Low muscle quality in Japanese type 2 diabetic patients with visceral fat accumulation

Abstract

BackgroundAlthough obesity-related type 2 diabetes mellitus (T2DM) and sarcopenia in the elderly have been increasing worldwide, the associations among visceral fat accumulation, skeletal muscle indices (mass, strength, and quality) and cardiovascular diseases in T2DM remain poorly investigated.MethodsWe enrolled 183 Japanese T2DM inpatients (126 men, 57 women; mean age 64.7 ± 12.6 years, ± SD). The estimated-visceral fat area (eVFA) and skeletal muscle mass were measured by each device using bioelectrical impedance analysis method. We also measured grip strength by dynamometer and motor nerve conduction velocity (MCV). We analyzed the difference in skeletal muscle indices between T2DM patients with and without visceral fat accumulation, and examined the impact of skeletal muscle indices on cardiovascular diseases in patients with visceral fat accumulation.ResultsThe prevalence of sarcopenia defined by the Consensus of Asian Working Group for Sarcopenia and low skeletal muscle mass were both lower in the visceral fat accumulation (+) group than in (−) group. However, the prevalence of weak hand grip strength was similar in the visceral fat accumulation (−) and (+) groups, indicating that considerable patients with visceral fat accumulation had weak grip strength in spite of fair skeletal muscle mass. Muscle quality [grip strength (kg)/arm muscle mass (kg)] was significantly lower in patients with visceral fat accumulation. Multiple regression analysis identified eVFA, MCV and sex as significant and independent determinants of muscle quality. In visceral fat accumulation (+) group, the patients with low muscle quality had longer duration of diabetes, lower eGFR, higher serum adiponectin, lower MCV and higher prevalence of cardiovascular diseases, compared to the patients with high muscle quality. Finally, sex- and age-adjusted models showed significant association between low muscle quality and cardiovascular diseases in all subjects (odds ratio 2.28, p = 0.012), especially in patients with visceral fat accumulation (odds ratio 2.72, p = 0.018).ConclusionsT2DM patients with visceral fat accumulation had low muscle quality, and patients with low muscle quality were more affected with cardiovascular diseases.Electronic supplementary materialThe online version of this article (10.1186/s12933-018-0755-3) contains supplementary material, which is available to authorized users.

Comparison of field- and laboratory-based estimates of muscle quality index between octogenarians and young older adults: an observational study

“…Field MQI used the ratio of grip strength by the BMI (Barbat-Artigas et al, 2012;Choquette et al, 2010;Straight et al, 2013;Studenski et al, 2014). The validity and reliability of the MQI measures (field and laboratory) have been previously reported and the definition of muscle quality adopted in this study is commonly used in large-scale studies because of its convenience (Barbat-Artigas et al, 2012;Barbat-Artigas et al, 2013a;Choquette et al, 2010;Murai et al, 2018;Straight et al, 2013;Studenski et al, 2014).…”

“…Laboratory MQI in both cross-sectional studies used the ratio of grip strength to the entire arm muscle in kilograms measured by DXA (Murai et al, 2018). Field MQI used the ratio of grip strength by the BMI (Barbat-Artigas et al, 2012;Choquette et al, 2010;Straight et al, 2013;Studenski et al, 2014).…”

Comparison of adiposity indices in relation to prehypertension by age and gender: A community‐based survey in Henan, China

“…PBF was calculated as the total mass of fat divided by total body mass. VFI is a novel and accurate and reliable indicator for assessing body fat stored around important internal organs, which is significantly associated with many health‐related outcomes, such as prehypertension, adipose tissue dysfunction, and type 2 diabetes . Bioimpedance analysis is a measurement technique based on electrophysiological characteristics of the dielectric and conductive properties of human tissues .…”

Glucose Levels as a Mediator of the Detrimental Effect of Abdominal Obesity on Relative Handgrip Strength in Older Adults

“…Other studies show that fatness is a mediator of muscular fitness and metabolic syndrome [44] in adolescents and, similarly, Brand et al [45] and Bailey et al [46] found that body fat mediated the relationship between cardiorespiratory fitness and cardiovascular risk factors. Also, it has been shown that patients with T2DM and with visceral fat accumulation have low muscle quality [47]. Although we did not perform measures of muscle quality per se, previous evidence is suggestive that total and regional adiposity is associated with inter-and intramuscular adipose tissue infiltration, which is considered to be an important anatomical correlation of poor muscle quality [48].…”