Effect of diabetes mellitus on muscle size and strength in patients receiving dialysis therapy.
BACKGROUND
Diabetes mellitus (DM) is a potential contributor to the muscle abnormalities and poor physical functioning of the dialysis population.


METHODS
Thirty-three dialysis patients without DM (non-DM group) were compared with 25 dialysis patients with DM (DM group). Measures were made of cross-sectional area and composition of the leg muscles by using proton T1-weighted magnetic resonance imaging; body composition by means of dual-energy X-ray absorptiometry; leg muscle strength by means of isokinetic knee extension; isometric dorsiflexor maximum voluntary contraction by means of force plate; physical activity by means of 3-dimensional accelerometry; and functional capacity by using various functional tests.


RESULTS
The DM group was older, weaker, more atrophic, and had a greater amount of intramuscular fat compared with the non-DM group. However, when the overall analysis was adjusted for age and sex, there were no differences between the 2 groups with respect to muscle cross-sectional area, leg strength, or physical activity. To further account for sex and age differences, a paired analysis was performed after matching patients by age (within 5 years) and sex (N = 16/group). In the matched analysis, only intramuscular fat and leg adipose tissue were different between the 2 groups.


CONCLUSIONS
DM is associated with more fat within muscles of dialysis patients, but is unrelated to muscle size or strength. Demographic differences between the DM and non-DM groups on dialysis therapy likely are responsible for the general perception that patients with DM are more debilitated.
Sakkas
Giorgos K
GK
General Clinical Research Center, San Francisco General Hospital, USA. gsakkas@med.uth.gr
Kent-Braun
Jane A
JA
Doyle
Julie W
JW
Shubert
Tiffany
T
Gordon
Patricia
P
Johansen
Kirsten L
KL
D048909:Diabetes Complications / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology* / Q000503:physiopathology*; D009133:Muscular Atrophy / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D009929:Organ Size; D006435:Renal Dialysis