Association of Decreased Handgrip Strength with Reduced Cortical Thickness in Japanese Female Patients with Type 2 Diabetes Mellitus

Abstract

LD-100, a quantitative ultrasonic device, allows us to measure cortical thickness (CoTh). Patients with type 2 diabetes mellitus (T2DM) show high prevalence of sarcopenia. This study aimed to clarify the association of handgrip strength (HGS) with cortical porosis, a major risk for fracture of DM. CoTh and trabecular bone mineral density (TrBMD) at the 5.5% distal radius were assessed in T2DM female patients (n = 122) and non-DM female controls (n = 704) by LD-100. T2DM patients aged older 40 years showed significantly lower HGS and CoTh, but not TrBMD, than non-DM counterparts. Although HGS was significantly and positively correlated with CoTh and TrBMD in T2DM patients, multivariate analysis revealed HGS as an independent factor positively associated with CoTh, but not TrBMD, in T2DM patients, suggesting the preferential association of HGS with cortical, but not trabecular, bone component in T2DM female patients. In conclusion, the present study demonstrated an early decline of HGS in T2DM female patients as compared with non-DM healthy controls after the age of 40 years, which is independently associated with thinner CoTh, but not TrBMD in T2DM patients, and thus suggested that reduced muscle strength associated with DM might be a major factor for cortical porosis development in DM patients.

Importance of Considering Malnutrition and Sarcopenia in Order to Improve the QOL of Elderly Hemodialysis Patients in Japan in the Era of 100-Year Life

“…In addition to aging and malnutrition, sarcopenia is known to preferentially occur in HD patients with osteoporosis and DM [ 38 ]. Additionally, the rates for the co-existence of sarcopenia, osteoporosis, and DM are known to be higher in HD patients and increase with aging.…”

The Relationship Between Bone Mineral Density and Type 2 Diabetes in Obese Children and Adolescents at the Time of Initial Diagnosis

“…A previous study has reported that the higher the ratio of cortical and trabecular bone (distal radius > femoral neck > lumbar spine), the lower the BMD Z-score (lumbar spine > femoral neck > distal radius) in women with T2D [6]. Nakamura et al [18] have also reported that T2D patients have significantly lower cortical bone thickness, but not trabecular BMD, compared to non-diabetic controls. These results suggest that selective loss of cortical bone might have influenced different bone density at multiple bony sites.…”

Trajectories of Handgrip Strength and Their Associations with Mortality among Older Adults in Korea: Analysis of the Korean Longitudinal Study of Aging

“…Although the precise mechanism underlying the correlation between HGS and mortality is not yet known, several studies have confirmed that sarcopenia associated with aging is associated with mortality. Among older adults, it is known that sarcopenia increases the risk of cardiovascular disease and is related to the risk of type 2 DM and falls [ 18 - 20 ]. Sarcopenia reflects weaker whole-body muscle strength, which is known to be associated with traditional risk factors for death or cardiovascular disease, that is, lower body weight [ 21 ], physical inactivity [ 22 ], and chronic diseases, such as diabetes and hypertension [ 23 ].…”