title: Effect of diabetes mellitus on muscle size and strength in patients receiving dialysis therapy.
abstract: 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.
authors.affiliation: General Clinical Research Center, San Francisco General Hospital, USA. gsakkas@med.uth.gr
authors.forename: Giorgos K
authors.initials: GK
authors.lastname: Sakkas
authors.forename: Jane A
authors.initials: JA
authors.lastname: Kent-Braun
authors.forename: Julie W
authors.initials: JW
authors.lastname: Doyle
authors.forename: Tiffany
authors.initials: T
authors.lastname: Shubert
authors.forename: Patricia
authors.initials: P
authors.lastname: Gordon
authors.forename: Kirsten L
authors.initials: KL
authors.lastname: Johansen
mesh_terms: 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