Park SW, Goodpaster BH, Lee JS, Kuller LH, Boudreau R, de Rekeneire N, Harris TB, Kritchevsky S, Tylavsky FA, Nevitt M, Cho YW, Newman AB
Excessive Loss of Skeletal Muscle Mass in Older Adults with Type 2 Diabetes. [JOURNAL ARTICLE]
Diabetes Care 2009 Jun 23.
Objective: A loss of skeletal muscle mass is frequently observed in older adults. The aim of the study was to investigate the impact of type 2 diabetes on the changes in body composition, with particular interest in the skeletal muscle mass. Research design and methods: We examined total body composition by dual energy X-ray absorptiometry annually for six years in 2,675 older adults. We also measured mid-thigh muscle cross-sectional area (CSA) by computed tomography in Year 1 and Year 6. At baseline, 75g oral glucose challenge test was performed. Diagnosed diabetes (n, 402, 15.0%) was identified by self-report or use of hypoglycemic agents. Undiagnosed diabetes (n, 226, 8.4%) was defined by fasting plasma glucose >/= 7 mmol/l or 2-hour post-challenge plasma glucose >/= 11.1 mmol/l. Longitudinal regression models were fit to examine the effect of diabetes on the changes in body composition variables.
Results: Older adults with either diagnosed or undiagnosed type 2 diabetes showed excessive loss of appendicular lean mass and trunk fat mass compared with non-diabetic subjects. Thigh muscle CSA declined two times faster in older women with diabetes than non-diabetic counterpart. These findings remained significant after adjusting for age, sex, race, clinic site, baseline body mass index, weight change intention, and actual weight changes over time.
Conclusions: Type 2 diabetes is associated with excessive loss of skeletal muscle and trunk fat mass in the community-dwelling older adults. Older women with type 2 diabetes are at especially high risk for loss of skeletal muscle mass.
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