Low thigh muscle strength in relation to myosteatosis in patients with type 2 diabetes mellitus

Abstract

This study aimed to investigate the association of thigh muscle fat infiltration by quantitative MRI with muscle strength in patients with type 2 diabetes mellitus (T2DM). Seventy T2DM patients and sixty control subjects (71 males; age: 52 ± 8 years) underwent 3.0T MRI and isokinetic muscle strength measurements to obtain the skeletal muscle index (SMI), intermuscular adipose tissue (IMAT) proton density fat fraction (PDFF), intramuscular fat (IMF) PDFF, peak torque (PT) and total work (TW) of knee extensors and flexors. The differences of measurements between T2DM patients and asymptomatic volunteers were compared. Multivariate regression analysis was used to determine significant predictors of thigh extension and flexion strength. The SMI, IMAT and IMF PDFF of thigh muscles in T2DM patients were higher than that in the control group (p < 0.001), while PT and TW were lower than those in the control subjects (p < 0.05). Both IMF and IMAT PDFF were negatively correlated with PT, TW in participants with T2DM (extensors: r = − 0.72, − 0.70, p < 0.001; r = − 0.62, − 0.56, p < 0.05. flexors: r = − 0.37, − 0.43, p < 0.05; r = − 0.39, − 0.46, p < 0.05). Moderate and strong correlations between HOMA-IR and muscle strength measurements, muscle PDFFs were observed in extensors and flexors. IMF PDFF and age were the statistically significant predictor of PT and TW of extensors of thigh in multivariate regression analysis. Therefore, the thigh muscle PDFF increased was associated with muscle strength decreased in T2DM patients beyond SMI. Age are also important factors influencing thigh muscle PDFF and strength in T2DM patients.

Prevalence of and Impact on the Outcome of Myosteatosis in Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

“…In the same study, among the subjects with a BMI < 25 mg/kg 2 , higher rates of intermuscular fat and visceral abdominal fat were linked to higher levels of fasting insulin [ 38 ]. The latter finding was confirmed in a recent study, in which the presence of myosteatosis was associated with insulin resistance in patients with T2DM, and this effect was more significant in older T2DM patients [ 39 ]. Interestingly, in patients with inflammatory bowel disease, although myosteatosis did not increase overall morbidity and mortality, it was associated with a higher postoperative morbidity following bowel resection [ 40 ].…”

Prediabetes-Associated Changes in Skeletal Muscle Function and Their Possible Links with Diabetes: A Literature Review

“…Diabetic myopathy is documented to be associated with reduced muscle mass and appendicular muscle strength [ 113 , 114 ]. Andersen et al [ 115 ] observed T2D-associated muscle strength loss around the ankle and knee joints.…”

“…Andersen et al [ 115 ] observed T2D-associated muscle strength loss around the ankle and knee joints. Studies document a positive correlation between reduced thigh muscle strength, muscle ectopic fat deposition, and insulin resistance in T2D patients [ 114 ]. Furthermore, age in T2D patients was associated with muscle ectopic fat and decreased muscle strength [ 114 ].…”

“…Studies document a positive correlation between reduced thigh muscle strength, muscle ectopic fat deposition, and insulin resistance in T2D patients [ 114 ]. Furthermore, age in T2D patients was associated with muscle ectopic fat and decreased muscle strength [ 114 ]. The fat infiltration in the muscle associated with muscle ectopic fat deposition, combined with low mitochondrial oxidative capacity, is suggested to potentially distort muscle architecture, resulting in the loss of muscle strength [ 116 , 117 ].…”

“…Skeletal muscle strength of the lower extremities is prominently affected, with hand grip strength being the least affected. Complications are noted over long-term poorly controlled T2DM [ 102 , 103 , 107 , 114 ].…”