Muscle adiposity and body fat distribution in type 1 and type 2 diabetes: varying relationships according to diabetes type

Abstract

Objective: To compare the relationships between markers of total and regional adiposity with muscle fat infiltration in type 1 diabetic and type 2 diabetic subjects and their respective nondiabetic controls, and to document these relationships in type 1 diabetic subjects. Design: Cross-sectional study. Subjects: In total, 86 healthy, with type 1 diabetes, type 2 diabetes or control subjects. Each diabetic group was matched for age, sex and body mass index with its respective nondiabetic control group. Measurements: Measures of body composition (hydrodensitometry), fat distribution (waist circumference, abdominal and mid-thigh computed tomography scans) and blood lipid profiles were assessed. Results: Low attenuation mid-thigh muscle surface correlated similarly with markers of adiposity and body composition in all groups, regardless of diabetes status, except for visceral adipose tissue and waist circumference. Indeed, relationships between visceral adiposity and muscle adiposity were significantly stronger in type 2 vs type 1 diabetic subjects (Po0.05 for comparison of slopes). In addition, in well-controlled type 1 diabetic subjects (mean HbA 1c of 6.8%), daily insulin requirements tended to correlate with low attenuation mid-thigh muscle surface, a specific component of fat-rich muscle (r ¼ 0.36, P ¼ 0.08), but not with glycemic control (HbA 1c ). Conclusion: This study suggests that the relationship of central adiposity and muscle adiposity is modulated by diabetes status and is stronger in the insulin resistant diabetes type (type 2 diabetes). In well-controlled nonobese type 1 diabetic subjects, the relationship between muscle fat accumulation and insulin sensitivity was also maintained.

Accelerated atrophy of lower leg and foot muscles—a follow-up study of long-term diabetic polyneuropathy using magnetic resonance imaging (MRI)

“…This is in contrast to the study by Park et al, who observed a small but significant difference in intrinsic muscle strength in a large group of older type 2 diabetic patients using dual-energy x-ray absorptiometry (DEXA) to evaluate muscle mass [40]. Overestimation of muscle mass by DEXA could account for the lower muscle quality observed [41], as could increased fat infiltration of the muscle, which is found more frequently in type 2 diabetic patients [42]. Analysis of magnetic resonance images allows exclusion of fat and fibrous tissue within muscle compartments.…”

Correlation of Abdominal Fat Distribution with Different Types of Diabetes in a Chinese Population

“…Compared with other studies done with other population [7, 20, 21], there was unique finding from our study. First, it is found that more subcutaneous fat in subjects with T1DM, and this is correlated to the state of diabetes.…”

“…There was a study that compared abdominal fat distribution in different types of diabetes and their correlations [7]. However, it is done for different regions of the body such as fat in skeletal muscle and thigh, and it was performed in Canadians.…”

Intermuscular Fat: A Review of the Consequences and Causes

“…Muscle dysfunction may lead to further inactivity and increased levels of IMAT precipitating a cycle of increased IMAT, insulin resistance, and muscle dysfunction. This close relationship between the muscle fibers and IMAT becomes particularly important in populations that are known to have increased IMAT, muscle dysfunction, and insulin resistance including individuals with diabetes [70] and survivors of stroke [28, 40] and spinal cord injury [39, 57, 58]. …”