Association of skeletal muscle mass and its change with diabetes occurrence: a population-based cohort study

Abstract

Background Low muscle mass likely results in reduced capacity for glucose disposal, leading to a significant but under-appreciated contribution to increasing the risk of diabetes. But few prospective studies have investigated the association between the loss of muscle mass and the occurrence of diabetes. We aimed to investigate whether short-term changes in muscle mass affect the incidence of diabetes in a Chinese population. Methods This study included 1275 individuals without evident diabetes at baseline. In the baseline and re-examination, individuals completed the risk factors survey and underwent body composition measurement. Muscle mass index was defined as the percentage skeletal muscle mass, which was measured by an automatic bioelectric analyzer. Results After a median follow-up of 2.1 years, 142 individuals developed diabetes (11.1%). There was an inverse association between basal skeletal muscle mass index and the risk of diabetes in participants with impaired glucose regulation but not in those with normal glucose tolerance. Multivariate-adjusted hazard ratios for the risk of developing diabetes were 0.85 (95% CI: 0.74–0.98) and 1.15 (95% CI: 0.98–1.34), respectively. Furthermore, Cox regression analysis revealed that a two-year change in skeletal muscle mass was also inversely associated with the incidence of diabetes in both participants with normal glucose tolerance and with impaired glucose regulation (HR: 0.76, 95% CI: 0.65–0.89; HR: 0.81, 95% CI: 0.71–0.91). Conclusions These findings emphasized the importance of early detection and control of muscle mass loss for the prevention of diabetes.

Sarcopenia and Diabetes: A Detrimental Liaison of Advancing Age

“…Sarcopenia is associated with low glucose disposal at the skeletal muscle site [ 33 ]. Skeletal muscle is responsible for around 80% of glucose uptake during experimental conditions of euglycemic hyperinsulinemic clamp [ 34 ]. Skeletal muscle serves as a sort of buffer against hyperglycemia after a glucose load, as observed in the post-prandial phase under physiological conditions [ 35 ].…”

“…Skeletal muscle serves as a sort of buffer against hyperglycemia after a glucose load, as observed in the post-prandial phase under physiological conditions [ 35 ]. Preserving skeletal muscle mass prevents the onset of prediabetes and progression to T2D [ 34 ], as healthy insulin-sensitive skeletal muscle is essential to regulate glucose disposal. First, insulin stimulates the endothelial expression of nitric oxide synthase, nitric oxide production, and peripheral vasodilation.…”

The Vicious Cycle of Type 2 Diabetes Mellitus and Skeletal Muscle Atrophy: Clinical, Biochemical, and Nutritional Bases

“…Muscle loss and T2DM share common pathways, and both lead to impaired glucose homeostasis. Specifically, researchers have found notable commonalities in pathways associated with the onset of diabetes and SMA in adults [ 32 ]. A prospective, community-based study in older adults in China demonstrated that low baseline muscle mass and loss of muscle mass over time predicted T2DM incidence [ 32 ].…”

“…Specifically, researchers have found notable commonalities in pathways associated with the onset of diabetes and SMA in adults [ 32 ]. A prospective, community-based study in older adults in China demonstrated that low baseline muscle mass and loss of muscle mass over time predicted T2DM incidence [ 32 ]. By contrast, effective correction of poor glycemic control in T2DM patients (shown by a decrease in glycated hemoglobin [HbA1c] by 1% or more) was significantly associated with increased skeletal muscle mass and faster gait speed [ 33 ].…”

Muscle Strength and Male Sexual Function

“…An association between sarcopenia (i.e., low muscle mass and strength) and ED have been shown in elderly Turkish and Korean men [33,34], and a parallel decrease in muscle strength and erectile function has been shown in men with type 2 diabetes [35]. Furthermore, muscle mass is found to be preventative of diabetes type 2 and prediabetic states [36][37][38]. In a 10-year followup study, muscle mass showed a significant inverse association with CVD incidence risk after adjusting for confounders, implicating muscle mass as cardioprotective [39].…”