Excessive loss of skeletal muscle mass in older adults with type 2 diabetes.
OBJECTIVE
A loss of skeletal muscle mass is frequently observed in older adults. The aim of the study was to investigate the impact of type 2 diabetes on the changes in body composition, with particular interest in the skeletal muscle mass.


METHODS
We examined total body composition with dual-energy X-ray absorptiometry annually for 6 years in 2,675 older adults. We also measured mid-thigh muscle cross-sectional area (CSA) with computed tomography in year 1 and year 6. At baseline, 75-g oral glucose challenge tests were performed. Diagnosed diabetes (n = 402, 15.0%) was identified by self-report or use of hypoglycemic agents. Undiagnosed diabetes (n = 226, 8.4%) was defined by fasting plasma glucose (>or=7 mmol/l) or 2-h postchallenge plasma glucose (>or=11.1 mmol/l). Longitudinal regression models were fit to examine the effect of diabetes on the changes in body composition variables.


RESULTS
Older adults with either diagnosed or undiagnosed type 2 diabetes showed excessive loss of appendicular lean mass and trunk fat mass compared with nondiabetic subjects. Thigh muscle CSA declined two times faster in older women with diabetes than their nondiabetic counterparts. These findings remained significant after adjusting for age, sex, race, clinic site, baseline BMI, weight change intention, and actual weight changes over time.


CONCLUSIONS
Type 2 diabetes is associated with excessive loss of skeletal muscle and trunk fat mass in community-dwelling older adults. Older women with type 2 diabetes are at especially high risk for loss of skeletal muscle mass.
Park
Seok Won
SW
Department of Internal Medicine, CHA University, Sungnam, Korea. spark@cha.ac.kr
Goodpaster
Bret H
BH
Lee
Jung Sun
JS
Kuller
Lewis H
LH
Boudreau
Robert
R
de Rekeneire
Nathalie
N
Harris
Tamara B
TB
Kritchevsky
Stephen
S
Tylavsky
Frances A
FA
Nevitt
Michael
M
Cho
Yong-wook
YW
Newman
Anne B
AB
D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000033:anatomy & histology; D000368:Aged; D000375:Aging / Q000502:physiology*; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000473:pathology*; D009929:Organ Size; D012044:Regression Analysis; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha