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Minato-Inokawa S, Tsuboi-Kaji A, Honda M, Takeuchi M, Kitaoka K, Kurata M, Wu B, Kazumi T, Fukuo K. Low muscle mass is associated with low insulin sensitivity, impaired pancreatic β cell function, and high glucose excursion in nondiabetic nonobese Japanese women. Metabol Open 2024; 23:100306. [PMID: 39188637 PMCID: PMC11347059 DOI: 10.1016/j.metop.2024.100306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/29/2024] [Accepted: 07/29/2024] [Indexed: 08/28/2024] Open
Abstract
Aim We tested whether skeletal muscle mass is associated with insulin sensitivity, pancreatic β-cell function, and postglucose glycemia. Methods Appendicular skeletal muscle mass (ASM) (relative to body size, %ASM) by DXA, surrogate measures of insulin sensitivity, insulin secretion and the disposition index (insulin sensitivity adjusted insulin secretion: a product of the insulinogenic index and Matsuda insulin sensitivity index) inferred from serum insulin kinetics during a 75 g oral glucose tolerance test (OGTT) were evaluated in 168 young and 65 middle-aged women, whose BMI averaged <23.0 kg/m2 and HbA1c ≦ 5.5 %. Results In two groups of women, %ASM was associated negatively with homeostasis model assessment insulin resistance (HOMA-IR) and 2-h insulin (both p < 0.01 or less). In middle-aged women not in young women, %ASM was associated inversely with the Matsuda index (p < 0.001). In middle-aged women only, it also showed a positive association with the disposition index (p = 0.02) and inverse associations with 1-h and 2-h glucose (both p < 0.01) and area under the glucose concentration curve during OGTT (p = 0.006). On multivariate linear regression analyses, 2-h insulin emerged as a determinant of %ASM independently of HOMA-IR in young women (standardized β: 0.287, p < 0.001, R2 = 0.077). In middle-aged women, the Matsuda index emerged as a determinant of %ASM (standardized β: 0.476, p < 0.001) independently of HOMA-IR, log ODI and AUCg and explained 21.3 % of %ASM variability. Post-glucose glycemia and AUCg were higher and log ODI was lower in middle-aged women with low compared with high %ASM. Conclusion Low skeletal muscle mass (relative to body size) was associated with low insulin sensitivity in young and middle-aged Japanese women who were neither obese nor diabetic. Middle-aged women with low muscle mass had low disposition index, an early marker of inadequate pancreatic β-cell compensation, and hence high glucose excursion. Low skeletal muscle mass may be associated with the development of type 2 diabetes at a much lower BMI in Japanese people.
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Affiliation(s)
- Satomi Minato-Inokawa
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Laboratory of Community Health and Nutrition, Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Ehime, Japan
| | - Ayaka Tsuboi-Kaji
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Nutrition, Osaka City Juso Hospital, Osaka, Japan
| | - Mari Honda
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Health, Sports, and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Kobe, Hyogo, Japan
| | - Mika Takeuchi
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Kaori Kitaoka
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Advanced Epidemiology, Noncommunicable Disease (NCD) Epidemiology Research Center, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Miki Kurata
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Bin Wu
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Tsutomu Kazumi
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Medicine, Hakuhoukai Kakogawa Hospital, Kakogawa, Hyogo, Japan
| | - Keisuke Fukuo
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
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Suárez R, Andrade C, Bautista-Valarezo E, Sarmiento-Andrade Y, Matos A, Jimenez O, Montalvan M, Chapela S. Low muscle mass index is associated with type 2 diabetes risk in a Latin-American population: a cross-sectional study. Front Nutr 2024; 11:1448834. [PMID: 39139651 PMCID: PMC11319288 DOI: 10.3389/fnut.2024.1448834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 07/22/2024] [Indexed: 08/15/2024] Open
Abstract
Objective Diabetes mellitus is a growing disease with severe complications. Various scores predict the risk of developing this pathology. The amount of muscle mass is associated with insulin resistance, yet there is no established evidence linking muscle mass with diabetes risk. This work aims to study that relationship. Research methods and procedures This cross-sectional study included 1,388 employees. The FINDRISC score was used to assess type 2 diabetes risk, and bioimpedance was used for body composition analysis. Appendicular skeletal muscle mass adjusted by body mass index (ASM/BMI) was analyzed. Sociodemographic, clinical and anthropometric measures were evaluated, logistic regression models with sex stratification were conducted and ROC curves were calculated to determine the ability of ASM/BMI index to predict T2D risk. Results It was observed that patients with higher ASM/BMI had a lower FINDRISC score in both men and women (p < 0.001). A logistic regression model showed and association between ASM/BMI and diabetes risk in women [OR: 0.000 (0.000-0.900), p = 0.048], but not in men [OR: 0.267 (0.038-1.878), p = 0.185]. However, when the body mass index variable was excluded from the model, an association was found between muscle mass adjusted to BMI and diabetes risk in both men [OR: 0.000 (0.000-0.016), p < 0.001], and women [OR:0.001 (0.000-0.034), p < 0.001]. Other risk factors were having a low level of physical activity, waist circumference, age and sedentary lifestyle. A ROC curve was built and the optimal ASM/BMI cut-of value for predicting T2D risk was 0.82 with a sensitivity of 53.71% and specificity of 69.3% [AUC of 0.665 (0.64-0.69; p < 0.0001)]. Conclusion When quantifying the risk of type 2 diabetes in both women and men, assessing muscle mass can help detect adult individuals with a high risk of developing type 2 diabetes.
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Affiliation(s)
- Rosario Suárez
- School of Medicine, Universidad Técnica Particular del Loja, Loja, Ecuador
| | - Celina Andrade
- School of Medicine, Universidad Técnica Particular del Loja, Loja, Ecuador
| | | | | | - Andri Matos
- School of Allied Health, Eastwick College, Ramsey, NJ, United States
| | - Oliver Jimenez
- School of Medicine, Universidad Técnica Particular del Loja, Loja, Ecuador
| | - Martha Montalvan
- Escuela de Medicina, Universidad Espíritu Santo, Samborondón, Ecuador
| | - Sebastián Chapela
- Departamento de Bioquímica Humana, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
- Hospital Británico de Buenos Aires, Buenos Aires, Argentina
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Álvarez-Bustos A, Carnicero JA, Rueda R, Pereira SL, Santos-Fandila A, López-Pedrosa JM, Molina-Baena B, García-García FJ, Rodríguez-Mañas L. Relationship of endogenous plasma concentrations of β-hydroxy β-methyl butyrate (HMB) with frailty in community dwelling older adults with type-2 diabetes mellitus. J Nutr Health Aging 2024; 28:100229. [PMID: 38598977 DOI: 10.1016/j.jnha.2024.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Supplementation with β-hydroxy β-methyl butyrate (HMB) appears to be effective in preserving muscle in older adults. However, the association between endogenously produced HMB with frailty has not been studied in people with chronic disease. OBJECTIVES The purpose of this study is to explore whether an association exists between endogenous HMB levels and frailty status in older adults with type-2 diabetes mellitus (T2DM). METHODS Data were taken from the Toledo Study of Healthy Ageing, a community-dwelling aged (65 years+) cohort. Frailty was assessed at baseline and at 2.99 median years according to the Frailty Phenotype (FP) standardized to our population and the Frailty Trait Scale 12 (FTS12). The associations between HMB levels and frailty were assessed using three nested multivariate logistic regressions and segmented by sex. Glucose, HMB and glucose interaction, age and body composition were used as covariables. RESULTS 255 participants (mean age 75.3 years, 52.94% men) were included. HMB levels showed an inverse cross-sectional association with frailty, which was modified when the interaction term HMB*glucose was included, remaining significant only for FTS12 [OR (95% CI): 0.436 (0.253, 0.751), p-value 0.003]. The association between HMB endogenous levels and FTS12 appears to be independent of sex, in which the association was maintained after adjusting for the covariates. However, there appears to be threshold points for glucose levels, above which the protective effect of HMB is lost: 145.4 mg/dl adjusted by gender for the whole sample and 149.6 mg/dl and 138.9 mg/dl for men and women, respectively. Endogenous HMB levels were not found to be associated with incident frailty. CONCLUSIONS Cross-sectional analysis revealed that endogenous HMB levels were inversely associated with frailty as assessed by the FTS12 in older people with T2DM. This association was found to be dependent on circulating fasted glucose levels.
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Affiliation(s)
- Alejandro Álvarez-Bustos
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Biomédica La Paz (IdiPaz), Madrid, Spain
| | - Jose A Carnicero
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Fundación de Investigación Biomédica Hospital Universitario de Getafe, Getafe, Spain
| | | | | | | | | | | | - Francisco José García-García
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Geriatría, Hospital Virgen del Valle, Toledo, Spain
| | - Leocadio Rodríguez-Mañas
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Geriatría, Hospital Universitario de Getafe, Getafe, Spain; Instituto de Investigación Biomédica La Paz (IdiPaz), Madrid, Spain.
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Liu D, Li N, Zhou Y, Wang M, Song P, Yuan C, Shi Q, Chen H, Zhou K, Wang H, Li T, Pan XF, Tian H, Li S. Sex-specific associations between skeletal muscle mass and incident diabetes: A population-based cohort study. Diabetes Obes Metab 2024; 26:820-828. [PMID: 37997500 DOI: 10.1111/dom.15373] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/31/2023] [Accepted: 11/04/2023] [Indexed: 11/25/2023]
Abstract
AIMS To investigate the sex-specific associations between predicted skeletal muscle mass index (pSMI) and incident type 2 diabetes in a retrospective longitudinal cohort of Chinese men and women. MATERIALS AND METHODS We enrolled Chinese adults without diabetes at baseline from WATCH (West chinA adulT health CoHort), a large health check-up-based database. We calculated pSMI to estimate skeletal muscular mass, and measured blood glucose variables and assessed self-reported history to identify new-onset diabetes. The nonlinear association between pSMI and incident type 2 diabetes was modelled using the penalized spline method. The piecewise association was estimated using segmented linear splines in weighted Cox proportional hazards regression models. RESULTS Of 47 885 adults (53.2% women) with a median age of 40 years, 1836 developed type 2 diabetes after a 5-year median follow-up. In women, higher pSMI was associated with a lower risk of incident type 2 diabetes (Pnonlinearity = 0.09, hazard ratio [HR] per standard deviation increment in pSMI: 0.79 [95% confidence interval {CI} 0.68, 0.91]). A nonlinear association of pSMI with incident type 2 diabetes was detected in men (Pnonlinearity < 0.001). In men with pSMI lower than 8.1, higher pSMI was associated with a lower risk of incident type 2 diabetes (HR 0.58 [95% CI 0.40, 0.84]), whereas pSMI was not significantly associated with incident diabetes in men with pSMI equal to or greater than 8.1 (HR 1.08 [95% CI 0.93, 1.25]). CONCLUSIONS In females, a larger muscular mass is associated with a lower risk of type 2 diabetes. For males, this association is significant only among those with diminished muscle mass.
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Affiliation(s)
- Dan Liu
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Nan Li
- Department of Informatics, West China Hospital, Sichuan University, Chengdu, China
| | - Yiling Zhou
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Miye Wang
- Department of Informatics, West China Hospital, Sichuan University, Chengdu, China
| | - Peige Song
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Changzheng Yuan
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Qingyang Shi
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Hui Chen
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Kaixin Zhou
- College of Life Sciences, University of the Chinese Academy of Sciences, Beijing, China
- College of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Huan Wang
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - Tao Li
- Department of Anesthesiology, Laboratory of Mitochondria and Metabolism, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiong-Fei Pan
- Section of Epidemiology and Population Health, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Haoming Tian
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Sheyu Li
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
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Xu F, Earp JE, Riebe D, Delmonico MJ, Lofgren IE, Greene GW. The relationship between fat distribution and diabetes in US adults by race/ethnicity. Front Public Health 2024; 12:1373544. [PMID: 38450122 PMCID: PMC10916687 DOI: 10.3389/fpubh.2024.1373544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 02/07/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction This study examined the relationship between fat distribution and diabetes by sex-specific racial/ethnic groups. Methods A secondary data analysis of National Health and Nutrition Examination Survey 2011-2018 data (n = 11,972) was completed. Key variables examined were visceral adipose tissue area (VATA), subcutaneous fat area (SFA), diabetes prevalence, and race/ethnicity. The association of VATA and SFA and diabetes prevalence was examined separately and simultaneously using multiple logistic regression. Bonferroni corrections were applied to all multiple comparisons between racial/ethnic groups. All analyses were adjusted for demographics and muscle mass. Results VATA was positively associated with diabetes in both sexes (p < 0.001) and across all racial/ethnic groups (p < 0.05) except Black females. No statistically significant relationships were observed between SFA and diabetes while accounting for VATA with the exception of White females (p = 0.032). When comparing racial/ethnic groups, the relationship between VATA and diabetes was stronger in White and Hispanic females than in Black females (p < 0.005) while the relationship between SFA and diabetes did not differ between any racial/ethnic groups. Conclusion This study found that VATA is associated with diabetes for both sexes across almost all racial/ethnic groups independent of SFA whereas the only significant relationship between SFA and diabetes, independent of VATA, was observed in White females. The findings indicated that visceral fat was more strongly associated with diabetes than subcutaneous. Additionally, there are health disparities in sex-specific racial/ethnic groups thus further study is warranted.
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Affiliation(s)
- Furong Xu
- College of Education, University of Rhode Island, Kingston, RI, United States
| | - Jacob E. Earp
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States
| | - Deborah Riebe
- Department of Kinesiology, University of Rhode Island, Kingston, RI, United States
| | - Matthew J. Delmonico
- Department of Kinesiology, University of Rhode Island, Kingston, RI, United States
| | - Ingrid E. Lofgren
- Department of Nutrition, University of Rhode Island, Kingston, RI, United States
| | - Geoffrey W. Greene
- Department of Nutrition, University of Rhode Island, Kingston, RI, United States
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Lopez-Pedrosa JM, Camprubi-Robles M, Guzman-Rolo G, Lopez-Gonzalez A, Garcia-Almeida JM, Sanz-Paris A, Rueda R. The Vicious Cycle of Type 2 Diabetes Mellitus and Skeletal Muscle Atrophy: Clinical, Biochemical, and Nutritional Bases. Nutrients 2024; 16:172. [PMID: 38202001 PMCID: PMC10780454 DOI: 10.3390/nu16010172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/30/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
Today, type 2 diabetes mellitus (T2DM) and skeletal muscle atrophy (SMA) have become increasingly common occurrences. Whether the onset of T2DM increases the risk of SMA or vice versa has long been under investigation. Both conditions are associated with negative changes in skeletal muscle health, which can, in turn, lead to impaired physical function, a lowered quality of life, and an increased risk of mortality. Poor nutrition can exacerbate both T2DM and SMA. T2DM and SMA are linked by a vicious cycle of events that reinforce and worsen each other. Muscle insulin resistance appears to be the pathophysiological link between T2DM and SMA. To explore this association, our review (i) compiles evidence on the clinical association between T2DM and SMA, (ii) reviews mechanisms underlying biochemical changes in the muscles of people with or at risk of T2DM and SMA, and (iii) examines how nutritional therapy and increased physical activity as muscle-targeted treatments benefit this population. Based on the evidence, we conclude that effective treatment of patients with T2DM-SMA depends on the restoration and maintenance of muscle mass. We thus propose that regular intake of key functional nutrients, along with guidance for physical activity, can help maintain euglycemia and improve muscle status in all patients with T2DM and SMA.
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Affiliation(s)
| | | | | | | | - Jose Manuel Garcia-Almeida
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, 29010 Malaga, Spain;
| | - Alejandro Sanz-Paris
- Nutrition Unit, Universitary Hospital Miguel Servet, Isabel the Catholic 1-3, 50009 Zaragoza, Spain;
| | - Ricardo Rueda
- Abbott Nutrition R&D, 18004 Granada, Spain; (M.C.-R.); (A.L.-G.); (R.R.)
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Al-Sofiani ME, Asiri A, Alajmi S, Alkeridy W. Perspectives on Prediabetes and Aging. Endocrinol Metab Clin North Am 2023; 52:377-388. [PMID: 36948785 DOI: 10.1016/j.ecl.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Diabetes prevention programs (DPPs) have been shown to effectively delay, and sometimes prevent, the progression from prediabetes to diabetes; however, labeling someone with prediabetes comes with potential negative psychological, financial, and self-perception consequences. Many older adults with prediabetes nowadays have a relatively "low-risk" form of prediabetes that rarely progresses to diabetes and may regress to normoglycemia. In this article, we review the impact of aging on glucose metabolism and provide a holistic approach to cases of prediabetes in older adults that maximizes the benefit-risk balance of interventions aimed at addressing prediabetes.
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Affiliation(s)
- Mohammed E Al-Sofiani
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Central Region, 12372, Saudi Arabia; Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University, 1830 East Monument Street, Baltimore, MD 21287, USA.
| | - Alanood Asiri
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Central Region, 12372, Saudi Arabia
| | - Sarah Alajmi
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Central Region, 12372, Saudi Arabia
| | - Walid Alkeridy
- Department of Medicine, King Saud University, College of Medicine, Riyadh, Central Region, 12372, Saudi Arabia
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Kuang M, Lu S, Yang R, Chen H, Zhang S, Sheng G, Zou Y. Association of predicted fat mass and lean body mass with diabetes: a longitudinal cohort study in an Asian population. Front Nutr 2023; 10:1093438. [PMID: 37229472 PMCID: PMC10203423 DOI: 10.3389/fnut.2023.1093438] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/17/2023] [Indexed: 05/27/2023] Open
Abstract
Objective The relationship between body composition fat mass (FM) and lean body mass (LBM) and diabetes risk is currently debated, and the purpose of this study was to examine the association of predicted FM and LBM with diabetes in both sexes. Methods The current study was a secondary analysis of data from the NAGALA (NAfld in the Gifu Area, Longitudinal Analysis) cohort study of 15,463 baseline normoglycemic participants. Predicted LBM and FM were calculated for each participant using anthropometric prediction equations developed and validated for different sexes based on the National Health and Nutrition Examination Survey (NHANES) database, and the outcome of interest was diabetes (types not distinguished) onset. Multivariate Cox regression analyses were applied to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of predicted FM and LBM with diabetes risk and further visualized their associations using a restricted cubic spline function. Results The incidence density of diabetes was 3.93/1000 person-years over a mean observation period of 6.13 years. In women, predicted LBM and FM were linearly associated with diabetes risk, with each kilogram increase in predicted LBM reducing the diabetes risk by 65% (HR 0.35, 95%CI 0.17, 0.71; P < 0.05), whereas each kilogram increase in predicted FM increased the diabetes risk by 84% (HR 1.84, 95%CI 1.26, 2.69; P < 0.05). In contrast, predicted LBM and FM were non-linearly associated with diabetes risk in men (all P for non-linearity < 0.05), with an L-shaped association between predicted LBM and diabetes risk and a saturation point that minimized the risk of diabetes was 45.4 kg, while predicted FM was associated with diabetes risk in a U-shape pattern and a threshold point with the lowest predicted FM-related diabetes risk was 13.76 kg. Conclusion In this Asian population cohort, we found that high LBM and low FM were associated with lower diabetes risk according to anthropometric equations. Based on the results of the non-linear analysis, we believed that it may be appropriate for Asian men to keep their LBM above 45.4 kg and their FM around 13.76 kg.
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Affiliation(s)
- Maobin Kuang
- Medical College of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Song Lu
- Medical College of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Ruijuan Yang
- Medical College of Nanchang University, Nanchang, Jiangxi, China
- Department of Endocrinology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Huaigang Chen
- Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Shuhua Zhang
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Guotai Sheng
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
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Haines MS, Leong A, Porneala BC, Zhong VW, Lewis CE, Schreiner PJ, Miller KK, Meigs JB, Carnethon MR. More appendicular lean mass relative to body mass index is associated with lower incident diabetes in middle-aged adults in the CARDIA study. Nutr Metab Cardiovasc Dis 2023; 33:105-111. [PMID: 36435699 PMCID: PMC9812900 DOI: 10.1016/j.numecd.2022.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/07/2022] [Accepted: 09/27/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Although lower lean mass is associated with greater diabetes prevalence in cross-sectional studies, prospective data specifically in middle-aged Black and White adults are lacking. Relative appendicular lean mass (ALM), such as ALM adjusted for body mass index (BMI), is important to consider since muscle mass is associated with overall body size. We investigated whether ALM/BMI is associated with incident type 2 diabetes in the Coronary Artery Risk Development in Young Adults study. METHODS AND RESULTS 1893 middle-aged adults (55% women) were included. ALM was measured by DXA in 2005-06. Incident type 2 diabetes was defined in 2010-11 or 2015-16 as fasting glucose ≥7 mmol/L (126 mg/dL), 2-h glucose on OGTT ≥11.1 mmol/L (200 mg/dL) (2010-11 only), HbA1C ≥48 mmol/mol (6.5%) (2010-11 only), or glucose-lowering medications. Cox regression models with sex stratification were performed. In men and women, ALM/BMI was 1.07 ± 0.14 (mean ± SD) and 0.73 ± 0.12, respectively. Seventy men (8.2%) and 71 women (6.8%) developed type 2 diabetes. Per sex-specific SD higher ALM/BMI, unadjusted diabetes risk was lower by 21% in men [HR 0.79 (0.62-0.99), p = 0.04] and 29% in women [HR 0.71 (0.55-0.91), p = 0.008]. After adjusting for age, race, smoking, education, physical activity, and waist circumference, the association was no longer significant. Adjustment for waist circumference accounted for the attenuation in men. CONCLUSION Although more appendicular lean mass relative to BMI is associated with lower incident type 2 diabetes in middle-aged men and women over 10 years, its effect may be through other metabolic risk factors such as waist circumference, which is a correlate of abdominal fat mass.
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Affiliation(s)
- Melanie S Haines
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Aaron Leong
- Harvard Medical School, Boston, MA, USA; Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA; Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Bianca C Porneala
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Victor W Zhong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Cora E Lewis
- Department of Epidemiology, University of Alabama, Birmingham, AL, USA
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Karen K Miller
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - James B Meigs
- Harvard Medical School, Boston, MA, USA; Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
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10
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Kaga H, Tamura Y, Someya Y, Naito H, Tabata H, Kakehi S, Yamasaki N, Sato M, Kadowaki S, Suzuki R, Sugimoto D, Kawamori R, Watada H. Prediabetes is an independent risk factor for sarcopenia in older men, but not in older women: the Bunkyo Health Study. J Cachexia Sarcopenia Muscle 2022; 13:2835-2842. [PMID: 36052707 PMCID: PMC9745500 DOI: 10.1002/jcsm.13074] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 03/16/2022] [Accepted: 08/18/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Sarcopenia is a major cause of disability in the elderly. Although type 2 diabetes is a risk factor for increased sarcopenia, the relationship between prediabetes and sarcopenia has not been elucidated. We aimed to examine the relationship between sarcopenia and prediabetes. METHODS The design of this study is a cross-sectional study. We evaluated glucose metabolism using the 75-g oral glucose tolerance test and glycated haemoglobin, appendicular skeletal muscle mass, and hand grip strength in 1629 older adults living in an urban area of Tokyo, Japan. We investigated the frequency of sarcopenia in participants with normal glucose tolerance (NGT), prediabetes and diabetes. A multivariable logistic regression model was used to analyse the association between glucose tolerance and the prevalence of sarcopenia. RESULTS The mean age of participants was 73.1 ± 5.4 years. In men, 44.3% had NGT, 26.6% had prediabetes, and 29.1% had diabetes. In women, the distribution was 56.1%, 28.8% and 15.2%. The prevalence of sarcopenia was 12.7% in men and 11.9% in women. Logistic regression revealed that prediabetes and diabetes are independent risk factors for sarcopenia in men (prediabetes, odds ratio [OR] = 2.081 [95% confidence interval {CI}: 1.031-4.199]; diabetes, OR = 2.614 [95% CI: 1.362-5.018]) and diabetes, but not prediabetes, is an independent risk factor for sarcopenia in women (prediabetes, OR = 1.036 [95% CI: 0.611-1.757]; diabetes, OR = 2.099 [95% CI: 1.146-3.844]). In both sexes, higher age (men, OR = 1.086 [95% CI: 1.028-1.146]; women, OR = 1.195 [95% CI: 1.142-1.251]), higher body fat percentage (men, OR = 1.346 [95% CI: 1.240-1.461]; women, OR = 1.218 [95% CI: 1.138-1.303]) and lower body mass index (men, OR = 0.371 [95% CI: 0.299-0.461]; women, OR = 0.498 [95% CI: 0.419-0.593]) were independent risk factors for sarcopenia. CONCLUSIONS Although we confirmed that diabetes mellitus is associated with sarcopenia in both sexes, prediabetes is associated with sarcopenia in men, but not in women.
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Affiliation(s)
- Hideyoshi Kaga
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yoshifumi Tamura
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sports Medicine and Sportology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yuki Someya
- Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hitoshi Naito
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hiroki Tabata
- Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Saori Kakehi
- Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sports Medicine and Sportology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Nozomu Yamasaki
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Motonori Sato
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Satoshi Kadowaki
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Ruriko Suzuki
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Daisuke Sugimoto
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Ryuzo Kawamori
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sports Medicine and Sportology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hirotaka Watada
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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11
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Shin Y, Moon JH, Oh TJ, Ahn CH, Moon JH, Choi SH, Jang HC. Higher Muscle Mass Protects Women with Gestational Diabetes Mellitus from Progression to Type 2 Diabetes Mellitus. Diabetes Metab J 2022; 46:890-900. [PMID: 35483675 PMCID: PMC9723199 DOI: 10.4093/dmj.2021.0334] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/08/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND We evaluated whether postpartum muscle mass affects the risk of type 2 diabetes mellitus (T2DM) in Korean women with gestational diabetes mellitus (GDM). METHODS A total of 305 women with GDM (mean age, 34.9 years) was prospectively evaluated for incident prediabetes and T2DM from 2 months after delivery and annually thereafter. Appendicular skeletal muscle mass (ASM) was assessed with bioelectrical impedance analysis at the initial postpartum visit, and ASM, either divided by body mass index (BMI) or squared height, and the absolute ASM were used as muscle mass indices. The risk of incident prediabetes and T2DM was assessed according to tertiles of these indices using a logistic regression model. RESULTS After a mean follow-up duration of 3.3 years, the highest ASM/BMI tertile group had a 61% lower risk of incident prediabetes and T2DM compared to the lowest tertile group, and this remained significant after we adjusted for covariates (adjusted odds ratio, 0.37; 95% confidence interval [CI], 0.15 to 0.92; P=0.032). Equivalent findings were observed in normal weight women (BMI <23 kg/m2), but this association was not significant for overweight women (BMI ≥23 kg/m2). Absolute ASM or ASM/height2 was not associated with the risk of postpartum T2DM. CONCLUSION A higher muscle mass, as defined by the ASM/BMI index, was associated with a lower risk of postpartum prediabetes and T2DM in Korean women with GDM.
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Affiliation(s)
- Yujin Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Joon Ho Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Jung Oh
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Chang Ho Ahn
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Hoon Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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12
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Wang X, Karvonen-Gutierrez CA, Gold EB, Derby C, Greendale G, Wu X, Schwartz J, Park SK. Longitudinal Associations of Air Pollution With Body Size and Composition in Midlife Women: The Study of Women's Health Across the Nation. Diabetes Care 2022; 45:2577-2584. [PMID: 36084038 PMCID: PMC9679268 DOI: 10.2337/dc22-0963] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/18/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE We examined longitudinal associations of air pollution exposure, including fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3), with weight, BMI, waist circumference, fat mass, lean mass, and proportion fat mass in midlife women. RESEARCH DESIGN AND METHODS The study population included 1,654 White, Black, Chinese, and Japanese women from the Study of Women's Health Across the Nation, with the baseline median age of 49.6 years, followed from 2000 to 2008. Annual air pollution exposures were assigned by linking residential addresses with hybrid estimates of air pollutant concentrations at 1-km2 resolution. Body size was measured, and body composition was measured using DXA at approximately annual visits. Linear mixed effects models were used to examine the associations between air pollution and body size and composition measures and whether these associations differed by physical activity. RESULTS After adjusting for potential confounders, an interquartile range increase in PM2.5 concentration (4.5 μg/m3) was associated with 4.53% (95% CI 3.85%, 5.22%) higher fat mass, 1.10% (95% CI 0.95%, 1.25%) higher proportion fat mass, and 0.39% (95% CI -0.77%, -0.01%) lower lean mass. Similar associations were also observed for NO2 and O3. Weaker associations of PM2.5 and NO2 with body composition were observed in participants who engaged in more physical activity. CONCLUSIONS Our analyses provide evidence that exposure to PM2.5, NO2, and O3, is adversely associated with body composition, including higher fat mass, higher proportional fat mass, and lower lean mass, highlighting their potential contribution to obesity.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
| | | | - Ellen B. Gold
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA
| | - Carol Derby
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY
| | - Gail Greendale
- Division of Geriatrics, Department of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Xiangmei Wu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA
| | - Joel Schwartz
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Sung Kyun Park
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI
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13
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González-Martos R, Aparicio-Ugarriza R, Alcazar J, Ramirez-Castillejo C, Reihmane D, Menéndez-Rey A, González-Gross M, Guadalupe-Grau A. Circulating Sestrins and Force Velocity Profiling in Older Adults with Type 2 Diabetes. Eur J Sport Sci 2022:1-10. [PMID: 35876123 DOI: 10.1080/17461391.2022.2106158] [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: 11/03/2022]
Abstract
ABSTRACTType 2 diabetes mellitus (T2DM) in old age affects the musculoskeletal system causing loss of muscle mass, strength, and physical function. Stress-inducible proteins named sestrins are potential novel biomarkers of muscle function due to their ability to suppress oxidative stress and prevent muscle degeneration. Our aim was to determine the association between different force-velocity (F-V) profiles with body composition, physical performance, and glucose control in older adults with T2DM. We also intended to determine the potential utility of sestrin 1 (Sesn1) and 2 (Sesn2) as biomarkers of physical functionality. Fifty-nine participants (69-79 years) were classified in 3 groups according to their F-V profile based on the leg press exercise: nondeficit (NDEF = 40.7%), force deficit (FDEF = 28.8%), and velocity deficit (VDEF = 30.5%). Both VDEF and FDEF groups showed lower muscle power than NDEF (Cohen's d 0.87 and 0.75 for effect size, respectively). Serum Sesn2 levels, maximal dynamic strength, arms and legs fat-free mass were reduced in FDEF compared to the NDEF group (p < 0.05), whereas glycated hemoglobin (HbA1c) and fasting glucose levels were similar among groups. ROC analysis revealed the distinction between the NDEF and FDEF group based on Sesn2 concentrations (<0.72 ng/mL), suggesting their potential use as functional biomarkers for early intervention through exercise. Older adults with T2DM show different F-V profiles, related to low levels of Sesn2, impaired body composition and physical performance, and may be taken into consideration to target exercise training in this specific population.
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Affiliation(s)
- Raquel González-Martos
- ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Madrid, 28040, Spain.,Cancer Stem Cell Research Group. Department of Biotechnology-Vegetal Biology. Centro de Tecnología Biomédica. Universidad Politécnica de Madrid. Madrid, 28223, Spain.,GENUD Toledo Research Group, Universidad Castilla-La Mancha. Toledo, 45071, Spain
| | - Raquel Aparicio-Ugarriza
- ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Madrid, 28040, Spain.,CIBER of Biomedical Research Networking Center on Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII). Madrid, 28222, Spain
| | - Julian Alcazar
- GENUD Toledo Research Group, Universidad Castilla-La Mancha. Toledo, 45071, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, ISCIII. Madrid, 28222, Spain
| | - Carmen Ramirez-Castillejo
- Cancer Stem Cell Research Group. Department of Biotechnology-Vegetal Biology. Centro de Tecnología Biomédica. Universidad Politécnica de Madrid. Madrid, 28223, Spain
| | - Dace Reihmane
- Department of Human Physiology and Biochemistry, Riga Stradiņš University. Riga, LV-1007, Latvia
| | - Adrian Menéndez-Rey
- Cancer Stem Cell Research Group. Department of Biotechnology-Vegetal Biology. Centro de Tecnología Biomédica. Universidad Politécnica de Madrid. Madrid, 28223, Spain
| | - Marcela González-Gross
- ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Madrid, 28040, Spain.,CIBER of Biomedical Research Networking Center on Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII). Madrid, 28222, Spain
| | - Amelia Guadalupe-Grau
- ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Madrid, 28040, Spain.,GENUD Toledo Research Group, Universidad Castilla-La Mancha. Toledo, 45071, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, ISCIII. Madrid, 28222, Spain
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14
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Qiu S, Cai X, Yuan Y, Xie B, Sun Z, Wu T. Is imaging-based muscle quantity associated with risk of diabetes? A meta-analysis of cohort studies. Diabetes Res Clin Pract 2022; 189:109939. [PMID: 35662615 DOI: 10.1016/j.diabres.2022.109939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/01/2022] [Accepted: 05/30/2022] [Indexed: 11/03/2022]
Abstract
AIMS Greater muscle quantity (muscle mass and area) is associated with better glycemic control in adults, but its longitudinal association with risk of diabetes remains debatable. We therefore conducted this meta-analysis to address this issue. METHODS We performed a literature search and included cohort studies that measured muscle quantity objectively by imaging-based approaches and reported their association with risk of diabetes. Study-specific data were pooled using a random-effects model. RESULTS Thirty-three unique datasets, with 10 on total muscle quantity, and 23 on regional (8 on appendicular, 4 on leg, 6 on thigh, and 5 on abdominal) muscle quantity, were included. Muscle quantity was all measured by dual energy x-ray absorptiometry or computed tomography. Most datasets revealed nonsignificant outcomes. Meta-analysis showed collectively that the risk of diabetes was not related to total or regional muscle quantity in either normalized or unnormalized form, with the hazard ratios ranged from 0.92 to 1.09 per every 1 standard deviation higher of corresponding muscle quantity in general (all P > 0.10). Neither sex nor weight status affected the relationship. CONCLUSIONS Our study did not provide adequate evidence to support the concept that large muscle quantity was associated with low risk of diabetes in population-based cohort studies.
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Affiliation(s)
- Shanhu Qiu
- Department of General Practice, Zhongda Hospital, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China; Research and Education Centre of General Practice, Zhongda Hospital, Southeast University, Nanjing, China; The First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, China(1)
| | - Xue Cai
- Department of Nursing Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yang Yuan
- Department of Endocrinology, Zhongda Hospital; Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Bo Xie
- Department of General Practice, Zhongda Hospital, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China; Research and Education Centre of General Practice, Zhongda Hospital, Southeast University, Nanjing, China.
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital; Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China.
| | - Tongzhi Wu
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia
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15
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Haines MS, Leong A, Porneala BC, Meigs JB, Miller KK. Association between muscle mass and diabetes prevalence independent of body fat distribution in adults under 50 years old. Nutr Diabetes 2022; 12:29. [PMID: 35643933 PMCID: PMC9148314 DOI: 10.1038/s41387-022-00204-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 03/23/2022] [Accepted: 04/26/2022] [Indexed: 11/17/2022] Open
Abstract
Background/objectives Although relatively less muscle mass has been associated with greater diabetes prevalence, whether there is an association between muscle mass and diabetes prevalence independent of body fat distribution is unknown. The objective was to determine whether less skeletal muscle mass is associated with greater diabetes prevalence in young men and women independent of body fat distribution. Subjects/methods One thousand seven hundred and sixty-four adults, aged 20–49 years old, from the United States National Health and Nutrition Examination Survey (2005–2006). Body composition, including appendicular lean mass (ALM), was measured by dual-energy x-ray absorptiometry. Diabetes was defined as fasting blood glucose ≥7 mmol/l, 2-h blood glucose ≥11.1 mmol/l on 75 g OGTT, HbA1c ≥ 48 mmol/mol (6.5%), use of diabetes medications, or self-reported diagnosis of diabetes. Results The odds of diabetes were 1.31 times higher in men [OR 1.31 (1.18–1.45), p = 0.0001], and 1.24 times higher in women [OR 1.24 (1.05–1.46), p = 0.01], per percent decrease in ALM/weight after controlling for age, race, height, smoking, and education. After additionally controlling for android/gynoid fat, the odds of diabetes were 1.20 times higher per percent decrease in ALM/weight in men [OR 1.20 (1.04–1.37), p = 0.01]; an inverse association was also observed in women, albeit was not statistically significant [OR 1.08 (0.90–1.30), p = 0.42]. Conclusions Less muscle mass was associated with greater diabetes prevalence independent of body fat distribution in young men. The association was not statistically significant in women after controlling for android and gynoid adiposity. Low muscle mass could be a causal factor in the development of type 2 diabetes or a correlated marker of higher metabolic risk.
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Affiliation(s)
- Melanie S Haines
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Aaron Leong
- Harvard Medical School, Boston, MA, USA.,Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Bianca C Porneala
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - James B Meigs
- Harvard Medical School, Boston, MA, USA.,Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Karen K Miller
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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16
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Takase M, Nakamura T, Hirata T, Tsuchiya N, Kogure M, Itabashi F, Nakaya N, Hamanaka Y, Sugawara J, Suzuki K, Fuse N, Uruno A, Kodama EN, Kuriyama S, Tsuji I, Kure S, Hozawa A. Association between fat mass index, fat-free mass index and hemoglobin A1c in a Japanese population: The Tohoku Medical Megabank Community-based Cohort Study. J Diabetes Investig 2022; 13:858-867. [PMID: 34860465 PMCID: PMC9077739 DOI: 10.1111/jdi.13729] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 12/25/2022] Open
Abstract
AIMS/INTRODUCTION Fat mass and fat-free mass affect glycated hemoglobin A1c (HbA1c) levels and blood glucose levels, respectively. The aim of the present study was to examine the association between the fat mass index and fat-free mass index with HbA1c. MATERIALS AND METHODS We carried out a cross-sectional study that included 3,731 men and 9,191 women aged ≥20 years, living in Miyagi Prefecture, Japan, who were not treated for diabetes. The fat mass index and fat-free mass index were calculated as fat mass and fat-free mass divided by the height squared, respectively. The indices were classified into sex-specific quartiles and combined into 16 groups. An analysis of covariance was used to assess associations between the combined fat mass index and fat-free mass index with HbA1c adjusted for potential confounders. The linear trend test was carried out by stratifying the fat mass index and fat-free mass index, entering the number as a continuous term in the regression model. RESULTS In multivariable models, a higher fat mass index was related to higher HbA1c levels in men and women in all fat-free mass index subgroups (P < 0.001 for linear trend). When we excluded the participants who had been identified as having diabetes, the fat-free mass index was also related to higher HbA1c levels in most fat mass index subgroups (P < 0.05 for linear trend). CONCLUSIONS Fat mass index was positively related to HbA1c levels. The fat-free mass index was also related to HbA1c levels when we excluded participants who had been identified as having have diabetes.
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Affiliation(s)
- Masato Takase
- Graduate School of MedicineTohoku UniversitySendaiJapan
| | - Tomohiro Nakamura
- Graduate School of MedicineTohoku UniversitySendaiJapan
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Takumi Hirata
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
- Department of Public HealthFaculty of MedicineHokkaido UniversitySapporoJapan
| | - Naho Tsuchiya
- Graduate School of MedicineTohoku UniversitySendaiJapan
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Mana Kogure
- Graduate School of MedicineTohoku UniversitySendaiJapan
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Fumi Itabashi
- Graduate School of MedicineTohoku UniversitySendaiJapan
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Naoki Nakaya
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
- Department of Health SciencesSaitama Prefectural UniversityKoshigayaJapan
| | - Yohei Hamanaka
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Junichi Sugawara
- Graduate School of MedicineTohoku UniversitySendaiJapan
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
- Tohoku University HospitalTohoku UniversitySendaiJapan
| | - Kichiya Suzuki
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Nobuo Fuse
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Akira Uruno
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Eiichi N Kodama
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
- International Research Institute of Disaster ScienceTohoku UniversitySendaiJapan
| | - Shinichi Kuriyama
- Graduate School of MedicineTohoku UniversitySendaiJapan
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
- International Research Institute of Disaster ScienceTohoku UniversitySendaiJapan
| | - Ichiro Tsuji
- Graduate School of MedicineTohoku UniversitySendaiJapan
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Shigeo Kure
- Graduate School of MedicineTohoku UniversitySendaiJapan
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
- Tohoku University HospitalTohoku UniversitySendaiJapan
| | - Atsushi Hozawa
- Graduate School of MedicineTohoku UniversitySendaiJapan
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
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17
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Qiu S, Cai X, Xie B, Yuan Y, Sun Z, Wu T. Normalized Creatinine-to-Cystatin C Ratio and Risk of Diabetes in Middle-Aged and Older Adults: The China Health and Retirement Longitudinal Study. Diabetes Metab J 2022; 46:476-485. [PMID: 35249274 PMCID: PMC9171165 DOI: 10.4093/dmj.2021.0074] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/13/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Creatinine-to-cystatin C ratio is recently suggested to be a surrogate marker for sarcopenia. However, little is known about its association with diabetes. This study aimed to fill in this gap based on a large-scale prospective cohort. METHODS A population-based representative sample of 5,055 participants aged ≥45 years from the China Health and Retirement Longitudinal Study was enrolled between 2011 and 2012 and followed at least once during the subsequent surveys at 2013, 2015, or 2018. Creatinine-to-cystatin C ratio was calculated and normalized by body weight. Incident diabetes was ascertained by plasma glucose, glycosylated hemoglobin, self-reported history, or use of anti-diabetic drugs. Logistic regression analysis and mediation analysis were employed. RESULTS During follow-up, 634 participants developed diabetes. The risk of diabetes was gradually and significantly decreased with increased normalized creatinine-cystatin C ratio. The multivariable-adjusted odds ratio for diabetes was 0.91 (95% confidence interval, 0.83 to 0.99) per 1 standard deviation higher of normalized creatinine-to-cystatin C ratio, and this relationship remained significant after controlling for muscle strength. The risk reduction in diabetes was significantly larger in participants with normal-weight and high normalized creatinine-to-cystatin C ratio compared with those with overweight/obesity and high normalized creatinine-to-cystatin C ratio (Pinteraction=0.01). Insulin resistance and inflammation appeared to be key mediators accounting for the observed relationship between normalized creatinine-to-cystatin C ratio and risk of diabetes, with their mediating effect being 93.1% and 22.0%, respectively. CONCLUSION High normalized creatinine-to-cystatin C ratio is associated with reduced risk of diabetes in middle-aged and older adults.
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Affiliation(s)
- Shanhu Qiu
- Institute of Diabetes, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
- Department of Endocrinology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University and The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Xue Cai
- Institute of Diabetes, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Bo Xie
- Institute of Diabetes, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yang Yuan
- Institute of Diabetes, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
- Department of Endocrinology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Zilin Sun
- Institute of Diabetes, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
- Department of Endocrinology, Zhongda Hospital, Southeast University, Nanjing, China
- Corresponding author: Zilin Sun https://orcid.org/0000-0001-7936-0196 Institute of Diabetes, Zhongda Hospital, School of Medicine, Southeast University, Dingjiaqiao No. 87, Nanjing 210009, China E-mail:
| | - Tongzhi Wu
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia
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Farid D, Li P, Da Costa D, Afif W, Szabo J, Dasgupta K, Rahme E. Depression, diabetes and immigration status: a retrospective cohort study using the Canadian Longitudinal Study on Aging. CMAJ Open 2022; 10:E508-E518. [PMID: 35700994 PMCID: PMC9343120 DOI: 10.9778/cmajo.20210019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND A bidirectional association between depression and diabetes exists, but has not been evaluated in the context of immigrant status. Given that social determinants of health differ between immigrants and nonimmigrants, we evaluated the association between diabetes and depression incidence, depression and diabetes incidence, and whether immigrant status modified this association, among immigrants and nonimmigrants in Canada. METHODS We employed a retrospective cohort design using data from the Canadian Longitudinal Study on Aging Comprehensive cohort (baseline [2012-2015] and 3-year follow-up [2015-2018]). We defined participants as having diabetes if they self-reported it or if their glycated hemoglobin A1c level was 7% or more; we defined participants as having depression if their Center for Epidemiological Studies Depression score was 10 or higher or if they were currently undergoing depression treatment. We excluded those with baseline depression (Cohort 1) and baseline diabetes (Cohort 2) to evaluate the associations between diabetes and depression incidence, and between depression and diabetes incidence, respectively. We constructed logistic regression models with interaction by immigrant status. RESULTS Cohort 1 (n = 20 723; mean age 62.7 yr, standard deviation [SD] 10.1 yr; 47.6% female) included 3766 (18.2%) immigrants. Among immigrants, 16.4% had diabetes, compared with 15.6% among nonimmigrants. Diabetes was associated with an increased risk of depression in nonimmigrants (adjusted odds ratio [OR] 1.27, 95% confidence interval [CI] 1.08-1.49), but not in immigrants (adjusted OR 1.12, 95% CI 0.80-1.56). Younger age, female sex, weight change, poor sleep quality and pain increased depression risk. Cohort 2 (n = 22 054; mean age 62.1 yr, SD 10.1 yr; 52.2% female) included 3913 (17.7%) immigrants. Depression was associated with an increased risk of diabetes in both nonimmigrants (adjusted OR 1.39, 95% CI 1.16-1.68) and immigrants (adjusted OR 1.60, 95% CI 1.08-2.37). Younger age, male sex, waist circumference, weight change, hypertension and heart disease increased diabetes risk. INTERPRETATION We found an overall bidirectional association between diabetes and depression that was not significantly modified by immigrant status. Screening for diabetes for people with depression and screening for depression for those with diabetes should be considered.
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Affiliation(s)
- Doaa Farid
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Patricia Li
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Deborah Da Costa
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Waqqas Afif
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Jason Szabo
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Kaberi Dasgupta
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Elham Rahme
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que.
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Lee SJ, Chandrasekran P, Mazucanti CH, O’Connell JF, Egan JM, Kim Y. Dietary curcumin restores insulin homeostasis in diet-induced obese aged mice. Aging (Albany NY) 2022; 14:225-239. [PMID: 35017319 PMCID: PMC8791219 DOI: 10.18632/aging.203821] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/29/2021] [Indexed: 06/14/2023]
Abstract
Although aging is a physiological process to which all organisms are subject, the presence of obesity and type 2 diabetes accelerates biological aging. Recent studies have demonstrated the causal relationships between dietary interventions suppressing obesity and type 2 diabetes and delaying the onset of age-related endocrine changes. Curcumin, a natural antioxidant, has putative therapeutic properties such as improving insulin sensitivity in obese mice. However, how curcumin contributes to maintaining insulin homeostasis in aged organisms largely remains unclear. Thus, the objective of this study is to examine the pleiotropic effect of dietary curcumin on insulin homeostasis in a diet-induced obese (DIO) aged mouse model. Aged (18-20 months old) male mice given a high-fat high-sugar diet supplemented with 0.4% (w/w) curcumin (equivalent to 2 g/day for a 60 kg adult) displayed a different metabolic phenotype compared to mice given a high-fat high-sugar diet alone. Furthermore, curcumin supplementation altered hepatic gene expression profiling, especially insulin signaling and senescence pathways. We then mechanistically investigated how curcumin functions to fine-tune insulin sensitivity. We found that curcumin supplementation increased hepatic insulin-degrading enzyme (IDE) expression levels and preserved islet integrity, both outcomes that are beneficial to preserving good health with age. Our findings suggest that the multifaceted therapeutic potential of curcumin can be used as a protective agent for age-induced metabolic diseases.
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Affiliation(s)
- Su-Jeong Lee
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA
| | - Prabha Chandrasekran
- Laboratory of Clinical Investigation, National Institute on Aging (NIA), Baltimore, MD 21224, USA
| | - Caio Henrique Mazucanti
- Laboratory of Clinical Investigation, National Institute on Aging (NIA), Baltimore, MD 21224, USA
| | - Jennifer F. O’Connell
- Laboratory of Clinical Investigation, National Institute on Aging (NIA), Baltimore, MD 21224, USA
| | - Josephine M. Egan
- Laboratory of Clinical Investigation, National Institute on Aging (NIA), Baltimore, MD 21224, USA
| | - Yoo Kim
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA
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20
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Song BK, Kim GH, Kim JW, Lefferts EC, Brellenthin AG, Lee DC, Kim YM, Kim MK, Choi BY, Kim YS. Association Between Relative Quadriceps Strength and Type 2 Diabetes Mellitus in Older Adults: The Yangpyeong Cohort of the Korean Genome and Epidemiology Study. J Phys Act Health 2021; 18:1539-1546. [PMID: 34697251 DOI: 10.1123/jpah.2021-0361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/06/2021] [Accepted: 08/25/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND To examine the independent and combined association between relative quadriceps strength and the prevalence of type 2 diabetes mellitus (T2DM) in older adults. METHODS Among 1441 Korean older adults aged ≥65 years (71 [4.7] y) recruited between 2007 and 2016, 1055 older adults with no history of myocardial infarction, stroke, or cancer were included in the analysis. Cases of T2DM were identified by self-reported physician diagnosis, use antihyperglycemic medication or insulin, or fasting blood glucose ≥126 mg/dL. Logistic regression was used to calculate the odds ratios and 95% confidence intervals of T2DM by quartiles of relative quadriceps strength. RESULTS There were 162 T2DM cases (15%). Compared with the lowest quartile (weakest), the odds ratios (95% confidence intervals) of T2DM were 0.56 (0.34-0.90), 0.60 (0.37-0.96), and 0.47 (0.28-0.80) in the second, third, and fourth quartiles, respectively, after adjusting for possible confounders, including body mass index. In the joint analysis, compared with the "weak and overweight/obese" group, the odds (odds ratios [95% confidence intervals]) of T2DM was only lower in the "strong and normal weight" group (0.36 [0.22-0.60]) after adjusting for possible confounders. CONCLUSIONS Greater relative quadriceps strength is associated with reduced odds of T2DM in older adults after adjusting for potential confounders including body mass index.
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21
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Association of Adherence to a Mediterranean Diet with Excess Body Mass, Muscle Strength and Physical Performance in Overweight or Obese Adults with or without Type 2 Diabetes: Two Cross-Sectional Studies. Healthcare (Basel) 2021; 9:healthcare9101255. [PMID: 34682935 PMCID: PMC8535373 DOI: 10.3390/healthcare9101255] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 12/17/2022] Open
Abstract
Overweight and obesity in older adults is associated with disability and is exacerbated by the presence of type 2 diabetes (T2DM). There is emerging evidence that adherence to a Mediterranean diet (MedDiet) reduces adiposity and attenuates physical disability. These cross-sectional studies explored the associations of adherence to a MedDiet with body mass index (BMI), adiposity, muscle strength, and physical performance in older adults without diabetes and in middle-aged or older adults with T2DM. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener. Fat mass and percent body fat were assessed by dual energy X-ray absorptiometry. Muscle strength was assessed using hand-grip strength, while physical performance was assessed using the Short Physical Performance Battery and gait speed. A total of n = 87 participants with T2DM (T2DM sample: 71.2 ± 8.2 years, BMI: 29.5 ± 5.9) and n = 65 participants without diabetes (non-T2DM sample: 68.7 ± 5.6 years, BMI: 33.7 ± 4.9) were included in these analyses. In the T2DM sample, when controlled for age, gender, and appendicular lean mass index, adherence to a MedDiet was inversely associated with BMI, fat mass, and percent body fat. However, this was no longer maintained in the fully adjusted models. Although, adherence to a MedDiet was positively associated with gait speed (β = 0.155; p = 0.050) independent of all covariates used. Adherence to a MedDiet may be a suitable dietary strategy for preserving lower body physical function in middle-aged and older adults with T2DM. However, these findings should be further investigated using well-designed randomised controlled trials and prospective cohort studies with a wider range of adherence scores to investigate temporal associations.
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22
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Barzilay JI, Buzkova P, Shlipak MG, Lyles MF, Bansal N, Garimella PS, Ix JH, Kizer JR, Strotmeyer ES, Djousse L, Biggs ML, Siscovick D, Mukamal KJ. Urine creatinine concentration and clinical outcomes in older adults: The Cardiovascular Health Study. J Am Geriatr Soc 2021; 69:3486-3496. [PMID: 34363689 DOI: 10.1111/jgs.17388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 07/02/2021] [Accepted: 07/11/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Loss of muscle mass and strength are associated with long-term adverse health outcomes in older adults. Urine creatinine concentrations (Ucr; mg/dl) are a measure of muscle tissue mass and turnover. This study assessed the associations of a spot Ucr level with muscle mass and with risk of hospitalization, mortality, and diabetes mellitus in older adults. METHODS We examined 3424 participants from the Cardiovascular Health Study who provided spot urine samples in 1996-1997 and who were followed through June 2015. All participants underwent baseline measurement of grip strength. In a sub-cohort, 1331 participants underwent dual energy X-ray absorptiometry (DEXA) scans, from which lean muscle mass was derived. Participants were followed for a median of 10 years for hospitalizations and mortality, and 9 years for diabetes mellitus. RESULTS In linear regression analysis, a one standard deviation higher Ucr concentration (64.6 mg/dl) was associated with greater grip strength (kg force) β = 0.44 [0.16, 0.72]; p = 0.002) and higher lean muscle mass (kg) (β = 0.43 [0.08, 0.78]; p = 0.02). In Cox regression analyses, each standard deviation greater Ucr concentration was associated with lower rates of hospitalizations (0.94 [95% confidence interval, 0.90, 0.98]; p < 0.001) and lower mortality risk (0.92 [0.88, 0.97]; p < 0.001), while a one standard deviation increase in muscle mass derived from DEXA had no such significant association. Ucr levels were not associated with incident diabetes mellitus risk (0.97 [0.85, 1.11]; p = 0.65). CONCLUSION A higher spot Ucr concentration was favorably associated with muscle mass and strength and with health outcomes in older community-living adults. The ease of obtaining a spot Ucr makes it an attractive analyte to use for gauging the health of older adults.
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Affiliation(s)
- Joshua I Barzilay
- Division of Endocrinology, Kaiser Permanente of Georgia, Atlanta, Georgia, USA.,Division of Endocrinology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Petra Buzkova
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington, USA
| | - Michael G Shlipak
- Kidney Health Research Collaborative, San Francisco VA Medical Center, San Francisco, California, USA
| | - Mary F Lyles
- Department of Medicine, Division of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Nisha Bansal
- Division of Nephrology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Pranav S Garimella
- Division of Nephrology-Hypertension, University of California-San Diego, San Diego, California, USA
| | - Joachim H Ix
- Division of Nephrology-Hypertension, University of California-San Diego, San Diego, California, USA.,Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Jorge R Kizer
- Cardiology Section, San Francisco Veterans Affairs Health Care System, San Francisco, California, USA.,Departments of Medicine, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Luc Djousse
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Mary L Biggs
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington, USA
| | | | - Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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Buscemi C, Ferro Y, Pujia R, Mazza E, Boragina G, Sciacqua A, Piro S, Pujia A, Sesti G, Buscemi S, Montalcini T. Sarcopenia and Appendicular Muscle Mass as Predictors of Impaired Fasting Glucose/Type 2 Diabetes in Elderly Women. Nutrients 2021; 13:nu13061909. [PMID: 34199375 PMCID: PMC8227668 DOI: 10.3390/nu13061909] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/26/2021] [Accepted: 05/29/2021] [Indexed: 12/18/2022] Open
Abstract
Elderly women exhibit a high risk of type 2 diabetes (T2D), but no definitive data exist about the possible role of postmenopausal increases in visceral adiposity, the loss of lean body mass, or decreases in the sum of the lean mass of arms and legs (appendicular skeletal muscle mass (ASMM)). This retrospective, longitudinal study investigated whether body composition (bioelectrical impedance analysis) predicted the development of impaired fasting glucose (IFG) or T2D in a cohort of 159 elderly women (age: 71 ± 5 years, follow-up: 94 months) from southern Italy (Clinical Nutrition and Geriatric Units of the “Mater Domini” University Hospital in Catanzaro, Calabria region, and the “P. Giaccone ”University Hospital in Palermo, Sicily region). Sarcopenia was defined in a subgroup of 128 women according to the EWGSOP criteria as the presence of low muscle strength (handgrip strength <16 kg) plus low muscle mass (reported as appendicular skeletal muscle mass <15 kg). Participants with a low ASMM had a higher IFG/T2D incidence than those with a normal ASMM (17% vs. 6%, p-adjusted = 0.044); this finding was independent of BMI, fat mass, waist circumference, and habitual fat intake (OR = 3.81, p = 0.034). A higher incidence of IFG/T2D was observed in the subgroup with sarcopenia than those without sarcopenia (33% vs. 7%, p-adjusted = 0.005) independent of BMI and fat mass (OR = 6.75, p = 0.007). In conclusion, this study demonstrates that elderly women with low ASMM had a higher probability of developing IFG/T2D. Further studies are needed to confirm these results in men and in other age groups.
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Affiliation(s)
- Carola Buscemi
- Department of Clinical and Molecular Medicine, Postgraduate Specialization School in Geriatrics, University of Catania, 95100 Catania, Italy; (C.B.); (S.P.)
- Unit of Clinical Nutrition, Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy;
| | - Yvelise Ferro
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Roberta Pujia
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Elisa Mazza
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Giada Boragina
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Angela Sciacqua
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Salvatore Piro
- Department of Clinical and Molecular Medicine, Postgraduate Specialization School in Geriatrics, University of Catania, 95100 Catania, Italy; (C.B.); (S.P.)
| | - Arturo Pujia
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Giorgio Sesti
- Dipartimento di Medicina clinica e molecolare, Università la Sapienza, 00185 Roma, Italy;
| | - Silvio Buscemi
- Unit of Clinical Nutrition, Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy;
| | - Tiziana Montalcini
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy
- Correspondence:
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A high lean body mass is not protecting from type 2 diabetes in the presence of a high body fat mass. DIABETES & METABOLISM 2021; 47:101219. [PMID: 33418084 DOI: 10.1016/j.diabet.2020.101219] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/10/2020] [Accepted: 12/14/2020] [Indexed: 02/01/2023]
Abstract
AIM Most studies examining the associations between body composition and type 2 diabetes have been cross-sectional with prevalent diabetes diagnosis or they have analyzed only fat or lean body mass. Hence, the combined effect of fat and lean body mass on the risk of developing type 2 diabetes remains unclear. We investigated whether baseline lean and fat body mass taken simultaneously into account are associated with incidence of type 2 diabetes over a 15-year follow-up in older adults. METHODS We studied 704 men (n = 297) and women (n = 407) from the Helsinki Birth Cohort Study (mean age 61 years at baseline) without diabetes at baseline. Bioelectrical impedance analysis was used to derive baseline fat mass index (FMI, fat mass/height2) and lean mass index (LMI, lean mass/height2), dichotomized at sex-specific medians. Incident diabetes was defined as the composite of fasting plasma glucose (FPG) ≥ 7.0 mmol/l, haemoglobin A1c (HbA1C) ≥ 6.5% (48 mmol/mol) or physician-based diagnosis. RESULTS After a median 14.8 (range 12.5-16.8) years of follow-up, 110 incident diabetes cases occurred (15.6%). Participants with high FMI and LMI at baseline had higher composite incidence of type 2 diabetes (P < 0.001), and significantly increased risk of type 2 diabetes after adjustment for potential confounding factors (sex, physical activity, education and body mass index) compared to the other participants. CONCLUSION Contrary to a general belief greater muscle mass is not protective against type 2 diabetes. High LMI accompanied with high FMI seem to predict subsequent development of type 2 diabetes.
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Thyroid hormone signaling is associated with physical performance, muscle mass, and strength in a cohort of oldest-old: results from the Mugello study. GeroScience 2020; 43:1053-1064. [PMID: 33219914 PMCID: PMC8110652 DOI: 10.1007/s11357-020-00302-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/16/2020] [Indexed: 12/23/2022] Open
Abstract
Thyroid hormones (THs) play a crucial role in the homeostasis of muscle function, such as myogenesis and energy metabolism, suggesting that the thyroid may be also involved in the entropic processes of muscle aging. The aim of the present study is to evaluate the effect of TH signaling on physical performance, muscle mass, and strength in a cohort of community-dwelling oldest-old subjects (> 90 years). The study population was selected in a rural area of central Italy (Mugello, Tuscany), and the design was cross-sectional. Four hundred seventy-five subjects (130 males and 345 females) were enrolled, representing about 65% of all the nonagenarians living in the Mugello area. After adjusting for multiple confounding factors (sex, age, diabetes, and levothyroxine administration), the lowest quartile of FT3/FT4 ratio distribution showed lower physical performance compared to the other quartiles (β ± SE: − 0.49 ± 0.12; p < 0.001), whereas the highest quartile of FT3/FT4 ratio was associated with higher skeletal muscle index (β ± SE: 1.11 ± 0.42; p = 0.009). In addition, the lowest quartile of FT4 showed a statistically significant higher handgrip strength (β ± SE: 1.78 ± 0.68; p = 0.009) compared to all other quartiles. This study demonstrates that nonagenarians with higher FT3/FT4 ratios had better preserved muscle function, therefore successfully overcoming the imbalance of homeostatic and entropic processes involved in muscle aging. However, we could not establish a cause-effect relationship due to the cross-sectional design of the study.
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