Prediabetes is an independent risk factor for sarcopenia in older men, but not in older women: the Bunkyo Health Study

Abstract

Background Sarcopenia is a major cause of disability in the elderly. Although type 2 diabetes is a risk factor for increased sarcopenia, the relationship between prediabetes and sarcopenia has not been elucidated. We aimed to examine the relationship between sarcopenia and prediabetes. Methods The design of this study is a cross‐sectional study. We evaluated glucose metabolism using the 75‐g oral glucose tolerance test and glycated haemoglobin, appendicular skeletal muscle mass, and hand grip strength in 1629 older adults living in an urban area of Tokyo, Japan. We investigated the frequency of sarcopenia in participants with normal glucose tolerance (NGT), prediabetes and diabetes. A multivariable logistic regression model was used to analyse the association between glucose tolerance and the prevalence of sarcopenia. Results The mean age of participants was 73.1 ± 5.4 years. In men, 44.3% had NGT, 26.6% had prediabetes, and 29.1% had diabetes. In women, the distribution was 56.1%, 28.8% and 15.2%. The prevalence of sarcopenia was 12.7% in men and 11.9% in women. Logistic regression revealed that prediabetes and diabetes are independent risk factors for sarcopenia in men (prediabetes, odds ratio [OR] = 2.081 [95% confidence interval {CI}: 1.031–4.199]; diabetes, OR = 2.614 [95% CI: 1.362–5.018]) and diabetes, but not prediabetes, is an independent risk factor for sarcopenia in women (prediabetes, OR = 1.036 [95% CI: 0.611–1.757]; diabetes, OR = 2.099 [95% CI: 1.146–3.844]). In both sexes, higher age (men, OR = 1.086 [95% CI: 1.028–1.146]; women, OR = 1.195 [95% CI: 1.142–1.251]), higher body fat percentage (men, OR = 1.346 [95% CI: 1.240–1.461]; women, OR = 1.218 [95% CI: 1.138–1.303]) and lower body mass index (men, OR = 0.371 [95% CI: 0.299–0.461]; women, OR = 0.498 [95% CI: 0.419–0.593]) were independent risk factors for sarcopenia. Conclusions Although we confirmed that diabetes mellitus is associated with sarcopenia in both sexes, prediabetes is associated with sarcopenia in men, but not in women.

Prediabetes is associated with loss of appendicular skeletal muscle mass and sarcopenia

“…Few studies had been conducted to investigate the correlation between pre-diabetes and sarcopenia. A recent study conducted in Japan revealed increasing sarcopenia rate in pre-diabetic older men, but not women (21). Focusing on the whole US population, our study found that pre-diabetes was an independent risk factor for sarcopenia.…”

Low Muscle Mass Is Associated with Poorer Glycemic Control and Higher Oxidative Stress in Older Patients with Type 2 Diabetes

“…The role of gender, on the other hand, remains unclear in the literature. While in the cohort of this study, a relationship between LM and glycemic control was only obtained in women, there are other studies in which this relationship between T2D and SMM only appears in men [ 42 , 43 ].…”

Comment on ‘Prediabetes is an independent risk factor for sarcopenia in older men, but not in older women: the Bunkyo Health Study’ by Kaga et al.

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We read, with great interest, the recent article by Kaga et al, in which prediabetes was reported to be associated with sarcopenia in older men but not in older women based on the cross-sectional analysis using the baseline data from the Bunkyo Health Study. 1 This finding indicates that sarcopenia could have occurred prior to the onset of diabetes, particularly in older men, and highlights the need of conducting screening-oriented strategy for sarcopenia prevention in the aging population. However, in this article, several issues are worthy of discussion.First, as indicated in the Methods part, the authors performed separate analyses by sex for the association of glycaemic status with sarcopenia.

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