title: Adipose tissue content, muscle performance and physical function in obese adults with type 2 diabetes mellitus and peripheral neuropathy.
abstract: OBJECTIVE
  To determine leg intermuscular (IMAT) and subcutaneous (SQAT) adipose tissue and their relationships with muscle performance and function in obese adults with and without type 2 diabetes and peripheral neuropathy (T2DMPN).
  
  
  METHODS
  Seventy-nine age-matched obese adults were studied, 13 T2DM, 54 T2DMPN, and 24 obese controls. Leg fat (%IMAT, %SQAT) volumes were quantified using MRI. Ankle plantar flexion (PF) torque and power were assessed with isokinetic dynamometry. Physical function was assessed with 9-item Physical Performance Test (PPT), 6-minute walk distance, single-limb balance, and time to ascend 10 stairs. One-way ANOVAs determined group differences, and multiple regression predicted PPT score from disease status, % IMAT, and PF power.
  
  
  RESULTS
  T2DMPN participants had 37% greater IMAT volumes and 15% lower SQAT volumes than controls (p =. 01). T2DMPN and T2DM showed reduced PF torque and power compared to controls. T2DMPN participants had lower PPT score, 6-minute walk, single-limb balance, and stair climbing than controls (all p<.05). %IMAT volume correlated inversely, and %SQAT correlated directly, with PPT. Leg %IMAT and disease status predicted 49% of PPT score.
  
  
  CONCLUSIONS
  T2DMPN may represent a shift in adipose tissue accumulation from SQAT to IMAT depots, which is inversely associated with muscle performance and physical function.
authors.affiliation: Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Ave, St Louis, MO, 63110. Electronic address: bitteld@wusm.wustl.edu.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Bittel
authors.affiliation: Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Ave, St Louis, MO, 63110.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Bittel
authors.affiliation: Doctor of Physical Therapy Program, School of Exercise and Nutritional Sciences, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182.
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Tuttle
authors.affiliation: Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Ave, St Louis, MO, 63110.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Hastings
authors.affiliation: Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Ave, St Louis, MO, 63110.
authors.forename: Paul K
authors.initials: PK
authors.lastname: Commean
authors.affiliation: Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Ave, St Louis, MO, 63110.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mueller
authors.affiliation: Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Ave, St Louis, MO, 63110.
authors.forename: W Todd
authors.initials: WT
authors.lastname: Cade
authors.affiliation: Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Ave, St Louis, MO, 63110.
authors.forename: David R
authors.initials: DR
authors.lastname: Sinacore
mesh_terms: D052436:Adipose Tissue, White / Q000473:pathology*; D050154:Adiposity; D000368:Aged; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003929:Diabetic Neuropathies / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007866:Leg; D008279:Magnetic Resonance Imaging; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D024510:Muscle Development; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000294:innervation / Q000473:pathology / Q000503:physiopathology*; D009765:Obesity / Q000150:complications*; D011597:Psychomotor Performance; D012720:Severity of Illness Index; D050151:Subcutaneous Fat / Q000473:pathology
keywords: Adipose tissue; Diabetes; Muscle; Neuropathy; Physical function