Diabetes Metab J.  2019 Feb;43(1):105-113. 10.4093/dmj.2018.0036.

Proportion and Characteristics of the Subjects with Low Muscle Mass and Abdominal Obesity among the Newly Diagnosed and Drug-Naïve Type 2 Diabetes Mellitus Patients

• Kim JA
• Hwang SY
• Chung HS
• Kim NH
• Seo JA
• Kim SG
• Kim NH
• Choi KM
• Baik SH
• Yoo HJ

• KMID: 2460977
• DOI: http://doi.org/10.4093/dmj.2018.0036

Abstract

BACKGROUND
Sarcopenic obesity (SO) is a serious public health concern, few studies have examined the clinical implications of SO in newly-diagnosed type 2 diabetes mellitus (T2DM) patients. We evaluated the prevalence of the newly diagnosed, drug-naïve T2DM patients with low muscle mass with abdominal obesity and its association with insulin resistance and other diabetic complications.
METHODS
We classified 233 drug-naïve T2DM subjects into four groups according to abdominal obesity (waist circumference ≥90 cm in men and ≥85 cm in women) and low muscle mass status (appendicular skeletal muscle <7.0 kg/m² for men and <5.4 kg/m² for women).
RESULTS
The proportion of the subjects with low muscle mass and abdominal obesity among the newly diagnosed, drug-naïve T2DM patients was 8.2%. Homeostasis model assessment of insulin resistance (HOMA-IR) increased linearly according to body composition group from normal to abdominal obesity to both low muscle mass and abdominal obesity. The multiple logistic regression analysis indicated that subjects with low muscle mass and abdominal obesity (odds ratio [OR], 9.39; 95% confidence interval [CI], 2.41 to 36.56) showed a higher risk for insulin resistance, defined as HOMA-IR ≥3, than those with abdominal obesity (OR, 5.36; 95% CI, 2.46 to 11.69), even after adjusting for other covariates. However, there were no differences in lipid profiles, microalbuminuria, or various surrogate markers for atherosclerosis among the four groups.
CONCLUSION
Subjects with both low muscle mass and abdominal obesity had a higher risk of insulin resistance than those with low muscle mass or abdominal obesity only.

Keyword

Body composition; Diabetes mellitus, type 2; Insulin resistance; Muscle, skeletal; Obesity, abdominal

MeSH Terms

Atherosclerosis
Biomarkers
Body Composition
Diabetes Complications
Diabetes Mellitus, Type 2*
Homeostasis
Humans
Insulin Resistance
Logistic Models
Male
Muscle, Skeletal
Obesity
Obesity, Abdominal*
Prevalence
Public Health
Biomarkers

Figure

• 

  Fig. 1 Proportion of newly-diagnosed and drug-naïve type 2 diabetes mellitus subjects in normal body composition, low muscle mass (LM), abdominal obesity (AO), and low muscle mass with obesity (LMAO) groups. (A) All subjects, (B) men, and (C) women.

• 

  Fig. 2 Homeostasis model assessment of insulin resistance (HOMA-IR) values by body composition group (normal, low muscle mass [LM], abdominal obesity [AO], and low muscle mass with obesity [LMAO]). P value for linear trend was calculated using analysis of covariance (ANCOVA) adjusted for age, gender, smoking status, alcohol status, physical activity, and high density lipoprotein cholesterol, triglyceride, aspartate aminotransferase, alanine aminotransferase and medication history including statin, antiplatelet, and antihypertensive agents.

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