466-P: Appendicular Skeletal Muscle Mass and Grip Strength in Relation to the Progression of Carotid Plaque Score in Patients with Type 2 Diabetes

Abstract

Sarcopenia is suggested to be associated with increased cardiovascular (CV) risk and mortality in old adults. We investigated longitudinal associations of appendicular skeletal muscle mass (ASM) and hand grip strength (GS) with carotid plaque score progression (PSP) in patients with type 2 diabetes (T2D). A total of 1507 patients with T2D were recruited from January 2018 to June 2020 in the out-patients clinic. Finally, 1187 patients (Mean age = 62.6 ± 9.7 years, BMI=25.1 ± 3.4 kg/m2) completed the follow-up (fu) study. Mean fu duration (fuD) was 3.5±0.9 years. ASM and GS were measured at baseline using dual-energy X-ray absorptiometry and digital dynamometer. Carotid PS (0 to 12) was measured at baseline and fu (after≥2 years). PSP was defined as PS at fu≥1 point increase compared with one at baseline. Out of 1187 patients, 389 patients (32.8%) had PSP. Mean PS were 2.9 ± 2.8 and 3.4 ± 3.2 at baseline and fu. Patients with PSP were more likely to be old, male, and hypertensive and had higher systolic BP, diabetes duration, intima-medial thickness, and PS, but lower diastolic BP, HDL cholesterol, eGFR, ASM/BMI, and GS than those without PSP. Prevalence of PSP increased progressively with decreasing ASM/BMI and GS terile (Highest vs. Middle vs. Lowest=18.5% vs. 30.8% vs. 49.0% and 18.0% vs. 30.9% vs. 50.1%, p < 0.001). The hazard ratios and 95% CI for PSP after adjusting for age and sex were 1.53 (1.08 - 2.16) and 2.90 (2.06 - 4.08) in the middle and the lowest ASM/BMI tertile groups and 1.50 (1.06 - 2.14) and 2.66 (1.85 - 3.84) in the middle and the lowest GS tertile groups. The association of ASM/BMI and GS with PSP remained significant after further adjusting for multiple potential confounders. This study showed that low baseline ASM/BMI and low GS were longitudinally associated with PSP in patients with T2D regardless of variable metabolic and CV risk factors. Our findings suggest that low muscle mass and strength may be predicting factors for PSP. Disclosure J.Shin: None.