Diabetes Metab J.  2016 Apr;40(2):140-146. 10.4093/dmj.2016.40.2.140.

Hyperglycemia Is Associated with Impaired Muscle Quality in Older Men with Diabetes: The Korean Longitudinal Study on Health and Aging

• Yoon JW
• Ha YC
• Kim KM
• Moon JH
• Choi SH
• Lim S
• Park YJ
• Lim JY
• Kim KW
• Park KS
• Jang HC

• KMID: 2162085
• DOI: http://doi.org/10.4093/dmj.2016.40.2.140

Abstract

BACKGROUND
The study aimed to investigate the influence of hyperglycemia on muscle quality in older men with type 2 diabetes.
METHODS
This was a subsidiary study of the Korean Longitudinal Study of Health and Aging. Among 326 older men consenting to tests of body composition and muscle strength, 269 men were ultimately analyzed after the exclusion because of stroke (n=30) and uncertainty about the diagnosis of diabetes (n=27). Body composition was measured using dual-energy X-ray absorptiometry and computed tomography. Muscle strength for knee extension was measured using an isokinetic dynamometer. Muscle quality was assessed from the ratio of leg strength to the entire corresponding leg muscle mass.
RESULTS
The muscle mass, strength, and quality in patients with type 2 diabetes did not differ significantly from controls. However, when patients with diabetes were subdivided according to their glycemic control status, patients with a glycosylated hemoglobin (HbA1c) level of ≥8.5% showed significantly decreased leg muscle quality by multivariate analysis (odds ratio, 4.510; P=0.045) after adjustment for age, body mass index, smoking amount, alcohol consumption, physical activity, and duration of diabetes. Physical performance status was also impaired in subjects with an HbA1c of ≥8.5%.
CONCLUSION
Poor glycemic control in these older patients with diabetes was associated with significant risk of decreased muscle quality and performance status. Glycemic control with an HbA1c of <8.5% might be needed to reduce the risk of adverse skeletal and functional outcomes in this population.

Keyword

Aging; Diabetes mellitus, type 2; Muscle, skeletal; Sarcopenia

MeSH Terms

Absorptiometry, Photon
Aging*
Alcohol Drinking
Body Composition
Body Mass Index
Diabetes Mellitus, Type 2
Diagnosis
Hemoglobin A, Glycosylated
Humans
Hyperglycemia*
Knee
Leg
Longitudinal Studies*
Male
Motor Activity
Multivariate Analysis
Muscle Strength
Muscle, Skeletal
Sarcopenia
Smoke
Smoking
Stroke
Uncertainty
Smoke

Figure

• 

  Fig. 1 Poor glycemic control was associated with lower muscle quality. Older patients with diabetes and glycosylated hemoglobin (HbA1c) levels of ≥8.5% showed significantly decreased muscle quality compared with patients with HbA1c levels of <8.5%, as well as non-diabetes mellitus (DM). Nm, newton meter. aP<0.05, bP=0.053.

• 

  Fig. 2 Comparison of physical performance status related to the glycemic control of older diabetic patients with glycosylated hemoglobin (HbA1c) levels of ≥8.5% showed significantly lower Short Physical Performance Battery (SPPB) scores than diabetic patients with HbA1c levels of <8.5%, as well as non-diabetes mellitus (DM). aP<0.01 vs. non-DM, bP<0.05 vs. HbA1c <8.5%.

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