Short energy intake is associated with muscle mass loss in older patients with type 2 diabetes: A prospective study of the KAMOGAWA-DM cohort

Kawano, Rena; Takahashi, Fuyuko; Hashimoto, Yoshitaka; Okamura, Tomio; Miki, Akane; Kaji, Ayumi; Sakai, Ryosuke; Kitagawa, Noriyuki; Senmaru, Takufumi; Majima, Susumu; Okada, Hiroshi; Nakanishi, Naoko; Ushigome, Emi; Yamazaki, Masahiro; Fukui, Michiaki

doi:10.1016/j.clnu.2021.02.049

Cited by 26 publications

(19 citation statements)

References 37 publications

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“…In fact, among our study participants, the prevalence of sarcopenia was 15.1%, which was almost similar to that of previous studies ( 34 , 35 ). Exercise training as well as adequate protein and calorie intakes are necessary to maintain and increase muscle mass ( 36 – 40 ). Furthermore, handgrip exercises decrease vascular resistance by a cholinergic mechanism ( 41 ), although it is possible that such a physiological effect may be attenuated in people with T2D because of autonomic nervous dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia Is Associated With a Risk of Mortality in People With Type 2 Diabetes Mellitus

et al. 2021

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BackgroundSarcopenia has reportedly been associated with increased risk of mortality in general populations. However, few studies have investigated the association between sarcopenia and mortality in older people with type 2 diabetes mellitus (T2D). This study aimed to investigate the effect of sarcopenia on incident all-cause mortality in older people with T2D.MethodsLow muscle strength were set at handgrip strength <28 kg for men and <18 kg for women, and low skeletal muscle mass index (SMI), evaluated using the impedance body composition analyzer, were set at SMI <7.0 kg/m2 for men and <5.7 kg/m2 for women. People who had both low muscle strength and low SMI were diagnosed with sarcopenia. Due to a low incidence of all-cause mortality, the propensity score was used. The propensity score was evaluated using multivariable logistic regression models with the following parameters: age, sex, duration of diabetes, history of heart disease, history of cancer, smoking, exercise, alcohol, sodium-glucose cotransporter-2 inhibitor, glucagon-like peptide-1 receptor agonist, insulin, corticosteroid, hypertension, body mass index, glycosylated hemoglobin A1c, triglycerides, and creatinine, and the C-statistic was 0.89.ResultsIn this prospective cohort study, 396 people with an average age and duration of diabetes of 71.3 (6.3) years and 16.3 (11.3) years, respectively, were included. Of those included, 14.6% had sarcopenia. During the average 40.5 (16.5) months of follow-up, 13 people (6 out of the 338 without sarcopenia and 7 out of the 58 with sarcopenia) died. Incident rate were 5.1/1000 person years of follow-up in people without sarcopenia and 41.3/1000 person years of follow-up in people with sarcopenia. According to Cox regression analysis, sarcopenia was associated with all-cause mortality (adjusted hazard ratio: 6.12, 95% confidence interval: 1.52–24.7, p = 0.011).ConclusionSarcopenia is associated with incident all-cause mortality in older outpatients with T2D.

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Section: Discussionmentioning

confidence: 99%

Sarcopenia Is Associated With a Risk of Mortality in People With Type 2 Diabetes Mellitus

et al. 2021

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“…Furthermore, the rate of SMI reduction ≥0.5% [11] and 2.0% [42] were used for other cut-off levels of loss of muscle mass.…”

Section: Methodsmentioning

confidence: 99%

“…Macronutrient intake, such as adequate energy and protein intake, is recommended for maintenance of the body's muscle mass [5,[10][11][12]. On the other hand, micronutrients have also been associated with muscle mass [13].…”

Section: Introductionmentioning

confidence: 99%

Vitamin Intake and Loss of Muscle Mass in Older People with Type 2 Diabetes: A Prospective Study of the KAMOGAWA-DM Cohort

et al. 2021

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The aim of this prospective cohort study was to examine the relationships between the intakes of various vitamins and the loss of muscle mass in older people with type 2 diabetes (T2DM). The change in skeletal muscle mass index (SMI, kg/m2) (kg/m2/year) was defined as follows: (SMI at baseline (kg/m2) − SMI at follow-up (kg/m2))/follow-up period (year). The rate of SMI reduction (%) was calculated as follows (the change in SMI (kg/m2/year)/SMI at baseline (kg/m2)) × 100. The rate of SMI reduction ≥ 1.2% was considered as the loss of muscle mass. Among 197 people with T2DM, 47.2% of them experienced the loss of muscle mass at the 13.7 ± 5.2 month follow-up. Vitamin B1 (0.8 ± 0.3 vs. 0.8 ± 0.3 mg/day, p = 0.031), vitamin B12 (11.2 ± 8.3 vs. 13.4 ± 7.5 μg/day, p = 0.049), and vitamin D (16.5 ± 12.2 vs. 21.6 ± 13.0 μg/day, p = 0.004) intakes in people with the loss of muscle mass were significantly lower than those without. Vitamin D intake was related to the loss of muscle mass after adjusting for sex, age, exercise, alcohol, smoking, body mass index, SMI, glucagon-like peptide-1 agonist, sodium glucose cotransporter-2 inhibitor, insulin, HbA1c, creatinine, energy intake, and protein intake (adjusted odds ratio 0.93, 95% confidence interval: 0.88–0.97, p = 0.003). This study showed that vitamin D intake was related to the loss of muscle mass in older people with T2DM. Vitamin B12 intake tended to be related to the loss of muscle mass, although vitamin A, vitamin B2, vitamin B6, vitamin C, and vitamin E intake were not related.

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“…In a prospective cohort study, insufficient energy intake was associated with muscle mass loss in older people with type 2 diabetes. 86 In 2019, the European Society for Clinical Nutrition and Metabolism guidelines for older adults recommended an energy intake in older persons of 30 kcal/kg bodyweight/day. 87 This value can constitute one of the criteria for setting an energy target, although it should be individually adjusted for nutrition status, physical activity level, disease status and tolerance.…”

Section: Energy Intakementioning

confidence: 99%

Skeletal muscle as a treatment target for older adults with diabetes mellitus: The importance of a multimodal intervention based on functional category

Omura

Araki

2022

Geriatrics Gerontology Int

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Although the lifespan of people with diabetes has increased in many countries, the age-related increase in comorbidities (sarcopenia, frailty and disabilities) and diabetic complications has become a major issue. Diabetes accelerates the aging of skeletal muscles and blood vessels through mechanisms, such as increased oxidative stress, chronic inflammation, insulin resistance, mitochondrial dysfunction, genetic polymorphism (fat mass and obesity-associated genes) and accumulation of advanced glycation end-products. Diabetes is associated with early onset, and progression of muscle weakness and sarcopenia, thus resulting in diminished daily life function. The type and duration of diabetes, insulin section/resistance, hyperglycemia, diabetic neuropathy, malnutrition and low physical activity might affect muscular loss and weakness. To prevent the decline in daily activities in older adults with diabetes, resistance training or multicomponent exercise should be recommended. To maintain muscle function, optimal energy and sufficient protein intake are necessary. Although no specific drug enhances muscle mass and function, antidiabetic drugs that increase insulin sensitivity or secretion could be candidates for improvement of sarcopenia. The goals of glycemic control for older patients are determined based on three functional categories through an assessment of cognitive function and activities of daily living, and the presence or absence of medications that pose a hypoglycemic risk. As these functional categories are associated with muscle weakness, frailty and mortality risk, providing multimodal interventions (exercise, nutrition, social network or support and optimal medical treatment) is important, starting at the category II stage for maintenance or improvement in daily life functions. Geriatr Gerontol Int 2022; 22: 110-120.

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Short energy intake is associated with muscle mass loss in older patients with type 2 diabetes: A prospective study of the KAMOGAWA-DM cohort

Cited by 26 publications

References 37 publications

Sarcopenia Is Associated With a Risk of Mortality in People With Type 2 Diabetes Mellitus

Sarcopenia Is Associated With a Risk of Mortality in People With Type 2 Diabetes Mellitus

Vitamin Intake and Loss of Muscle Mass in Older People with Type 2 Diabetes: A Prospective Study of the KAMOGAWA-DM Cohort

Skeletal muscle as a treatment target for older adults with diabetes mellitus: The importance of a multimodal intervention based on functional category

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