Diabetes Metab J.  2019 Oct;43(5):627-639. 10.4093/dmj.2018.0141.

Longitudinal Changes of Body Composition Phenotypes and Their Association with Incident Type 2 Diabetes Mellitus during a 5-Year Follow-up in Koreans

• Kim HK
• Lee MJ
• Kim EH
• Bae SJ
• Choe J
• Kim CH
• Park JY

• KMID: 2460956
• DOI: http://doi.org/10.4093/dmj.2018.0141

Abstract

BACKGROUND
To elucidate longitudinal changes of complex body composition phenotypes and their association with incident type 2 diabetes mellitus.
METHODS
A total of 17,280 (mean age, 48.1±8.2 years) Korean adults who underwent medical check-ups were included. The mean follow-up duration was 5.5±0.5 years. Body compositions were assessed using a bioelectrical impedance analysis. Four body composition phenotypes were defined using the median of appendicular skeletal muscle mass (ASM) index and fat mass index: low muscle/low fat (LM/LF); high muscle (HM)/LF; LM/high fat (HF); and HM/HF groups.
RESULTS
Of the individuals in the LM/LF or HM/HF groups, over 60% remained in the same group, and over 30% were moved to the LM/HF group. Most of the LM/HF group remained in this group. In the baseline HM/LF group, approximately 30% stayed in the group, and the remaining individuals transitioned to the three other groups in similar proportions. Incident diabetes was significantly lower in participants who remained in the HM/LF group than those who transitioned to the LM/LF or LM/HF group from the baseline HM/LF group in men. ASM index was significantly associated with a decreased risk for incident diabetes in men regardless of obesity status (adjusted odds ratio [OR], 0.71 per kg/m²; 95% confidence interval [CI], 0.52 to 0.97 in non-obese) (adjusted OR, 0.87; 95% CI, 0.77 to 0.98 in obese) after adjusting for other strong risk factors (e.g., baseline glycosylated hemoglobin and homeostasis model assessment of insulin resistance).
CONCLUSION
Maintenance of ASM may be protective against the development of type 2 diabetes mellitus in men, regardless of obesity status.

Keyword

Adipose tissue; Body composition; Diabetes mellitus, type 2; Muscle, skeletal

MeSH Terms

Adipose Tissue
Adult
Body Composition*
Diabetes Mellitus, Type 2*
Electric Impedance
Follow-Up Studies*
Hemoglobin A, Glycosylated
Homeostasis
Humans
Insulin
Male
Muscle, Skeletal
Obesity
Odds Ratio
Phenotype*
Risk Factors
Insulin

Figure

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  Fig. 1 Distribution of the four types of body composition according to sex and age groups at (A, B) baseline and (C, D) their respective changes after the 5-year follow-up period.

• 

  Fig. 2 (A) Transitions of each body composition phenotype from baseline to follow-up after 5 years. (B) Incidence of type 2 diabetes mellitus (T2DM) in the baseline “high muscle/low fat” group according to the transition of body composition during the follow-up period. aP<0.01 between the groups by chi-square test.

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