Abstract
BackgroundAlthough obesity-related type 2 diabetes mellitus (T2DM) and sarcopenia in the elderly have been increasing worldwide, the associations among visceral fat accumulation, skeletal muscle indices (mass, strength, and quality) and cardiovascular diseases in T2DM remain poorly investigated.MethodsWe enrolled 183 Japanese T2DM inpatients (126 men, 57 women; mean age 64.7 ± 12.6 years, ± SD). The estimated-visceral fat area (eVFA) and skeletal muscle mass were measured by each device using bioelectrical impedance analysis method. We also measured grip strength by dynamometer and motor nerve conduction velocity (MCV). We analyzed the difference in skeletal muscle indices between T2DM patients with and without visceral fat accumulation, and examined the impact of skeletal muscle indices on cardiovascular diseases in patients with visceral fat accumulation.ResultsThe prevalence of sarcopenia defined by the Consensus of Asian Working Group for Sarcopenia and low skeletal muscle mass were both lower in the visceral fat accumulation (+) group than in (−) group. However, the prevalence of weak hand grip strength was similar in the visceral fat accumulation (−) and (+) groups, indicating that considerable patients with visceral fat accumulation had weak grip strength in spite of fair skeletal muscle mass. Muscle quality [grip strength (kg)/arm muscle mass (kg)] was significantly lower in patients with visceral fat accumulation. Multiple regression analysis identified eVFA, MCV and sex as significant and independent determinants of muscle quality. In visceral fat accumulation (+) group, the patients with low muscle quality had longer duration of diabetes, lower eGFR, higher serum adiponectin, lower MCV and higher prevalence of cardiovascular diseases, compared to the patients with high muscle quality. Finally, sex- and age-adjusted models showed significant association between low muscle quality and cardiovascular diseases in all subjects (odds ratio 2.28, p = 0.012), especially in patients with visceral fat accumulation (odds ratio 2.72, p = 0.018).ConclusionsT2DM patients with visceral fat accumulation had low muscle quality, and patients with low muscle quality were more affected with cardiovascular diseases.
Highlights
Obesity-related type 2 diabetes mellitus (T2DM) has been increasing worldwide, especially in Asia [1,2,3,4]
We divided the patients into two groups; patients with and those without visceral fat accumulation, and examined the prevalence of sarcopenia and its related factors (Fig. 1)
Clinical features of T2DM patients with visceral fat accumulation and low muscle quality Based on the above results, we focused on the clinical features of patients with both visceral fat accumulation and low muscle quality
Summary
Obesity-related type 2 diabetes mellitus (T2DM) has been increasing worldwide, especially in Asia [1,2,3,4]. Asians are more susceptible to T2DM despite of relatively low body mass index (BMI), compared to Caucasians [5]. Prevention of sarcopenia, which is defined as reduction in skeletal muscle mass and strength with aging, is important for improvement in quality of life in the elderly [8, 9]. Sarcopenia with obesity-related T2DM may be more susceptible to complications of T2DM, such as cardiovascular diseases. Obesity-related type 2 diabetes mellitus (T2DM) and sarcopenia in the elderly have been increasing worldwide, the associations among visceral fat accumulation, skeletal muscle indices (mass, strength, and quality) and cardiovascular diseases in T2DM remain poorly investigated
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