Protein Intake, Especially Vegetable Protein Intake, Is Associated with Higher Skeletal Muscle Mass in Elderly Patients with Type 2 Diabetes

Abstract

Background/Aims Protein intake is important for maintaining muscle mass in general population. However, it remains to be elucidated the association between dietary protein intake and skeletal muscle mass in elderly patients with type 2 diabetes. Methods In this cross-sectional study of 168 elderly patients with type 2 diabetes, we investigated the relationship between skeletal muscle index (SMI) and protein intake. Bioimpedance analysis was used for measurement for skeletal muscle mass (kg) and SMI (%), which was defined as skeletal muscle mass (kg)/total body weight (kg) × 100. Habitual food and nutrient intake were estimated by a questionnaire. Results Protein intake was independently correlated with SMI after adjusting for age, hemoglobin A1c, C-peptide index, exercise, smoking, insulin treatment, total energy intake, and C-reactive protein (standardized regression coefficient = 0.664, P < 0.001 in men and standardized regression coefficient = 0.516, P = 0.005 in women). Additionally, the animal protein to vegetable protein ratio was negatively correlated with SMI after adjusting for covariates in men (standardized regression coefficient = −0.339, P = 0.005). Conclusions We found that total protein intake, especially vegetable protein intake, was positively associated with skeletal muscle mass in elderly patients with type 2 diabetes.

Shortage of energy intake rather than protein intake is associated with sarcopenia in elderly patients with type 2 diabetes: A cross‐sectional study of the KAMOGAWA‐DM cohort

“…Another study revealed that protein intake was important for the maintenance of muscle mass in elderly people . In a previous study, we also reported that protein intake is associated with muscle mass . A protein intake of 1 to 1.2 g/kg BW per day is generally recommended for the maintenance of muscle mass in the elderly .…”

“…It has been estimated that healthy elderly people should consume 1 g protein per kilogram of body weight each day to promote muscle protein anabolism and increase muscle mass . In addition, we recently demonstrated that protein intake is significantly associated with skeletal muscle mass in elderly patients with T2D . However, it is possible that the mechanisms underlying sarcopenia differ between a diabetic aging population and a healthy aging population because of autophagy, muscle protein degradation, and mitochondrial dysfunction caused by insulin resistance …”

“…4 In addition, we recently demonstrated that protein intake is significantly associated with skeletal muscle mass in elderly patients with T2D. 5 However, it is possible that the mechanisms underlying sarcopenia differ between a diabetic aging population and a healthy aging population because of autophagy, muscle protein degradation, and mitochondrial dysfunction caused by insulin resistance. [6][7][8][9][10] Conversely, energy intake was reported to be associated with muscle mass in healthy elderly people.…”

Sarcopenia is associated with blood pressure variability in older patients with type 2 diabetes: A cross‐sectional study of the KAMOGAWA‐DM cohort study

“…In this cross‐sectional study, we used the patients’ data, which were gathered to clarify the impact of sarcopenia on the natural history of patients with diabetes from December 2016 to December 2017. The inclusion criteria of this cross‐sectional study were older patients with type 2 diabetes (aged ≥65 years) without physical inactivity, who agreed to participate in the KAMOGAWA‐DM cohort study . We excluded patients who were not tested with a multifrequency impedance body composition analyzer and patients without data for handgrip strength, and without four or more blood pressure readings for 1 year.…”

“…The inclusion criteria of this cross-sectional study were older patients with type 2 diabetes (aged ≥65 years) without physical inactivity, who agreed to participate in the KAMOGAWA-DM cohort study. 14 We excluded patients who were not tested with a multifrequency impedance body composition analyzer and patients without data for handgrip strength, and without four or more blood pressure readings for 1 year. None of the patients changed medication for hypertension during the 1 year of this study.…”