Characteristics of changes in muscle quality and strength in patients with type 2 diabetes mellitus / 中华老年医学杂志

ABSTRACT

Objective:To investigate the characteristics of changes in muscle quality and strength in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 670 patients(320 males and 350 females)aged 50 years and over from the endocrinology departments of 9 hospitals in Beijing were recruited as the type 2 diabetes mellitus group(T2DM group)by using systematic random sampling, and 214(54 males and 75 females)age-matched Beijing Hospital retirees without T2DM were randomly enrolled as the control group.Body composition was measured by using bioimpedance analysis.Low muscle mass was defined as appendicular skeletal muscle mass index(ASMI)below 7.18 kg/m 2 in men and 5.73 kg/m 2 in women.Low muscle strength was defined as grip strength below 29.5 kg in men and 21.2 kg in women.Sarcopenia was defined by the presence of low muscle mass with low grip strength.Muscle quality was calculated by grip strength divided by muscle mass of the dominant upper limb, and muscle strength per mass unit was compared.Multivariate Logistic regression was used for correlation analysis. Results:The fasting blood glucose(FPG)level, the waist to hip ratio, the percentages of smokers and drinkers, and the proportions of subjects with concurrent hypertension and coronary heart disease were higher in the T2DM group than in the control group( P<0.05 or 0.01). Compared with the control group, grip strength and muscle quality decreased significantly in male T2DM patients( t=4.408 and 3.972, P<0.01). In male participants, BMI( t=-5.567, 95% CI: -0.375~-0.179, P<0.01)and glycated hemoglobin(HbA1c)( t=-2.322, 95% CI: -0.420~-0.035, P<0.05)were negatively correlated with muscle quality, while old age( OR=1.062, 95% CI: 1.023~1.103, P<0.01; OR=1.074, 95% CI: 1.027~1.122, P<0.01)and increased HbA1c level( OR=1.062, 95% CI: 1.023~1.103, P<0.01; OR=1.074, 95% CI: 1.027~1.122, P<0.01)were risk factors for low muscle strength and sarcopenia. Conclusions:Compared with non-diabetes patients, muscle quality and strength decrease significantly in middle-aged and elderly male T2DM patients.Besides aging, increased levels of HbA1c and BMI are risk factors for low muscle quality and strength.