kanters
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Center of Physiological Research, University of California, San Francisco, CA, USA
| | - Michael Larsen
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lars Køber
- Department of Cardiology and Radiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Klaus Fuglsang Kofoed
- Department of Clinical Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Cardiology and Radiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ruth Loos
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Allan Linneberg
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Allan Vaag
- Steno Diabetes Center Copenhagen, Herlev, Denmark
- Lund University Diabetes Center, Malmö, Sweden
- Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
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Wang D, Zhang G, Yu Y, Zhang Z. Imaging of Sarcopenia in Type 2 Diabetes Mellitus. Clin Interv Aging 2024; 19:141-151. [PMID: 38292460 PMCID: PMC10826713 DOI: 10.2147/cia.s443572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/17/2024] [Indexed: 02/01/2024] Open
Abstract
Sarcopenia is an age-related condition characterized by the loss of skeletal muscle mass, muscular strength, and muscle function. In older adults, type 2 diabetes mellitus (T2DM) constitutes a significant health burden. Skeletal muscle damage and deterioration have emerged as novel chronic complications in patients with diabetes, often linked to their increased longevity. Diabetic sarcopenia has been associated with increased rates of hospitalization, cardiovascular events, and mortality. Nevertheless, effectively managing metabolic disorders in patients with T2DM through appropriate therapeutic interventions could potentially mitigate the risk of sarcopenia. Utilizing imaging technologies holds substantial clinical significance in the early detection of skeletal muscle mass alterations associated with sarcopenia. Such detection is pivotal for arresting disease progression and preserving patients' quality of life. These imaging modalities offer reproducible and consistent patterns over time, as they all provide varying degrees of quantitative data. This review primarily delves into the application of dual-energy X-ray absorptiometry, computed tomography, magnetic resonance imaging, and ultrasound for both qualitative and quantitative assessments of muscle mass in patients with T2DM. It also juxtaposes the merits and limitations of these four techniques. By understanding the nuances of each method, clinicians can discern how best to apply them in diverse clinical scenarios.
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Affiliation(s)
- Dingyue Wang
- Department of Ultrasound, the First Affiliated Hospital China Medical University, Shenyang City, Liaoning Province, 110001, People’s Republic of China
| | - Gaosen Zhang
- Department of Ultrasound, the First Affiliated Hospital China Medical University, Shenyang City, Liaoning Province, 110001, People’s Republic of China
| | - Yana Yu
- Department of Ultrasound, the First Affiliated Hospital China Medical University, Shenyang City, Liaoning Province, 110001, People’s Republic of China
| | - Zhen Zhang
- Department of Ultrasound, the First Affiliated Hospital China Medical University, Shenyang City, Liaoning Province, 110001, People’s Republic of China
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Luo C, Liu RY, Zhang GW, Hu F, Jin YH, Liu BY. Possible sarcopenia and risk of new-onset type 2 diabetes mellitus in older adults in China: a 7-year longitudinal cohort study. BMC Geriatr 2023; 23:404. [PMID: 37400759 DOI: 10.1186/s12877-023-04104-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/13/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Previous studies have shown that type 2 diabetes mellitus (T2DM) can cause sarcopenia; however, these conditions may have a bidirectional association. This study aimed to explore the longitudinal association between possible sarcopenia and new-onset T2DM. METHODS We conducted a population-based cohort study using nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS). This study included participants aged ≥ 60 years who were free of diabetes during the baseline survey of CHARLS (2011 to 2012) and were followed up until 2018. Possible sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 criteria. Cox proportional hazards regression models were used to evaluate the effect of possible sarcopenia on new-onset T2DM. RESULTS In total, 3,707 individuals were enrolled in this study, with a median age of 66 years; the prevalence of possible sarcopenia was 45.1%. During the 7-year follow-up, 575 cases (15.5%) of incident diabetes were identified. Participants with possible sarcopenia were more likely to have new-onset T2DM than those without possible sarcopenia (hazard ratio: 1.27, 95% confidence interval: 1.07-1.50; p = 0.006). In subgroup analysis, we found a significant association between possible sarcopenia and T2DM in individuals aged < 75 years or with a BMI < 24 kg/m². However, this association was not significant in individuals aged ≥ 75 years or with a BMI ≥ 24 kg/m². CONCLUSIONS Possible sarcopenia is associated with an increased risk of new-onset T2DM in older adults, especially in individuals who are not overweight and aged 75 years or younger.
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Affiliation(s)
- Chun Luo
- Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Rui-Yan Liu
- Wenzhou Medical University Renji College, Wenzhou, China
| | - Guang-Wu Zhang
- Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Fei Hu
- Cixi Biomedical Research Institute, Wenzhou Medical University, Cixi, China
| | - Yu-Hong Jin
- Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Bing-Yang Liu
- Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China.
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Jung HN, Jung CH, Hwang YC. Sarcopenia in youth. Metabolism 2023; 144:155557. [PMID: 37080353 DOI: 10.1016/j.metabol.2023.155557] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/01/2023] [Accepted: 04/04/2023] [Indexed: 04/22/2023]
Abstract
Recent research has revealed causes other than aging that may induce sarcopenia in young people, contrary to the long-studied age-dependent reduction in muscular mass and function. The risk of sarcopenia begins in early adulthood, resulting in exaggerated muscle dysfunction in later life. Despite its clinical significance, research on youth-onset sarcopenia is still in its infancy. Due to a paucity of epidemiologic data and standardized criteria for sarcopenia in youth, determining the prevalence of sarcopenia in the young population remains challenging. Based on the evidence, >1 in every 10 young adults of most ethnicities is estimated to have sarcopenia. This review summarizes the possible etiologies of sarcopenia in young populations, including metabolic syndrome, physical inactivity, inadequate nutrition, inherent and perinatal factors, vitamin D deficiency, endocrinopathy, an imbalance of gut microbiota, neuromuscular diseases, organ failure, malignancy, and other inflammatory disorders. This is the first review of the current knowledge on the importance, prevalence, diagnosis, and causes of sarcopenia in youth.
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Affiliation(s)
- Han Na Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang-si, Gyeonggi-do, Republic of Korea
| | - Chang Hee Jung
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Asan Diabetes Center, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - You-Cheol Hwang
- Department of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, 892, Dongnam-ro, Gangdong-gu, Seoul 05278, Republic of Korea.
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Paez HG, Pitzer CR, Alway SE. Age-Related Dysfunction in Proteostasis and Cellular Quality Control in the Development of Sarcopenia. Cells 2023; 12:cells12020249. [PMID: 36672183 PMCID: PMC9856405 DOI: 10.3390/cells12020249] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Sarcopenia is a debilitating skeletal muscle disease that accelerates in the last decades of life and is characterized by marked deficits in muscle strength, mass, quality, and metabolic health. The multifactorial causes of sarcopenia have proven difficult to treat and involve a complex interplay between environmental factors and intrinsic age-associated changes. It is generally accepted that sarcopenia results in a progressive loss of skeletal muscle function that exceeds the loss of mass, indicating that while loss of muscle mass is important, loss of muscle quality is the primary defect with advanced age. Furthermore, preclinical models have suggested that aged skeletal muscle exhibits defects in cellular quality control such as the degradation of damaged mitochondria. Recent evidence suggests that a dysregulation of proteostasis, an important regulator of cellular quality control, is a significant contributor to the aging-associated declines in muscle quality, function, and mass. Although skeletal muscle mammalian target of rapamycin complex 1 (mTORC1) plays a critical role in cellular control, including skeletal muscle hypertrophy, paradoxically, sustained activation of mTORC1 recapitulates several characteristics of sarcopenia. Pharmaceutical inhibition of mTORC1 as well as caloric restriction significantly improves muscle quality in aged animals, however, the mechanisms controlling cellular proteostasis are not fully known. This information is important for developing effective therapeutic strategies that mitigate or prevent sarcopenia and associated disability. This review identifies recent and historical understanding of the molecular mechanisms of proteostasis driving age-associated muscle loss and suggests potential therapeutic interventions to slow or prevent sarcopenia.
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Affiliation(s)
- Hector G. Paez
- Department of Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Integrated Biomedical Sciences Graduate Program, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Laboratory of Muscle Biology and Sarcopenia, Department of Physical Therapy, College of Health Professions, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Center for Muscle, Metabolism and Neuropathology, Division of Regenerative and Rehabilitation Sciences, College of Health Professions, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Christopher R. Pitzer
- Department of Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Integrated Biomedical Sciences Graduate Program, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Laboratory of Muscle Biology and Sarcopenia, Department of Physical Therapy, College of Health Professions, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Center for Muscle, Metabolism and Neuropathology, Division of Regenerative and Rehabilitation Sciences, College of Health Professions, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Stephen E. Alway
- Department of Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Integrated Biomedical Sciences Graduate Program, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Laboratory of Muscle Biology and Sarcopenia, Department of Physical Therapy, College of Health Professions, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Center for Muscle, Metabolism and Neuropathology, Division of Regenerative and Rehabilitation Sciences, College of Health Professions, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- The Tennessee Institute of Regenerative Medicine, Memphis, TN 38163, USA
- Correspondence:
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9
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[Malnutrition management of hospitalized patients with diabetes/hyperglycemia and sarcopenia]. NUTR HOSP 2022; 39:15-22. [PMID: 36546336 DOI: 10.20960/nh.04507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction Sarcopenia is a multidimensional condition that negatively affects muscle mass, muscle strength, and physical performance. The prevalence of sarcopenia in people with diabetes is much higher than that of the general population, especially in individuals with poor nutritional status. Both sarcopenia and malnutrition are conditions amenable to intervention to improve clinical prognosis. This article describes the results of the expert consensus and the responses of the panelists on the nutritional management in routine clinical practice of patients with diabetes/hyperglycemia hospitalized (non-critically ill) with sarcopenia.
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Sex Difference in Cutoff and Prevalence of Sarcopenia among 300,090 Urban Korean Population: Association with Metabolic Syndrome. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101361. [PMID: 36295523 PMCID: PMC9611231 DOI: 10.3390/medicina58101361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 12/18/2022]
Abstract
Background and Objectives: The study aimed to establish the threshold values and prevalence of sarcopenia and to investigate the association of sarcopenia with metabolic syndrome in an urban Korean population. Materials and Methods: The study included 300,090 adults who underwent anthropometric analyses by bioelectrical impedance analyzer. Sarcopenia was defined as: (1) class I, skeletal muscle mass index (SMI) within −1 to −2 standard deviations (SDs); (2) or class II, <−2 SD of SMI in a young population. Results: Low SMI threshold levels for class I and class II sarcopenia were 39.8 and 36.7% in men, and 35.5 and 32.3% in women. Among all age groups, the prevalence rates of sarcopenia were highest in the age group 80−89 years. Following adjustment for possible confounders including age, sex, height, metabolic and health behavioral factors, adjusted odds ratios (95% confidence intervals) for the risk of metabolic syndrome were 2.43 (2.33−2.54) for class I and 2.69 (2.49−2.91) for class II sarcopenia, compared with the normal reference. Sarcopenia was more strongly associated with metabolic syndrome in women than men (p for interaction < 0.01). The threshold values and prevalence of sarcopenia were demonstrated in a large Korean urban population. Conclusions: This study identified that sarcopenia was associated with increased risk of metabolic syndrome, showing itself to be significantly higher in women than men.
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Jang HN, Moon MK, Koo BK. Prevalence of Diabetic Retinopathy in Undiagnosed Diabetic Patients: A Nationwide Population-Based Study. Diabetes Metab J 2022; 46:620-629. [PMID: 35193173 PMCID: PMC9353559 DOI: 10.4093/dmj.2021.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 09/29/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND We investigated the prevalence of diabetic retinopathy (DR) in patients with undiagnosed diabetes through a nationwide survey, compared to those with known diabetes. METHODS Among the participants of the Korean National Health and Nutrition Examination Surveys (KNHANES) from 2017 to 2018, individuals aged ≥40 years with diabetes and fundus exam results were enrolled. Sampling weights were applied to represent the entire Korean population. Newly detected diabetes patients through KNHANES were classified under "undiagnosed diabetes." RESULTS Among a total of 9,108 participants aged ≥40 years, 951 were selected for analysis. Of them, 31.3% (standard error, ±2.0%) were classified under "undiagnosed diabetes." The prevalence of DR in patients with known and undiagnosed diabetes was 24.5%±2.0% and 10.7%±2.2%, respectively (P<0.001). The DR prevalence increased with rising glycosylated hemoglobin (HbA1c) levels in patients with known and undiagnosed diabetes (P for trend=0.001 in both). Among those with undiagnosed diabetes, the prevalence of DR was 6.9%±2.1%, 8.0%±3.4%, 5.6%±5.7%, 16.7%±9.4%, and 42.6%±14.8% for HbA1c levels of <7.0%, 7.0%-7.9%, 8.0%-8.9%, 9.0%-9.9%, and ≥10.0% respectively. There was no difference in the prevalence of hypertension, dyslipidemia, hypertriglyceridemia, or obesity according to the presence or absence of DR. CONCLUSION About one-third of patients with diabetes were unaware of their diabetes, and 10% of them have already developed DR. Considering increasing the prevalence of DR according to HbA1c level was found in patients with undiagnosed diabetes like those with known diabetes, screening and early detection of diabetes and DR are important.
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Affiliation(s)
- Han Na Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Bo Kyung Koo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
- Corresponding author: Bo Kyung Koo https://orcid.org/0000-0002-6489-2656 Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea E-mail:
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12
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Xu Z, Zhang P, Chen Y, Jiang J, Zhou Z, Zhu H. Comparing SARC-CalF With SARC-F for Screening Sarcopenia in Adults With Type 2 Diabetes Mellitus. Front Nutr 2022; 9:803924. [PMID: 35433779 PMCID: PMC9009513 DOI: 10.3389/fnut.2022.803924] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/28/2022] [Indexed: 01/11/2023] Open
Abstract
Background The prevalence of sarcopenia is high in older people with type 2 diabetes mellitus (T2DM) and is now considered a critical problem in the healthcare sector. However, the preferred screening tool for identifying sarcopenia remains unknown. Thus, the aim of this study was to ensure that the diagnostic values of the SARC-F (strength, assisting with walking, rising from a chair, climbing stairs, and falling) and SARC-CalF (SARC and calf circumference) scales were compared with five reference diagnostic criteria for sarcopenia. Methods This was a cross-sectional study. Patients diagnosed with diabetes were treated at the First Affiliated Hospital of Wenzhou Medical University. Appendicular skeletal muscle mass, muscle strength, and physical performance were assessed using dual-energy X-ray absorptiometry, handgrip strength, and gait speed assessment. Five diagnostic criteria for sarcopenia (Asian Working Group for Sarcopenia, International Working Group on Sarcopenia, Foundation for the National Institutes of Health, Sarcopenia Project, Society on Sarcopenia Cachexia and Wasting Disorders, and European Working Group on Sarcopenia in Older People criteria) were utilized. Sensitivity and specificity analyses were performed on the SARC-CalF and SARC-F scales. The diagnostic precision of both instruments was determined using the receiver-operating characteristic (ROC) curves and area under the ROC curves (AUC). Results This study included 689 subjects (459 men and 230 women) with a mean age of 58.1 ± 13.2 years. In accordance with the five reference diagnostic parameters, the prevalence of sarcopenia was between 4.5 and 19.2%. In addition, the range of sensitivity of SARC-F and SARC-CalF ranged from 61.4 to 67.4 and 82.6 to 91.8%, respectively. Concurrently, the specificity ranged from 63.1 to 67.3 and 51.5 to 61.2%, respectively. Overall, AUC values for SARC-CalF were higher than those for SARC-F, regardless of the diagnostic standard, sex, or age. Conclusion The results of this study suggest that SARC-CalF significantly enhances the sensitivity and overall diagnosis of SARC-F. SARC-CalF appears to be an optimal screening tool for sarcopenia in adults with T2DM.
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Affiliation(s)
- Zeru Xu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ping Zhang
- Department of Endocrinology, The Second People’s Hospital of Xining, Xining, China
| | - Yifei Chen
- Department of Medicine, Changsha Medical University, Changsha, China
| | - Jiahong Jiang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zijun Zhou
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hong Zhu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- *Correspondence: Hong Zhu,
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Koo BK, Moon S, Moon MK. Muscle strength, an independent determinant of glycemic control in older adults with long-standing type 2 diabetes: a prospective cohort study. BMC Geriatr 2021; 21:684. [PMID: 34876063 PMCID: PMC8650318 DOI: 10.1186/s12877-021-02629-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/09/2021] [Indexed: 12/25/2022] Open
Abstract
Background Although the proportion of older patients with type 2 diabetes mellitus (T2DM) has increased, few studies have reported the factors affecting glucose levels in older patients with long-standing T2DM. This study assessed the determinants of glycemic control in older adults with T2DM of a duration of ≥10 years, including muscle mass, muscle quality, and β-cell function. Methods This was a prospective study of older patients aged ≥60 years with a T2DM duration of ≥10 years. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index, handgrip strength (HGS), and body composition through bioelectrical impedance analysis were assessed. The primary outcome was a composite of: (i) increment of glycated hemoglobin (HbA1c) from the baseline ≥0.6% and (ii) HbA1c ≥ 9% at any time point during the follow-up period. To find the predicting determinants of the outcome, we performed the Cox proportional hazard analysis. Results Among 100 patients (mean age, 64.0 ± 8.6 years; median duration of diabetes, 20 [interquartile range (IQR), 17–23] years; median HbA1c at baseline, 7.1 [IQR, 6.7–7.4] %), the primary outcome was observed in 40 (40.0%) patients during 4.0 (IQR 2.3–5.0) years of follow-up. A Cox proportional hazards model adjusted for age, sex, baseline HbA1c, obesity, duration of DM and anti-diabetic medication at baseline showed that low HGS and insulin resistance at the baseline were independent determinants of the primary outcome (hazard ratio [HR] = 2.23 [95% confidence interval (CI), 1.06–4.72] and 2.39 [95% CI, 1.18–4.83], respectively). Sex stratification confirmed that HGS and muscle mass were independent determinants of the primary outcome only in women (HR per quartile, 0.58 [95% CI, 0.37–0.93] and 0.46 [95% CI, 0.25–0.85], respectively). `. Conclusions Low HGS and insulin resistance were independent risk factors for aggravated glycemic control among older patients with long standing T2DM. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02629-5.
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Affiliation(s)
- Bo Kyung Koo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Division of Endocrinology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Seoil Moon
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. .,Division of Endocrinology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
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Oguz A, Sahin M, Tuzun D, Kurutas EB, Ulgen C, Bozkus O, Gul K. Irisin is a predictor of sarcopenic obesity in type 2 diabetes mellitus: A cross-sectional study. Medicine (Baltimore) 2021; 100:e26529. [PMID: 34190188 PMCID: PMC8257893 DOI: 10.1097/md.0000000000026529] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/15/2021] [Indexed: 12/25/2022] Open
Abstract
We aimed to evaluate sarcopenia and sarcopenic obesity (SO) in patients with type 2 diabetes mellitus (T2DM), possible relationships with serum irisin and myostatin levels, and the effect of glycemic control on SO.Ninety T2DM patients were included in this a cross-sectional study. Sarcopenia was determined by evaluating muscle mass (bioelectrical impedance analysis), muscle strength (HGS), and gait speed (GS). Patients with muscle mass loss with functionally reduced muscle strength and/or performance were considered sarcopenic. In addition, participants were divided into 3 groups according to the FM (fat mass)/FFM (fat-free mass) ratio [group 1:5th-50th percentiles; group 2:50th-95th percentiles and group 3: ≥95 percentiles (sarcopenic obese)]. Irisin, myostatin levels and metabolic parameters were measured in all patients.The prevalence of sarcopenia and SO was 25.6% and 35.6%, respectively. Irisin levels were lower in sarcopenic patients, while glycosylated hemoglobin (A1c), body mass index (BMI), FM, and FM index were higher (P < .05). From group 1 to group 3, BMI, FM, FM index, GS, myostatin, and A1c increased, and muscle mass percentage, HGS, and irisin decreased (P < .05). A positive correlation was found between FM/FFM and myostatin and a negative correlation between FM/FFM and irisin (r = 0.303, P = .004 vs. r = -0.491, P < .001). Irisin remained an important predictor of SO, even after adjusting for confounding variables (OR:1.105; 95% CI:0.965-1.338, P = .002). The optimal cut-off value for irisin to predict SO was 9.49 ng/mL (specificity = 78.1%, sensitivity = 75.8%). In addition, A1c was an independent risk factor for SO development (OR:1.358, P = .055).This study showed that low irisin levels (<9.49ng/mL) and poor glycemic control in T2DM patients were an independent risk factor, especially for SO.
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Affiliation(s)
- Ayten Oguz
- Faculty of Medicine, Istinye University, Istanbul
| | | | | | | | - Cansu Ulgen
- Department of Internal Medicine, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | | | - Kamile Gul
- Faculty of Medicine, Istinye University, Istanbul
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15
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Qie R, Han M, Huang S, Li Q, Liu L, Zhang D, Cheng C, Zhao Y, Liu D, Qin P, Guo C, Zhou Q, Tian G, Zhang Y, Wu X, Wu Y, Li Y, Yang X, Zhao Y, Feng Y, Hu F, Zhang M, Hu D, Lu J. Association of TCF7L2 gene polymorphisms, methylation, and gene-environment interaction with type 2 diabetes mellitus risk: A nested case-control study in the Rural Chinese Cohort Study. J Diabetes Complications 2021; 35:107829. [PMID: 33419631 DOI: 10.1016/j.jdiacomp.2020.107829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/08/2020] [Accepted: 12/01/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND To assess the associations of single-nucleotide polymorphisms (SNPs) and methylation of transcription factor 7-like 2 (TCF7L2) gene with type 2 diabetes mellitus (T2DM) risk and further explore the interactions among SNPs, methylation, and environmental factors involved in T2DM risk. METHODS We conducted a nested case-control study with 290 pairs of T2DM cases and matched controls. We genotyped 3 SNPs of TCF7L2 in all included participants and tested 14 CpG loci of TCF7L2 in 76 pairs of cases and controls. Conditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for T2DM risk according to SNPs and methylation of TCF7L2. Multifactor dimensionality reduction (MDR) analysis was used to explore the potential TCF7L2 gene-environment interactions in T2DM risk. RESULTS We found no statistically significant association between the TCF7L2 polymorphisms and T2DM risk. We observed significant positive associations of methylation at CpG5 and CpG7_8 with T2DM risk. For each 1% increase in DNA methylation at CpG5 and CpG7_8, T2DM risk increased 12% (OR 1.12, 95% CI 1.01-1.25) and 32% (OR 1.32, 95% CI 1.07-1.63), respectively. Additionally, MDR analyses identified significant SNP-environment interactions among rs290487, alcohol drinking, and hypertension and methylation-environment interactions among CpG5, CpG7_8 and hypertension (P <0.05). CONCLUSIONS TCF7L2 polymorphisms were not independently associated with T2DM risk. However, TCF7L2 methylation were positively associated with T2DM risk in rural Chinese adults. Interactions among TCF7L2 polymorphisms, TCF7L2 methylation and environmental factors also suggest a possible etiologic pattern for T2DM.
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Affiliation(s)
- Ranran Qie
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Minghui Han
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Shengbing Huang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Quanman Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Leilei Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongdong Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Cheng Cheng
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dechen Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Pei Qin
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Chunmei Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Qionggui Zhou
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Gang Tian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yanyan Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Xiaoyan Wu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yuying Wu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yang Li
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Xingjin Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yifei Feng
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Jie Lu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
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16
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Zhang Y, Qin P, Lou Y, Zhao P, Li X, Qie R, Wu X, Han M, Huang S, Zhao Y, Liu D, Wu Y, Li Y, Yang X, Zhao Y, Feng Y, Wang C, Ma J, Peng X, Chen H, Zhao D, Xu S, Wang L, Luo X, Zhang M, Hu D, Hu F. Association of TG/HDLC ratio trajectory and risk of type 2 diabetes: A retrospective cohort study in China. J Diabetes 2020; 13:402-412. [PMID: 33074586 DOI: 10.1111/1753-0407.13123] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/20/2020] [Accepted: 10/15/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The association of ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDL-C ratio) change trajectory with risk of type 2 diabetes mellitus (T2DM) remains unknown. The aim of this study was to evaluate the association between risk of T2DM and TG/HDL-C ratio change trajectory. METHODS A total of 18 444 participants aged 18-80 years old were included in this cohort study. Linear regression and quadratic regression models were used to determine the TG/HDL-C ratio change trajectory. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between TG/HDL-C ratio change trajectory and probability of T2DM. RESULTS T2DM developed in 714 participants during a median follow-up of 5.74 years (92 076.23 person-years of follow-up). After adjusting for baseline potential confounders, odds of T2DM were greater for participants with the increasing, U-shape, bell-shape, and other shape change vs decreasing change (adjusted OR [aOR] 2.01, 95% CI 1.42-2.81; 1.56, 1.15-2.13; 1.60, 1.17-2.20; and 1.49, 1.13-2.00, respectively). The results were robust in the sensitivity analyses on excluding baseline participants with T2DM. Moreover, the associations remained significant with male sex, age <60 years and body mass index <24 kg/m2 . CONCLUSIONS This retrospective study revealed increased probability of T2DM with increasing, U-shape, bell-shape, and other-shape TG/HDL-C ratio change trajectories, especially with male sex, age <60 years and body mass index <24 kg/m2 .
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Affiliation(s)
- Yanyan Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Pei Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Yanmei Lou
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, People's Republic of China
| | - Ping Zhao
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, People's Republic of China
| | - Xue Li
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, People's Republic of China
| | - Ranran Qie
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Xiaoyan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Minghui Han
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Shengbing Huang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Dechen Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yuying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Yang Li
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Xingjin Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yifei Feng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Changyi Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Jianping Ma
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Xiaolin Peng
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Hongen Chen
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Dan Zhao
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Shan Xu
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Li Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Xinping Luo
- School of Basic Medicine, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Ming Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Fulan Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
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Ferrari U, Then C, Rottenkolber M, Selte C, Seissler J, Conzade R, Linkohr B, Peters A, Drey M, Thorand B. Longitudinal association of type 2 diabetes and insulin therapy with muscle parameters in the KORA-Age study. Acta Diabetol 2020; 57:1057-1063. [PMID: 32246270 DOI: 10.1007/s00592-020-01523-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 03/19/2020] [Indexed: 01/07/2023]
Abstract
AIMS The aim of the current study was to investigate the association of type 2 diabetes (T2D) and insulin treatment with changes in muscle mass, muscle strength, and physical performance in older adults. METHODS In 731 participants of the population-based KORA-Age study aged 74.6 ± 6.2 years (T2D: n = 118; insulin treatment: n = 20), skeletal muscle index (SMI [kg/m2]), hand grip strength (GS [kg]), and a timed up and go test (TUG [s]) were performed at baseline and after a follow-up time of 3 years. The association of T2D and insulin therapy with changes in muscle parameters was analyzed using linear regression models. RESULTS After adjustment for sex, age, BMI, physical activity, smoking, and multimorbidity, T2D was associated with the change in SMI during follow-up (β - 0.1 (95% CI - 0.3 to - 0.02) kg/m2; p = 0.02), but not with a change in GS (β - 0.9 (95% CI - 1.9 to 0.04) kg) or TUG (β - 0.1 (95% CI - 0.7 to 0.5) s). Insulin therapy was positively associated with change in SMI (β 0.6 (95% CI 0.3-0.9) kg/m2; p = 0.001), but not in GS (β - 1.6 (95% CI - 4.1 to 0.8) kg) or TUG (β 1.6 (95% CI - 0.2-3.4) s) in comparison with treatment with oral anti-diabetic medication alone. CONCLUSIONS Participants with T2D showed an accelerated decline in muscle mass compared to non-diabetic participants. Insulin therapy was associated with preserved muscle mass, but not muscle function parameters, indicating a discrepancy between muscle mass and function in this high-risk population.
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Affiliation(s)
- Uta Ferrari
- Geriatrie, Department of Medicine IV, University Hospital, LMU Munich, Ziemssenstraße 1, 80336, Munich, Germany.
| | - Cornelia Then
- Geriatrie, Department of Medicine IV, University Hospital, LMU Munich, Ziemssenstraße 1, 80336, Munich, Germany
| | - Marietta Rottenkolber
- Geriatrie, Department of Medicine IV, University Hospital, LMU Munich, Ziemssenstraße 1, 80336, Munich, Germany
| | - Canan Selte
- Geriatrie, Department of Medicine IV, University Hospital, LMU Munich, Ziemssenstraße 1, 80336, Munich, Germany
| | - Jochen Seissler
- Geriatrie, Department of Medicine IV, University Hospital, LMU Munich, Ziemssenstraße 1, 80336, Munich, Germany
| | - Romy Conzade
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Birgit Linkohr
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Michael Drey
- Geriatrie, Department of Medicine IV, University Hospital, LMU Munich, Ziemssenstraße 1, 80336, Munich, Germany
| | - Barbara Thorand
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
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Yu Y, Pan F, Cui W, Tang W, Hu Y. Differences in early-phase insulin secretion and glucose disposition index between aged and middle-aged patients with newly diagnosed type 2 diabetes. Geriatr Gerontol Int 2020; 20:206-211. [PMID: 31923347 DOI: 10.1111/ggi.13861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/29/2019] [Accepted: 12/11/2019] [Indexed: 01/18/2023]
Abstract
AIM This cross-sectional study aimed to investigate the differences in β-cell function and insulin sensitivity between newly diagnosed aged and middle-aged type 2 diabetes mellitus (T2DM) patients. METHODS A total of 206 newly diagnosed T2DM patients aged ≥60 years (A-DM group) and 206 newly diagnosed sex- and glycated hemoglobin-matched T2DM patients aged <60 years (MA-DM group) were recruited. All patients underwent the 75-g oral glucose tolerance test. Plasma glucose, lipid profiles, liver and renal function, glycated hemoglobin, and insulin were measured. Homeostasis model assessment for insulin resistance, quantitative insulin sensitivity check index, area under the curve of glucose during 0-30 min (GluAUC30) × area under the curve of insulin during 0-30 min (InsAUC30) and β-cell function indexes were calculated. RESULTS The mean age of the total 412 patients (356 men and 56 women) was 59.76 ± 13.32 years. There were no significant differences in GluAUC120 between the two groups (106.89 ± 27.70 in A-DM vs 108.32 ± 27.58 in MA-DM; P = 0.6), but ΔI30/ΔG30, InsAUC30 and GluAUC30 × InsAUC30 levels were significantly higher in the A-DM group than in the MA-DM group (3.55 ± 4.54 vs 2.53 ± 3.83; P = 0.014, and 39.19 ± 32.19 vs 32.71 ± 28.81; P = 0.032, 675.05 ± 475.60 vs 584.56 ± 450.23; P = 0.048, respectively). The glucose disposition index (GDI) of the A-DM group was statistically higher than that of the MA-DM group (0.38 ± 0.40 vs 0.30 ± 0.35; P = 0.018). Age was positively associated with ΔI30/ΔG30 (r = 0.117; P = 0.017) and GDI (r = 0.147; P = 0.003), but had no correlation with InsAUC30, InsAUC120 or GluAUC30 × InsAUC30. After multiple adjustments for confounders, including sex, body mass index, glycated hemoglobin, triglyceride, total cholesterol and high-density lipoprotein cholesterol, age was positively associated with ΔI30/ΔG30, InsAUC30, InsAUC120, GluAUC30 × InsAUC30 and GDI. CONCLUSIONS Aged patients have relatively higher early-phase insulin secretion and GDI than middle-aged patients in newly diagnosed T2DM. Geriatr Gerontol Int 2020; ••: ••-••.
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Affiliation(s)
- Yun Yu
- Department of Geriatrics, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, China.,Department of Endocrinology and Metabolism, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Fenghui Pan
- Department of Geriatrics, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Wenxia Cui
- Department of Geriatrics, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Wei Tang
- Department of Endocrinology and Metabolism, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Yun Hu
- Department of Geriatrics, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, China
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The relationships between sarcopenic skeletal muscle loss during ageing and macronutrient metabolism, obesity and onset of diabetes. Proc Nutr Soc 2019; 79:158-169. [PMID: 31685055 DOI: 10.1017/s0029665119001150] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Skeletal muscle is integral to the metabolism and utilisation of macronutrients; however, substantial muscle loss and morphological changes occur with ageing. These are associated with loss of muscle function and accelerate rapidly from the age of 60 years, leading to the conditions of sarcopenia and frailty. As the relationship between muscle ageing and macronutrient metabolism and utilisation has seen limited research to date, this review focuses on the interactions between skeletal muscle changes during ageing, metabolism and utilisation of fat, carbohydrates and overall energy expenditure.Skeletal muscle contributes less to resting energy expenditure during ageing, potentially contributing to onset of obesity from middle age. Age-related changes to skeletal muscle lead to glucose dysregulation, with consequent reduction in glycaemic control, increased insulin resistance and ultimately onset of type-2 diabetes. Recent studies indicate that high total fat and SFA intake are detrimental to skeletal muscle, while higher intakes of PUFA are protective. Age-associated changes in skeletal muscle may also reduce total fatty acid utilisation.In conclusion, further research is needed to understand the relationships between macronutrient metabolism and utilisation and age-related changes to skeletal muscle. No dietary recommendations exist specifically for skeletal muscle health during ageing, but we advise individuals to follow healthy eating guidelines, by consuming sufficient protein, fruit and vegetables, and limited SFA and to maintain physically active lifestyles. Clinicians responsible for managing type-2 diabetes need to be aware of growing evidence relating age-related skeletal muscle changes to diabetes onset and progression.
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Sugimoto K, Tabara Y, Ikegami H, Takata Y, Kamide K, Ikezoe T, Kiyoshige E, Makutani Y, Onuma H, Gondo Y, Ikebe K, Ichihashi N, Tsuboyama T, Matsuda F, Kohara K, Kabayama M, Fukuda M, Katsuya T, Osawa H, Hiromine Y, Rakugi H. 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. J Diabetes Investig 2019; 10:1471-1479. [PMID: 31074209 PMCID: PMC6825926 DOI: 10.1111/jdi.13070] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/25/2019] [Accepted: 04/29/2019] [Indexed: 12/14/2022] Open
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.
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Affiliation(s)
- Ken Sugimoto
- Department of Geriatric and General MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Yasuharu Tabara
- Center for Genomic MedicineKyoto University Graduate School of MedicineKyotoJapan
| | - Hiroshi Ikegami
- Department of Endocrinology, Metabolism and DiabetesKindai UniversityOsaka‐sayamaJapan
| | - Yasunori Takata
- Department of Diabetes and Molecular GeneticsEhime University Graduate School of MedicineToonJapan
| | - Kei Kamide
- Department of Health Promotion SciencesDivision of Health SciencesOsaka University Graduate School of MedicineSuitaJapan
| | - Tome Ikezoe
- Department of Physical TherapyHuman Health SciencesKyoto University Graduate School of MedicineKyotoJapan
| | - Eri Kiyoshige
- Department of Health Promotion SciencesDivision of Health SciencesOsaka University Graduate School of MedicineSuitaJapan
| | - Yukako Makutani
- Department of Endocrinology, Metabolism and DiabetesKindai UniversityOsaka‐sayamaJapan
| | - Hiroshi Onuma
- Diabetes/Metabolic EndocrinologyYachiyo Medical CenterTokyo Women's Medical UniversityYachiyoJapan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral ScienceOsaka University Graduate School of Human SciencesJapan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral RehabilitationOsaka University Graduate School of DentistrySuitaJapan
| | - Noriaki Ichihashi
- Department of Physical TherapyHuman Health SciencesKyoto University Graduate School of MedicineKyotoJapan
| | - Tadao Tsuboyama
- Department of Physical TherapyHuman Health SciencesKyoto University Graduate School of MedicineKyotoJapan
- School of Health SciencesBukkyo UniversityKyotoJapan
| | - Fumihiko Matsuda
- Center for Genomic MedicineKyoto University Graduate School of MedicineKyotoJapan
| | - Katsuhiko Kohara
- Department of Regional Resource ManagementFaculty of Collaborative Regional InnovationEhime UniversityMatsuyamaJapan
| | - Mai Kabayama
- Department of Health Promotion SciencesDivision of Health SciencesOsaka University Graduate School of MedicineSuitaJapan
| | | | - Tomohiro Katsuya
- Katsuya ClinicAmagasakiJapan
- Department of Clinical Gene TherapyOsaka University Graduate School of MedicineSuitaJapan
| | - Haruhiko Osawa
- Department of Diabetes and Molecular GeneticsEhime University Graduate School of MedicineToonJapan
| | - Yoshihisa Hiromine
- Department of Endocrinology, Metabolism and DiabetesKindai UniversityOsaka‐sayamaJapan
| | - Hiromi Rakugi
- Department of Geriatric and General MedicineOsaka University Graduate School of MedicineSuitaJapan
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Veronese N, Pizzol D, Demurtas J, Soysal P, Smith L, Sieber C, Strandberg T, Bourdel-Marchasson I, Sinclair A, Petrovic M, Maggi S. Association between sarcopenia and diabetes: a systematic review and meta-analysis of observational studies. Eur Geriatr Med 2019; 10:685-696. [DOI: 10.1007/s41999-019-00216-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/28/2019] [Indexed: 12/25/2022]
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Koo BK. Letter: Projection of Diabetes Prevalence in Korean Adults for the Year 2030 Using Risk Factors Identified from National Data (Diabetes Metab J 2019;43:90-6). Diabetes Metab J 2019; 43:242-243. [PMID: 30993940 PMCID: PMC6470095 DOI: 10.4093/dmj.2019.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Bo Kyung Koo
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
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Teng S, Huang P. The effect of type 2 diabetes mellitus and obesity on muscle progenitor cell function. Stem Cell Res Ther 2019; 10:103. [PMID: 30898146 PMCID: PMC6427880 DOI: 10.1186/s13287-019-1186-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
In addition to its primary function to provide movement and maintain posture, the skeletal muscle plays important roles in energy and glucose metabolism. In healthy humans, skeletal muscle is the major site for postprandial glucose uptake and impairment of this process contributes to the pathogenesis of type 2 diabetes mellitus (T2DM). A key component to the maintenance of skeletal muscle integrity and plasticity is the presence of muscle progenitor cells, including satellite cells, fibroadipogenic progenitors, and some interstitial progenitor cells associated with vessels (myo-endothelial cells, pericytes, and mesoangioblasts). In this review, we aim to discuss the emerging concepts related to these progenitor cells, focusing on the identification and characterization of distinct progenitor cell populations, and the impact of obesity and T2DM on these cells. The recent advances in stem cell therapies by targeting diabetic and obese muscle are also discussed.
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Affiliation(s)
- Shuzhi Teng
- The Key Laboratory of Pathobiology, Ministry of Education, Norman Bethune College of Medicine, Jilin University, 126 Xinmin Street, Changchun, Jilin, 130021, People's Republic of China.
| | - Ping Huang
- The Key Laboratory of Pathobiology, Ministry of Education, Norman Bethune College of Medicine, Jilin University, 126 Xinmin Street, Changchun, Jilin, 130021, People's Republic of China.
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Su Y, Hirayama K, Han TF, Izutsu M, Yuki M. Sarcopenia Prevalence and Risk Factors among Japanese Community Dwelling Older Adults Living in a Snow-Covered City According to EWGSOP2. J Clin Med 2019; 8:E291. [PMID: 30823497 PMCID: PMC6463161 DOI: 10.3390/jcm8030291] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 12/16/2022] Open
Abstract
Sarcopenia is a common problem among the elderly worldwide. Muscle mass can decrease with aging and decreased physical activity may occur. However, the sarcopenia prevalence among community dwelling older adults living in snow-covered cities remains largely unknown. Therefore, we evaluated the prevalence of and risk factors for sarcopenia in this population aged 65 years or older according to the definitions and diagnoses of the European Working Group on Sarcopenia in Older People-2 from two welfare centers in Sapporo, Hokkaido, Japan. The demographic characteristics, nutrition, and depression status of 310 participants were assessed using a standardized questionnaire. All participants were assessed for grip strength. Skeletal muscle index, body mass index (BMI), and total body water (TBW) were measured using bioelectrical impedance analysis. The overall sarcopenia prevalence in the study population was 8.1%. Multivariate analysis revealed that diabetes and taking more than four drugs per day were independently associated with sarcopenia (adjusted odds ratio (OR) = 3.66, 95% confidence interval (CI) = 1.06⁻12.61; OR = 2.66, CI = 1.05⁻6.77, respectively). BMI and TBW were negatively associated with sarcopenia. Sarcopenia prevalence was low in community dwelling older adults living in the snow-covered city. It is indicated that welfare center exercise may be a good intervention for the prevention of sarcopenia. Moreover, the management of diabetes, medication, and nutrition is necessary for sarcopenia prevention in community dwelling older adults.
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Affiliation(s)
- Ya Su
- Graduate School of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan.
| | - Kengo Hirayama
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan.
| | - Tian-Fang Han
- Graduate School of Education, Hokkaido University, Sapporo 060-0812, Japan.
| | - Miku Izutsu
- Graduate School of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan.
| | - Michiko Yuki
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan.
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Predictive Value of Preoperative Sarcopenia in Patients with Gastric Cancer: a Meta-analysis and Systematic Review. J Gastrointest Surg 2018; 22:1890-1902. [PMID: 29987739 DOI: 10.1007/s11605-018-3856-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 06/18/2018] [Indexed: 01/31/2023]
Abstract
PURPOSE The impact of preoperative sarcopenia on postoperative complications and overall survival has been recently debated. Our meta-analysis aims to ascertain whether preoperative sarcopenia increases the risk of poor outcomes and to attempt to provide new ideas for the prognosis of outcomes for patients with gastric cancer. METHODS We searched for all relevant articles on PubMed, the EMBASE database, and Web of Science (up to September 1, 2017). Data synthesis and statistical analysis were carried out using RevMan 5.3 software. RESULTS Thirteen studies involving 4262 patients who underwent gastrectomy for gastric cancer were analyzed (sarcopenia group = 1234; non-sarcopenia group = 3028). The results showed that preoperative sarcopenia significantly associated with poor pathological staging (high pT: OR = 1.86, 95% CI = 1.49-2.31; P < 0.01; pN+: OR = 1.61, 95% CI = 1.33-1.94; P < 0.01; high TNM category: OR = 1.84, 95% CI = 1.53-2.22; P < 0.01). Patients with preoperative sarcopenia had an increased risk of total postoperative complications (OR = 2.17, 95% CI = 1.53-3.08; P < 0.01), severe complications (OR = 1.65, 95% CI = 1.09-2.50; P = 0.02), and poorer OS (HR = 1.70, 95% CI = 1.45-1.99; P < 0.01). The results of subgroup analyses revealed that patients with preoperative sarcopenia over 65 years old and those from Asian populations had higher risks for total postoperative complications and severe complications. CONCLUSION This meta-analysis reveals that preoperative sarcopenia may be used as a new indicator of poor pathological staging, impaired overall survival, and increased postoperative complications. Notably, patients with gastric cancer who are over 65 years old and from Asia should be routinely screened for sarcopenia before surgery to adequately assess the risk of postoperative complications in clinical practice.
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Trierweiler H, Kisielewicz G, Hoffmann Jonasson T, Rasmussen Petterle R, Aguiar Moreira C, Zeghbi Cochenski Borba V. Sarcopenia: a chronic complication of type 2 diabetes mellitus. Diabetol Metab Syndr 2018; 10:25. [PMID: 29632617 PMCID: PMC5883537 DOI: 10.1186/s13098-018-0326-5] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 03/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diabetics are at increased risk for impaired mobility and strength, frequently related to the disease control. Sarcopenia is the reduction of muscle mass associated with the decrease in muscle strength and/or performance, resulting in worse morbidity in chronic diseases. METHODS The objectives of this paper was to assess the prevalence of sarcopenia in patients with type 2 diabetes mellitus (T2DM) and determine its association with diabetes characteristics, progression, and complications, as well as changes in bone mineral density. The sample consisted of patients with T2DM followed at the outpatient clinics of the Serviço de Endocrinologia e Metabologia do Hospital de Clínicas da Universidade Federal do Paraná, from March to August 2016. Participants were men and women above 18 years with T2DM diagnosed at least 1 year earlier. Individuals with chronic diseases, users of any drug that modifies body composition, patients with body mass index (BMI) > 35 or < 18 kg/m2, and users of illicit drugs or hormonal or nutritional supplementation were excluded. The selected patients answered questionnaires about demographics, eating habits, and disease characteristics, and performed a bone densitometry exam in a dual energy absorptiometry (total body; spine and femur (total and neck)), a handgrip test by manual dynamometer, and an evaluation of the abdominal circumference (AC). The medical records were reviewed seeking diabetes data and laboratory test results. Patients were matched for sex, age, and race with healthy controls [Control Group (CG)]. The diagnosis of sarcopenia was conducted according to the criteria of the Foundation for National Institute of Health. RESULTS The final sample consisted of 83 patients in the DG and 83 in the CG. The DG had higher BMI, WC, past history of fractures and lower calcium and healthy diet intake (p < 0.005), compared to the CG. The DG presented a higher frequency of abnormal BMD (osteopenia in 45 (53%), and osteoporosis in 14 (19%)) and comorbidities than the CG (p < 0.005). Pre-sarcopenia was not different between groups, but muscle weakness was present in 25 diabetics (18 women) and only in 5 controls (4 men) (p = 0.00036). Sarcopenia was diagnosed in 13 (16.2%) patients in the DG and 2 (2.4%) in the CG (p = 0.01168). Pre-sarcopenia and sarcopenia were associated with altered BMD (p < 0.005), with no association with diabetes duration or control. Body mass index and osteoporosis increased the likelihood to have sarcopenia, but hypertension and healthy diet decreased it. CONCLUSION The DG had altered BMD associated with worse glycemic control, and a higher prevalence of sarcopenia, suggesting the need to look for their presence in diabetics.
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Affiliation(s)
| | | | | | | | - Carolina Aguiar Moreira
- Endocrine Division, Hospital de Clínicas da Universidade Federal do Paraná (SEMPR), Avenida Agostinho Leão Júnior, 285, Alto da Glória, Curitiba, PR 80030-110 Brazil
| | - Victória Zeghbi Cochenski Borba
- Endocrine Division, Hospital de Clínicas da Universidade Federal do Paraná (SEMPR), Avenida Agostinho Leão Júnior, 285, Alto da Glória, Curitiba, PR 80030-110 Brazil
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Drey M, Berr CM, Reincke M, Fazel J, Seissler J, Schopohl J, Bidlingmaier M, Zopp S, Reisch N, Beuschlein F, Osswald A, Schmidmaier R. Cushing's syndrome: a model for sarcopenic obesity. Endocrine 2017; 57:481-485. [PMID: 28702888 DOI: 10.1007/s12020-017-1370-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 06/30/2017] [Indexed: 01/04/2023]
Abstract
PURPOSE Obesity and its metabolic impairments are discussed as major risk factors for sarcopenia leading to sarcopenic obesity. Cushing's syndrome is known to be associated with obesity and muscle atrophy. We compared Cushing's syndrome with matched obese controls regarding body composition, physical performance, and biochemical markers to test the hypothesis that Cushing's syndrome could be a model for sarcopenic obesity. METHODS By propensity score matching, 47 controls were selected by body mass index and gender as obese controls. Fat mass and muscle mass were measured by bioelectrical impedance analysis. Muscle function was assessed by chair rising test and hand grip strength. Biochemical markers of glucose and lipid metabolism and inflammation (hsCRP) were measured in peripheral blood. RESULTS Muscle mass did not differ between Cushing's syndrome and obese controls. However, Cushing's syndrome patients showed significantly greater chair rising time (9.5 s vs. 7.3 s, p = 0.008) and significantly lower hand grip strength (32.1 kg vs. 36.8 kg, p = 0.003). Cushing's syndrome patients with impaired fasting glucose have shown the highest limitations in hand grip strength and chair rising time. CONCLUSIONS Similar to published data in ageing medicine, Cushing's syndrome patients show loss of muscle function that cannot be explained by loss of muscle mass. Impaired muscle quality due to fat infiltration may be the reason. This is supported by the observation that Cushing's syndrome patients with impaired glucose metabolism show strongest deterioration of muscle function. Research in sarcopenic obesity in elderly is hampered by confounding comorbidities and polypharmacy. As Cushing's syndrome patients are frequently free of comorbidities and as Cushing's syndrome is potentially curable we suggest Cushing's syndrome as a clinical model for further research in sarcopenic obesity.
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Affiliation(s)
- Michael Drey
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Akutgeriatrie, Klinikum der Universität München (LMU), Munich, Germany.
| | - Christina M Berr
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Martin Reincke
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Julia Fazel
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Jochen Seissler
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Jochen Schopohl
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Martin Bidlingmaier
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Stefanie Zopp
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Nicole Reisch
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Felix Beuschlein
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Andrea Osswald
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Ralf Schmidmaier
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Akutgeriatrie, Klinikum der Universität München (LMU), Munich, Germany
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
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Koo BK, Moon MK. Are We in the Same Risk of Diabetes Mellitus? Gender- and Age-Specific Epidemiology of Diabetes in 2001 to 2014 in the Korean Population. Diabetes Metab J 2016; 40:175-81. [PMID: 27273907 PMCID: PMC4929220 DOI: 10.4093/dmj.2016.40.3.175] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 05/09/2016] [Indexed: 01/15/2023] Open
Abstract
In the early 2000s, the prevalence of diabetes in adults aged ≥30 years in Korea was about 9% to 10%, and it remained stable. However, a nationwide survey showed that this prevalence increased over the past few years. After age-standardization using the Korean population of the year 2010, the prevalence of diabetes in adults aged ≥30 years was 10.0% to 10.8% between 2001 and 2012, which increased to 12.5% in 2013 and 11.6% in 2014. During that period, there have been changes in the gender- and age-specific prevalence of diabetes in Korean adults. The prevalence of diabetes in the elderly population increased significantly, while this prevalence in young adults, especially in young women, did not change significantly. The contribution of each diabetic risk factor, such as obesity, β-cell dysfunction, sarcopenia, and socioeconomic status, in developing diabetes has also changed during that period in each gender and age group. For young women, obesity was the most important risk factor; by contrast, for elderly diabetic patients, sarcopenia was more important than obesity as a risk factor. Considering the economic burden of diabetes and its associated comorbidities, a public health policy targeting the major risk factors in each population might be more effective in preventing diabetes.
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Affiliation(s)
- Bo Kyung Koo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
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30
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Koo BK, Roh E, Yang YS, Moon MK. Difference between old and young adults in contribution of β-cell function and sarcopenia in developing diabetes mellitus. J Diabetes Investig 2015; 7:233-40. [PMID: 27042276 PMCID: PMC4773679 DOI: 10.1111/jdi.12392] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 06/03/2015] [Accepted: 06/21/2015] [Indexed: 11/28/2022] Open
Abstract
AIMS/INTRODUCTION To investigate the difference in contributing factors in developing diabetes between old and young adults. MATERIALS AND METHODS Subjects with recent-onset diabetes were selected from a nationwide survey data and classified according to age: elderly (age ≥75 years), middle-age (age 45-64 years) and young (age 25-39 years). The homeostasis model assessment of insulin resistance and β-cell function were calculated. Sarcopenia was assessed using dual-energy X-ray absorptiometry. RESULTS The prevalence of recent-onset diabetes was 13.5%, 8.0%, and 1.4% in patients aged ≥75 years (unweighted n = 1,082), 45-64 years (unweighted n = 6,532), and 25-39 years (unweighted n = 5,178), respectively. Homeostasis model assessment of β-cell function along with homeostasis model assessment of insulin resistance showed increasing trends as onset age increased in recent-onset diabetes (P for trend < 0.001 in both). Elderly-onset diabetic patients had significantly higher homeostasis model assessment of β-cell function and homeostasis model assessment of insulin resistance compared with the middle-age-onset group (P < 0.001 and 0.014, respectively). Multivariate analysis showed that sarcopenia was significantly associated with recent-onset diabetes only in patients aged ≥75 years (odds ratio [OR] 2.478, 95% confidence interval [CI] 1.379-4.452) but not in patients aged 45-64 years. In the middle-age group, abdominal obesity (OR 2.933, 95% CI 2.086-4.122), hypertriglyceridemia (OR 1.529, 95% CI 1.078-2.169]) and low high-density lipoprotein cholesterolemia (OR 1.930, 95% CI 1.383-2.695) were associated with recent-onset diabetes. CONCLUSIONS Elderly-onset diabetic patients had higher insulin resistance and relatively preserved β-cell function compared with middle-age-onset patients. Sarcopenia might play a more important role in developing diabetes in the elderly population.
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Affiliation(s)
- Bo Kyung Koo
- Department of Internal Medicine Seoul National University College of Medicine Seoul Korea; Department of Internal Medicine Boramae Medical Center Seoul Korea
| | - Eun Roh
- Department of Internal Medicine Seoul National University College of Medicine Seoul Korea; Department of Medicine University of Ulsan College of Medicine Seoul Korea
| | - Ye Seul Yang
- Department of Internal Medicine Seoul National University College of Medicine Seoul Korea
| | - Min Kyong Moon
- Department of Internal Medicine Seoul National University College of Medicine Seoul Korea; Department of Internal Medicine Boramae Medical Center Seoul Korea
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