title: Association of Muscle Mass, Area, and Strength With Incident Diabetes in Older Adults: The Health ABC Study.
abstract: Skeletal muscle plays a key role in glucose regulation, yet the association between muscle quantity or quality and the risk of developing type 2 diabetes has not been explored.
  
  
  
  The objective of the study was to assess the association between muscle quantity and strength and incident diabetes and to explore whether this association differs by body mass index (BMI) category.
  
  
  
  Participants were 2166 older adults in the Health, Aging, and Body Composition Study who were free of diabetes at baseline (1997–1998). Computed tomography and dual-energy x-ray absorptiometry were used to measure abdominal and thigh muscle area and total body lean mass, respectively. Strength was quantified by grip and knee extensions.
  
  
  
  Incident diabetes, defined as fasting glucose of 126 mg/dL or greater, a physician's diagnosis, and/or the use of hypoglycemic medication were measured.
  
  
  
  After a median 11.3 years of follow-up, there were 265 incident diabetes cases (12.2%). In fully adjusted models, no association was found between muscle or strength measures and incident diabetes (for all, P > .05). For women, there was a significant interaction with BMI category for both abdominal and thigh muscle, such that greater muscle predicted lower risk of incident diabetes for normal-weight women (hazard ratio 0.37 [0.17–0.83] and 0.58 [0.27–1.27] per SD, respectively) and a greater risk for overweight and obese women (hazard ratio 1.23 [0.98–1.54] and 1.28 [1.00–1.64], respectively). No significant interactions by BMI category existed for strength measures or any measures for men (for all, P > .05).
  
  
  
  Greater muscle area is associated with a lower risk of incident diabetes for older normal-weight women but not for men or overweight women.
authors.affiliation: Department of Family Medicine and Public Health (B.A.L., M.H.C., I.X.), and Department of Medicine (J.H.I.), University of California, San Diego, San Diego, California 92093-0628; Department of Pathology and Laboratory Medicine (C.L.W.), College of Medicine, University of Vermont, Burlington, Vermont 05446; Wake Forest University and School of Medicine (S.B.K.), Winston-Salem, North Carolina 27157; Graduate School of Public Health (E.S.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15219; Division of General Internal Medicine (A.M.K.), Department of Epidemiology and Biostatistics (A.V.S.), University of California, San Francisco, San Francisco, California 94143; University of Pittsburgh School of Medicine and Veterans Affairs Pittsburgh Healthcare System (L.F.F.), Pittsburgh, Pennsylvania 15261; and National Institute on Aging (T.B.H.), Bethesda, Maryland 20892.
authors.forename: Britta A
authors.initials: BA
authors.lastname: Larsen
authors.affiliation: Department of Family Medicine and Public Health (B.A.L., M.H.C., I.X.), and Department of Medicine (J.H.I.), University of California, San Diego, San Diego, California 92093-0628; Department of Pathology and Laboratory Medicine (C.L.W.), College of Medicine, University of Vermont, Burlington, Vermont 05446; Wake Forest University and School of Medicine (S.B.K.), Winston-Salem, North Carolina 27157; Graduate School of Public Health (E.S.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15219; Division of General Internal Medicine (A.M.K.), Department of Epidemiology and Biostatistics (A.V.S.), University of California, San Francisco, San Francisco, California 94143; University of Pittsburgh School of Medicine and Veterans Affairs Pittsburgh Healthcare System (L.F.F.), Pittsburgh, Pennsylvania 15261; and National Institute on Aging (T.B.H.), Bethesda, Maryland 20892.
authors.forename: Christina L
authors.initials: CL
authors.lastname: Wassel
authors.affiliation: Department of Family Medicine and Public Health (B.A.L., M.H.C., I.X.), and Department of Medicine (J.H.I.), University of California, San Diego, San Diego, California 92093-0628; Department of Pathology and Laboratory Medicine (C.L.W.), College of Medicine, University of Vermont, Burlington, Vermont 05446; Wake Forest University and School of Medicine (S.B.K.), Winston-Salem, North Carolina 27157; Graduate School of Public Health (E.S.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15219; Division of General Internal Medicine (A.M.K.), Department of Epidemiology and Biostatistics (A.V.S.), University of California, San Francisco, San Francisco, California 94143; University of Pittsburgh School of Medicine and Veterans Affairs Pittsburgh Healthcare System (L.F.F.), Pittsburgh, Pennsylvania 15261; and National Institute on Aging (T.B.H.), Bethesda, Maryland 20892.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Kritchevsky
authors.affiliation: Department of Family Medicine and Public Health (B.A.L., M.H.C., I.X.), and Department of Medicine (J.H.I.), University of California, San Diego, San Diego, California 92093-0628; Department of Pathology and Laboratory Medicine (C.L.W.), College of Medicine, University of Vermont, Burlington, Vermont 05446; Wake Forest University and School of Medicine (S.B.K.), Winston-Salem, North Carolina 27157; Graduate School of Public Health (E.S.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15219; Division of General Internal Medicine (A.M.K.), Department of Epidemiology and Biostatistics (A.V.S.), University of California, San Francisco, San Francisco, California 94143; University of Pittsburgh School of Medicine and Veterans Affairs Pittsburgh Healthcare System (L.F.F.), Pittsburgh, Pennsylvania 15261; and National Institute on Aging (T.B.H.), Bethesda, Maryland 20892.
authors.forename: Elsa S
authors.initials: ES
authors.lastname: Strotmeyer
authors.affiliation: Department of Family Medicine and Public Health (B.A.L., M.H.C., I.X.), and Department of Medicine (J.H.I.), University of California, San Diego, San Diego, California 92093-0628; Department of Pathology and Laboratory Medicine (C.L.W.), College of Medicine, University of Vermont, Burlington, Vermont 05446; Wake Forest University and School of Medicine (S.B.K.), Winston-Salem, North Carolina 27157; Graduate School of Public Health (E.S.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15219; Division of General Internal Medicine (A.M.K.), Department of Epidemiology and Biostatistics (A.V.S.), University of California, San Francisco, San Francisco, California 94143; University of Pittsburgh School of Medicine and Veterans Affairs Pittsburgh Healthcare System (L.F.F.), Pittsburgh, Pennsylvania 15261; and National Institute on Aging (T.B.H.), Bethesda, Maryland 20892.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Criqui
authors.affiliation: Department of Family Medicine and Public Health (B.A.L., M.H.C., I.X.), and Department of Medicine (J.H.I.), University of California, San Diego, San Diego, California 92093-0628; Department of Pathology and Laboratory Medicine (C.L.W.), College of Medicine, University of Vermont, Burlington, Vermont 05446; Wake Forest University and School of Medicine (S.B.K.), Winston-Salem, North Carolina 27157; Graduate School of Public Health (E.S.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15219; Division of General Internal Medicine (A.M.K.), Department of Epidemiology and Biostatistics (A.V.S.), University of California, San Francisco, San Francisco, California 94143; University of Pittsburgh School of Medicine and Veterans Affairs Pittsburgh Healthcare System (L.F.F.), Pittsburgh, Pennsylvania 15261; and National Institute on Aging (T.B.H.), Bethesda, Maryland 20892.
authors.forename: Alka M
authors.initials: AM
authors.lastname: Kanaya
authors.affiliation: Department of Family Medicine and Public Health (B.A.L., M.H.C., I.X.), and Department of Medicine (J.H.I.), University of California, San Diego, San Diego, California 92093-0628; Department of Pathology and Laboratory Medicine (C.L.W.), College of Medicine, University of Vermont, Burlington, Vermont 05446; Wake Forest University and School of Medicine (S.B.K.), Winston-Salem, North Carolina 27157; Graduate School of Public Health (E.S.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15219; Division of General Internal Medicine (A.M.K.), Department of Epidemiology and Biostatistics (A.V.S.), University of California, San Francisco, San Francisco, California 94143; University of Pittsburgh School of Medicine and Veterans Affairs Pittsburgh Healthcare System (L.F.F.), Pittsburgh, Pennsylvania 15261; and National Institute on Aging (T.B.H.), Bethesda, Maryland 20892.
authors.forename: Linda F
authors.initials: LF
authors.lastname: Fried
authors.affiliation: Department of Family Medicine and Public Health (B.A.L., M.H.C., I.X.), and Department of Medicine (J.H.I.), University of California, San Diego, San Diego, California 92093-0628; Department of Pathology and Laboratory Medicine (C.L.W.), College of Medicine, University of Vermont, Burlington, Vermont 05446; Wake Forest University and School of Medicine (S.B.K.), Winston-Salem, North Carolina 27157; Graduate School of Public Health (E.S.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15219; Division of General Internal Medicine (A.M.K.), Department of Epidemiology and Biostatistics (A.V.S.), University of California, San Francisco, San Francisco, California 94143; University of Pittsburgh School of Medicine and Veterans Affairs Pittsburgh Healthcare System (L.F.F.), Pittsburgh, Pennsylvania 15261; and National Institute on Aging (T.B.H.), Bethesda, Maryland 20892.
authors.forename: Ann V
authors.initials: AV
authors.lastname: Schwartz
authors.affiliation: Department of Family Medicine and Public Health (B.A.L., M.H.C., I.X.), and Department of Medicine (J.H.I.), University of California, San Diego, San Diego, California 92093-0628; Department of Pathology and Laboratory Medicine (C.L.W.), College of Medicine, University of Vermont, Burlington, Vermont 05446; Wake Forest University and School of Medicine (S.B.K.), Winston-Salem, North Carolina 27157; Graduate School of Public Health (E.S.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15219; Division of General Internal Medicine (A.M.K.), Department of Epidemiology and Biostatistics (A.V.S.), University of California, San Francisco, San Francisco, California 94143; University of Pittsburgh School of Medicine and Veterans Affairs Pittsburgh Healthcare System (L.F.F.), Pittsburgh, Pennsylvania 15261; and National Institute on Aging (T.B.H.), Bethesda, Maryland 20892.
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.affiliation: Department of Family Medicine and Public Health (B.A.L., M.H.C., I.X.), and Department of Medicine (J.H.I.), University of California, San Diego, San Diego, California 92093-0628; Department of Pathology and Laboratory Medicine (C.L.W.), College of Medicine, University of Vermont, Burlington, Vermont 05446; Wake Forest University and School of Medicine (S.B.K.), Winston-Salem, North Carolina 27157; Graduate School of Public Health (E.S.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15219; Division of General Internal Medicine (A.M.K.), Department of Epidemiology and Biostatistics (A.V.S.), University of California, San Francisco, San Francisco, California 94143; University of Pittsburgh School of Medicine and Veterans Affairs Pittsburgh Healthcare System (L.F.F.), Pittsburgh, Pennsylvania 15261; and National Institute on Aging (T.B.H.), Bethesda, Maryland 20892.
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000503:physiopathology*; D009929:Organ Size / Q000502:physiology; D050177:Overweight / Q000000981:diagnostic imaging / Q000503:physiopathology; D012737:Sex Factors
chemical_list: D001786:Blood Glucose