Vitamin Intake and Loss of Muscle Mass in Older People with Type 2 Diabetes: A Prospective Study of the KAMOGAWA-DM Cohort

Abstract

The aim of this prospective cohort study was to examine the relationships between the intakes of various vitamins and the loss of muscle mass in older people with type 2 diabetes (T2DM). The change in skeletal muscle mass index (SMI, kg/m2) (kg/m2/year) was defined as follows: (SMI at baseline (kg/m2) − SMI at follow-up (kg/m2))/follow-up period (year). The rate of SMI reduction (%) was calculated as follows (the change in SMI (kg/m2/year)/SMI at baseline (kg/m2)) × 100. The rate of SMI reduction ≥ 1.2% was considered as the loss of muscle mass. Among 197 people with T2DM, 47.2% of them experienced the loss of muscle mass at the 13.7 ± 5.2 month follow-up. Vitamin B1 (0.8 ± 0.3 vs. 0.8 ± 0.3 mg/day, p = 0.031), vitamin B12 (11.2 ± 8.3 vs. 13.4 ± 7.5 μg/day, p = 0.049), and vitamin D (16.5 ± 12.2 vs. 21.6 ± 13.0 μg/day, p = 0.004) intakes in people with the loss of muscle mass were significantly lower than those without. Vitamin D intake was related to the loss of muscle mass after adjusting for sex, age, exercise, alcohol, smoking, body mass index, SMI, glucagon-like peptide-1 agonist, sodium glucose cotransporter-2 inhibitor, insulin, HbA1c, creatinine, energy intake, and protein intake (adjusted odds ratio 0.93, 95% confidence interval: 0.88–0.97, p = 0.003). This study showed that vitamin D intake was related to the loss of muscle mass in older people with T2DM. Vitamin B12 intake tended to be related to the loss of muscle mass, although vitamin A, vitamin B2, vitamin B6, vitamin C, and vitamin E intake were not related.

Folic Acid Is Related to Muscle Strength and Vitamin A Is Related to Health-Related Quality of Life: Results of the Korea National Health and Nutrition Examination Survey (KNHANES VII 2016–2018)

“…In our study, vitamin A is related to handgrip strength in the total population but there was no association when analyzed by age group (three groups). Similar to our results, vitamin A levels have not been associated with a loss of muscle mass in the elderly with type 2 diabetes mellitus [ 29 ]. A relationship between vitamin A and muscle strength has not been established.…”

Sarcopenia Is Associated With a Risk of Mortality in People With Type 2 Diabetes Mellitus

“…The number of outcomes was relatively small, further follow-up is imperative. Third, vitamin D status, including serum vitamin D level and vitamin D intake, did not assess in this study, although vitamin D status was reported to be associated with muscle mass loss (46) and muscle mass strength (47). Fourth, this study included only people with T2D; generalization to the other groups is hence uncertain.…”

Exercise and Nutrition Strategies for Combating Sarcopenia and Type 2 Diabetes Mellitus in Older Adults

“…Low levels of vitamin D have been observed to be related with muscle mass loss and enhanced sarcopenia [ 29 , 78 , 79 , 103 ]. Specifically, low levels of vitamin D are also related to reduced glycemic control, since vitamin D receptors located inside the pancreas and skeletal muscle contribute to glucose and muscle homeostasis [ 29 , 33 , 104 , 105 ].…”

“…There is no significant association between diabetes and total dairy intake, although a high intake of milk may reduce T2DM risk among men [ 77 ]. In some studies, low levels of vitamin D have been observed to be related with muscle mass loss and sarcopenia [ 78 , 79 ]. However, the infusion of vitamin D in frail older patients did not show any significant result [ 72 ].…”