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

Abstract

BackgroundDecreasing mass and metabolism in skeletal muscle are associated with increasing insulin resistance (IR) and type 2 diabetes mellitus (T2DM). The causal relation between sarcopenia and abnormal glucose metabolism may be bidirectional. This investigation is aimed to explore the detailed correlation between pre-diabetes and sarcopenia in United States (US) adults.MethodsA total of 22,482 adults aged ≥20 years in the National Health and Nutrition Examination Survey (NHANES) were included. Generalized linear models were conducted to examine associations between diabetes status, serum glucose, glycohemoglobin (HbA1c), and sarcopenia. Generalized additive models and smooth fitting curves were used to examine the non-linear relationship between HbA1c and ASMBMI. Sarcopenia was defined as ASMBMI (appendicular skeletal muscle mass/body mass index) < 0.789 for males, and <0.512 for females based on the cut-off values of the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project.ResultsAfter fully adjusting for multiple covariates, sarcopenia was directly correlated with pre-diabetes [OR (95%CI) = 1.230 (1.057, 1.431), p = 0.008] and T2DM [OR (95%CI) = 2.106 (1.625, 2.729), p < 0.001]. In non-T2DM population, HbA1c was negatively correlated with ASMBMI [β (95%CI) = −0.009 (−0.013, −0.005), p < 0.001]. The correlations only persisted in males. Furthermore, in male non-T2DM population, the association of HbA1c and ASMBMI presents an inverted U-shape curve with an inflection point of HbA1c 5.2%.ConclusionPre-diabetes is associated with increased risk of sarcopenia. HbA1c is an independent risk factor for loss of appendicular skeletal muscle mass and sarcopenia when HbA1c greater than 5.2% in the male non-T2DM population.

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 ].…”

“…According to a recent meta-analysis, three studies that used body mass index, SMI, or appendicular skeletal muscle mass as measures of muscle mass showed that poor glycemic control was strongly associated with loss of muscle mass but not with loss of muscle function [ 41 ]. It is known that each 10% increase in SMI is associated with a 12% reduction in prediabetes or established diabetes [ 42 ].…”

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

“…Studies indicate that there is an association between prediabetes and reduced appendicular muscle strength [ 89 , 90 ]. The diminished muscle strength is attributed to insulin resistance, elevated inflammatory cytokines, and advanced glycosylation end products (AGEs) associated with prediabetes and type 2 diabetes [ 91 , 92 ].…”

“…There is an onset of reduced skeletal muscle strength of lower extremities, with hand grip strength being the least affected. Complications are noted over PreDM progression [ 89 , 90 , 94 ].…”

“…The literature predominantly documents skeletal physical dysfunction in PreDM progression in the context of the effect of PreDM on skeletal muscle strength [ 89 , 90 , 94 , 95 , 96 ].…”