Abstract
Excess central adiposity accelerates the decline of muscle strength in older people. Additionally, hyperglycemia, independent of associated comorbidities, is related to the loss of muscle mass and strength, and contributes to functional impairment in older adults. We studied the mediation effect of glucose levels, in the relationship between abdominal obesity and relative handgrip strength (HGS). A total of 1571 participants (60.0% women, mean age 69.1 ± 7.0 years) from 86 municipalities were selected following a multistage area probability sampling design. Measurements included demographic and anthropometric/adiposity markers (weight, height, body mass index, and waist circumference). HGS was measured using a digital dynamometer for three sets and the mean value was recorded. The values were normalized to body weight (relative HGS). Fasting glucose was analyzed by enzymatic colorimetric methods. Mediation analyses were performed to identify associations between the independent variable (abdominal obesity) and outcomes (relative HGS), as well as to determine whether fasting glucose levels mediated the relationship between excess adiposity and relative HGS. A total of 1239 (78.8%) had abdominal obesity. Abdominal obesity had a negative effect on fasting glucose (β = 9.04, 95%CI = 5.87 to 12.21); while fasting glucose to relative HGS was inversely related (β = −0.003, 95%CI = −0.005 to −0.001), p < 0.001. The direct effect of abdominal obesity on relative HGS was statistically significant (β = −0.069, 95%CI = −0.082 to −0.057), p < 0.001. Lastly, fasting glucose levels mediates the detrimental effect of abdominal obesity on relative HGS (indirect effect β = −0.002, 95%CI = −0.004 to −0.001), p < 0.001. Our results suggest that the glucose level could worsen the association between abdominal obesity status and lower HGS. Thus, it is plausible to consider fasting glucose levels when assessing older adults with excess adiposity and/or suspected loss of muscle mass.
Highlights
Aging is related to a progressive unfavorable change in body composition, abdominal fat accumulation and loss of lean mass [1,2]
In a cross-sectional study of community-dwelling older adults, we found that central obesity was inversely associated with relative handgrip strength (HGS), as a measure of muscular strength, in older Colombian adults
Our results suggest that the glucose level could worsen the association between abdominal obesity status and lower relative HGS
Summary
Aging is related to a progressive unfavorable change in body composition, abdominal fat accumulation and loss of lean mass [1,2]. Abdominal obesity, measured by waist circumference (WC) [3], is associated with systemic inflammation, hyperlipidemia, cardiovascular diseases, impaired fasting glucose, prediabetes, insulin resistance, hyperinsulinemia, and type 2 diabetes (T2DM) [4,5,6,7,8,9,10,11,12,13,14]. Hyperglycemia, independent of associated comorbidities, is related to the loss of muscle mass and strength, and contributes to functional impairment in older adults [9,10,11,12,13]. Lower muscle mass is positively associated with central adiposity and an increased risk of developing T2DM [8]. It has been suggested that excessive and naturally occurring deposition of adipose tissue in the abdomen may increase the risk of hyperinsulinemia, metabolic syndrome, and type 2 T2DM [6,7,8]
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