Psoas major muscle mass and upper limb muscle strength are the main factors influencing the rate of HDL-cholesterol within the target in T2DM patients

Abstract

Background Achieving lipid control standards is one of the most important measures to slow down the development of diabetic complications. Clinically, effective drugs have been widely used to reduce low-density lipoprotein cholesterol (LDL-c) and triglycerides (TG). However, there are no effective drugs to increase high-density lipoprotein cholesterol (HDL-c). Studies have shown that exercise can improve HDL-c, so this study intends to investigate the association between muscle mass/muscle strength at different sites and HDL-c to provide clinical evidence to develop precise exercise therapy in the future. Methods We included 2 populations to analyze the relationship between muscle and HDL-c in two aspects: muscle mass and muscle strength. The first study population, including 218 participants, was recruited from inpatients with T2DM in the Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University between February 2017 and December 2020. The second study population, including 138 participants, was recruited from patients with T2DM in Shanghai Yangpu District Central Hospital from June to December 2021. Both groups were analyzed to determine the relationship between psoas major muscle (PMM) mass and muscle strength at different sites and HDL-c. Results The results showed that PMM mass and HDL-c were independently associated and that lower limb muscle strength was not associated with HDL-c. In addition, the odds of achieving the HDL-c target increased with the increase in biceps, triceps and deltoids after adjustment by weight. Furthermore, there were no significant interactions in the trend test for the correlation between PMM mass or upper limb muscle strength and HDL-c between age, sex, and BMI after stratification in the subgroup analysis. Conclusion Our study demonstrates that greater PMM mass and upper limb muscle strength are beneficial for reaching HDL-c targets in certain T2DM patients. This suggests that in clinical practice, specific training of PMM mass and upper limb muscle strength can improve HDL-c in those patients.