The Association between Body Composition using Dual energy X-ray Absorptiometry and Type-2 Diabetes: A Systematic Review and Meta-Analysis of Observational studies

Gupta, Preeti; Lança, Carla Costa; Gan, Alfred Tl; Soh, Pauline; Thakur, Sahil; Yue, Tao; Neelam, Kumari; Man, Ryan Eyn Kidd; Fenwick, Eva; Lamoureux, Ecosse L.

doi:10.1038/s41598-019-49162-5

Cited by 37 publications

(38 citation statements)

References 62 publications

(75 reference statements)

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“…In the present study, since the PAD patients with more proximal lesions of above the knee of iliac, femoral, and popliteal arteries were enrolled [15], the negative association between PAD and change in the thigh muscle area was elucidated. The findings of the present study were in line with those of a previous reports wherein diabetic patients were at risk of losing their skeletal muscle mass [2,22]. In another study, a large numbers of PAD patients suffered from peripheral neuropathy complicated with diabetes, which led to immobility losing their skeletal muscle [20].…”

Section: Discussionsupporting

confidence: 92%

Impact of Endovascular Treatment on Leg Muscle Mass in Peripheral Artery Disease: a Preliminary Report

Miyakuni¹,

Komiyama²,

Takano³

et al. 2020

Preprint

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Background: Peripheral artery disease (PAD), intermittent claudication, and impaired mobility lower patients' quality of life, contributing to the loss of skeletal muscle. This study sought to investigate the impact of endovascular treatment (EVT) by measuring the mid-thigh level of muscle volume in above the knee PAD patients before and after EVT. Methods:In this prospective, observational study, symptomatic PAD patients with above the knee lesions who had intermittent claudication and were undergoing optimal medical treatment were enrolled. The mid-thigh level of muscle area was measured by computed tomography initially, and then 3 and 6 months after EVT. Patients were categorized into ipsilateral or bilateral based on clinical symptoms and initial ABI value. The muscle area in ischemic and non-ischemic legs were compared in ipsilateral PAD patients. The correlations between alterations in the total thigh muscle area and clinical characteristics were analyzed in univariable and multivariable analysis to investigate the factor contributing skeletal muscle loss. Results:A total of 22 patients were analyzed. The muscle area of the thighs increased after EVT.Fourteen patients had ipsilateral lesions and 8 had bilateral stenosis. In patients with ipsilateral lesions, the mid-thigh muscle area of ischemic lower limbs was significantly lesser than that of nonischemic lower limbs (118.2±16.5 cm 2 vs 124.0±17.3 cm 2 , p=0.0002). The thigh muscle area of ischemic lower limbs increased after EVT (before: 118.2±16.5 cm 2 vs 3 months: 124.0±18.7 cm 2 , p=0.0166; before vs 6 months: 123.0±17.7 cm 2 , p= 0.0566), but this was not the case for nonischemic lower limbs. Multivariate regression analysis revealed that baseline glycated hemoglobin was the only factor that negatively correlated with the change in the muscle area after 3 (β= -3.74, 95% confidence interval [CI] = -7.3 to -0.2, p=0.0417) and 6 months (β= -5.24, 95%CI = -10.

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Section: Discussionsupporting

confidence: 92%

Impact of Endovascular Treatment on Leg Muscle Mass in Peripheral Artery Disease: a Preliminary Report

Miyakuni¹,

Komiyama²,

Takano³

et al. 2020

Preprint

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“…A prospective study found that total reduction in LBM was not significantly associated with incidence of diabetes . Moreover, even if a meta‐analysis found lower LBM levels in individuals with diabetes, this study failed to conclude that LBM was significantly associated with a reduction in the odds of MetS and suggest that this association is uncertain …”

Section: Introductionmentioning

confidence: 78%

“…5 Lean body mass is the primary site of glucose uptake 8 ; and therefore, it has been suggested that LBM protects against cardio-metabolic risk factors and diabetes. 9,10 Although rational, few studies support that both BMI and high-LBM are independently associated with unfavorable cardio-metabolic profiles. 5,11 For example, a study including 421 men and women suggests that age and LBM (but not fat mass) explained 46% of the unfavorable cardio-metabolic risk factors profile.…”

Section: Introductionmentioning

confidence: 99%

“…12 Moreover, even if a meta-analysis found lower LBM levels in individuals with diabetes, this study failed to conclude that LBM was significantly associated with a reduction in the odds of MetS and suggest that this association is uncertain. 10 Although studies have investigated the association between fat mass and LBM with cardio-metabolic risk factors, there are limited studies investigating the simultaneous contribution of LBM and BMI to MetS, and diabetes. This information is relevant as both MetS and diabetes have been associated with CVD, cancer, and all-cause mortality 13,14 and better insight into these factors might help provide more efficient interventions.…”

Section: Introductionmentioning

confidence: 99%

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Does lean body mass equal health despite body mass index?

Colpitts

B̀ouchard

Keshavarz

et al. 2019

Scandinavian Med Sci Sports

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Objective To determine the association between having simultaneously high body mass index (BMI) and high relative lean body mass (LBM) and cardio‐metabolic risk factors, metabolic syndrome (MetS), and diabetes in adults. Materials and Methods A cross‐sectional analysis was performed on 4982 adults aged 19‐85 years that participated in the National Health and Nutrition Examination Survey (cycles 1999‐2000‐2005‐2006). The primary exposure variable was categorization into four groups: (a) Low‐BMI/Low‐LBM, (b) Low‐BMI/High‐LBM, (c) High‐BMI/Low‐LBM, and (d) High‐BMI/High‐LBM. LBM was assessed using dual‐energy X‐ray absorptiometry. The primary outcome measures were cardio‐metabolic risk factors, MetS based on the ATP III definition; participants were required to have at least three of the following five criteria: high waist circumference, low HDL cholesterol, elevated triglyceride levels, high resting blood pressure, and self‐reported diabetes. Results Compared to the High‐BMI/High‐LBM, most cardio‐metabolic risk factors were significantly different among groups (P < .05) while no such differences were observed for the High‐BMI/Low‐LBM (P > .05). Exception of waist circumference (OR [95%]: 21.8 [8.84‐53.82]), there was no increased odds of having cardio‐metabolic risk factors in the High‐BMI/Low‐LBM compared with the High‐BMI/High‐LBM (P > .05). The odds of having MetS and diabetes for the High‐BMI/Low‐LBM compared with the High‐BMI/High‐LBM were OR (95% CI): 1.68 (0.84‐3.36) and 0.59 (0.26‐1.34), respectively. Conclusions Our results suggest that having a high‐BMI as well as high relative LBM levels is not associated with cardio‐metabolic risk factors, MetS, and diabetes. Therefore, maintaining a BMI below 30 kg/m2 appears to be clinically relevant, regardless of LBM levels.

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“…Indeed, most individuals with T2D are overweight or obese, 11 and T2D patients who are not considered overweight or obese may still have a high percentage of body fat primarily in the abdominal region. [11][12][13] Current studies have indicated that impaired glycemic control and disease duration are the two major contributing factors that affect body composition in individuals with T2D. 14,15 However, data about fat distribution and variations in individuals with T2D are limited and equivocal.…”

Section: Introductionmentioning

confidence: 99%

<p>Body Composition and the Components of Metabolic Syndrome in Type 2 Diabetes: The Roles of Disease Duration and Glycemic Control</p>

Abulmeaty

Aljuraiban

Alaidarous

et al. 2020

DMSO

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Purpose: Data about body compositional changes throughout the course of type 2 diabetes (T2D) are limited and inconsistent. We investigated the roles of the disease duration and glycemic control in T2D-associated changes of body composition and the components of metabolic syndrome (MetS). Patients and Methods: A total of 25 non-diabetic controls and 92 individuals aged 20-60 years with T2D were included in a case-control study conducted at King Faisal Specialist Hospital, Saudi Arabia. Based on disease duration (newly diagnosed: within the first year and long duration: ≥5 years) and glycemic control (glycated hemoglobin [HbA1C] level ≤7%), the patients were divided into the following groups: newly diagnosed and controlled (N&C, n=25), newly diagnosed and uncontrolled (N&U, n=17), old and controlled (O&C, n=25), and old and uncontrolled (O&U, n=25). Blood samples were collected to assess fasting blood glucose level, HbA1C level, and lipid profile. Anthropometric data were evaluated, and body composition was assessed using a bio-impedancemetry analyzer. Nonparametric tests and multivariable logistic regression analyses were performed. Results: Compared to the control group, the fat mass (FM) was significantly higher in all groups; furthermore, the fat mass/fat-free mass (FM/FFM) ratio was significantly higher in the N&C. The N&U and O&U groups showed significantly higher percentages of all components of MetS. Among all selected independent factors, only age increased the likelihood of MetS diagnosis by 7% (OR: 1.07; 95% CI: 1.004-1.149; P<0.05). Besides, age, gender, adherence to diet regimen, and T2D duration showed lower odds of increased FM/ FFM ratio. Conclusion: This study provided evidence about the impact of T2D on body composition and the other components of MetS. Thus, further characterization of T2D contributes to defining the etiology of the disease to detect and treat poor cardiometabolic health.

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The Association between Body Composition using Dual energy X-ray Absorptiometry and Type-2 Diabetes: A Systematic Review and Meta-Analysis of Observational studies

Cited by 37 publications

References 62 publications

Impact of Endovascular Treatment on Leg Muscle Mass in Peripheral Artery Disease: a Preliminary Report

Impact of Endovascular Treatment on Leg Muscle Mass in Peripheral Artery Disease: a Preliminary Report

Does lean body mass equal health despite body mass index?

<p>Body Composition and the Components of Metabolic Syndrome in Type 2 Diabetes: The Roles of Disease Duration and Glycemic Control</p>

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