Abstract
This study sought to evaluate the associations between changes in glycemic status and changes in total body (TB), trunk, and appendicular fat (FM) and lean mass (LM) in men. A population-based study of men aged 20–66 years at baseline were included in cross-sectional (n = 430) and three-year longitudinal (n = 411) analyses. Prediabetes was defined as fasting glucose 100–125 mg/dL. Type 2 diabetes (T2D) was determined by: self-reported diabetes, current anti-diabetic drug use (insulin/oral hypoglycemic agents), fasting glucose (≥126 mg/dL), or non-fasting glucose (≥200 mg/dL). Body composition was evaluated by dual-energy X-ray absorptiometry. Longitudinal analyses showed that changes in TB FM and LM, and appendicular LM differed among glycemic groups. Normoglycemic men who converted to prediabetes lost more TB and appendicular LM than men who remained normoglycemic (all, p < 0.05). Normoglycemic or prediabetic men who developed T2D had a greater loss of TB and appendicular LM than men who remained normoglycemic (both, p < 0.05). T2D men had greater gains in TB FM and greater losses in TB and appendicular LM than men who remained normoglycemic (all, p < 0.05). Dysglycemia is associated with adverse changes in TB and appendicular LM.
Highlights
Prediabetes and type 2 diabetes (T2D) are major public health issues in the United States.The national prevalence of prediabetes and T2D among adults aged ≥20 years has increased over time, with the prevalence of prediabetes rising from 26% in 1988–1994 [1] to 37% in 2009–2012 [2]
We found no epidemiological studies that investigated the association between glycemic status and changes in the total body (TB) and regional distribution of fat mass (FM)
The following a priori hypotheses were tested: (1) men with prediabetes or T2D at baseline would have higher TB and trunk fat measurements but lower appendicular fat than normoglycemic men; (2) men who were normoglycemic at baseline and developed either prediabetes or T2D would have increases in TB and trunk FM, and decreases in TB and appendicular lean mass (LM) over the three-year study compared with men who remained normoglycemic; (3) among men with prediabetes at baseline, the changes in TB and trunk FM and LM would differ over the three-year study depending on whether they remained prediabetic or developed T2D versus reverting to a normoglycemic state
Summary
Prediabetes and type 2 diabetes (T2D) are major public health issues in the United States. The national prevalence of prediabetes and T2D among adults aged ≥20 years has increased over time, with the prevalence of prediabetes rising from 26% in 1988–1994 [1] to 37% in 2009–2012 [2]. There are currently 25.8 million adults in the United States with prediabetes that will develop T2D by. Case-control and cross-sectional studies have reported inconsistent associations of total body (TB), trunk, and appendicular fat mass (FM) and lean mass (LM) with prediabetes and T2D diabetes in middle-aged and older adults, including a positive association [6], an inverse association [7,8,9,10], and no association [6,8,9]. Some studies reported differences in body composition measurements among glycemic
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