Accepted for/Published in: Interactive Journal of Medical Research
Date Submitted: Mar 4, 2024
Date Accepted: Oct 15, 2024
Skeletal muscle mass loss and physical function in young to middle-aged adult patients with diabetes: A cross-sectional observational study
ABSTRACT
Background:
Recently, it has been reported that older adults with type 2 diabetes mellitus (T2DM) have lower skeletal muscle mass than healthy individuals do. Although skeletal muscle mass in older adults with diabetes is occasionally reported, similar reports on young to middle-aged adults are limited.
Objective:
To clarify the existence of skeletal muscle loss in young to middle-aged patients with diabetes and examine the relationship between skeletal muscle loss and physical function in these patients.
Methods:
This retrospective, observational study included patients aged ˂65 years with T2DM who were admitted to our hospital between 2015 and 2021for educational admission for glycemic control and requested rehabilitation by the Department of Metabolism. The main parameters included skeletal muscle mass, muscle strength, physical function, and activities of daily living.
Results:
In total, 15%–18% of young to middle-aged adults with diabetes had skeletal muscle index values below the Asian Working Group for Sarcopenia criteria for sarcopenia; however, compared with the non-diabetes group, a significant difference was observed in men but not in women (P<0.001 in the men, P=0.35 in the women). Nonetheless, the diabetes group exhibited significantly lower muscle strength and physical functions, such as a walking speed of 1.3 ± 0.2 m/s in men and 1.2 ± 0.43 m/s in women in the T2DM group and 1.6 ± 0.2 m/s and 1.5 ± 0.1 m/s for men and women in the control group, respectively. One-leg standing time was measured as 30.7 ± 26.9 s and 29.4 ± 25.5 s for men and women in the T2DM group, respectively. Univariate logistic regression analysis showed that skeletal muscle mass index (SMI) was significantly correlated with age, body mass index (BMI), and peripheral neuropathy. Multiple logistic regression analysis showed that BMI exhibited the strongest correlation (odds ratio 1.15, confidence interval 1.07–1.23, P<0.001). Peripheral neuropathy was also significantly correlated with SMI (P=0.009).
Conclusions:
Patients with diabetes, even those who are not older adults, face an elevated risk of muscle weakness and a decline in physical function; moreover, they are susceptible to dynapenia and presarcopenia. Therefore, early intervention focusing on muscle evaluation and exercise is crucial. Clinical Trial: Ethics No. 2366, September 13, 2021
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