Ken Sugimoto1, Hiroshi Ikegami2, Yasunori Takata3, Tomohiro Katsuya4, Masahiro Fukuda5, Hiroshi Akasaka1, Yasuharu Tabara6, Haruhiko Osawa3, Yoshihisa Hiromine2, Hiromi Rakugi7. 1. Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan. 2. Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka-sayama, Japan. 3. Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Toon, Japan. 4. Katsuya Clinic, Amagasaki, Japan; Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Suita, Japan. 5. Fukuda Clinic, Osaka, Japan. 6. Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. 7. Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan. Electronic address: rakugi@geriat.med.osaka-u.ac.jp.
Abstract
OBJECTIVES: Type 2 diabetes is a risk factor for sarcopenia. Evidence on the prevention of sarcopenia using blood glucose-lowering therapy is limited. We aimed to examine the relationship between changes in glycemic control and sarcopenia and the effect of antidiabetic agents against sarcopenia in patients with type 2 diabetes. DESIGN: We conducted an observational longitudinal study. SETTING AND PARTICIPANTS: In total, 588 Japanese patients with diabetes of an ongoing multicenter study completed 1-year follow-up measurements for sarcopenia and clinical data. METHODS: The data set of the Multicenter Study for Clarifying Evidence for Sarcopenia in patients with Diabetes Mellitus (the MUSCLES-DM study) was analyzed. RESULTS: During the follow-up period, the frequency of sarcopenia marginally increased, and the means of skeletal muscle mass index (SMI), handgrip strength, and gait speed did not show any changes. However, on dividing into 5 groups depending on the degree of changes in glycated hemoglobin (HbA1c) value, the patients with a decrease of ≥1% in HbA1c exhibited a significant increase in SMI. Our analysis revealed similar results for gait speed but not handgrip strength. Using the multiple linear regression model, we identified that a ≥1% decrease in HbA1c value was an independent determinant of the changes in SMI and gait speed. We also determined that insulin use at baseline was an independent factor for the changes in SMI. CONCLUSIONS AND IMPLICATIONS: Correction of poor glycemic control and use of insulin were significantly associated with the increase in skeletal muscle mass or gait speed in Japanese patients with type 2 diabetes. The current finding increases our understanding of the importance of glycemic control for the prevention of cardiovascular diseases and sarcopenia.
OBJECTIVES:Type 2 diabetes is a risk factor for sarcopenia. Evidence on the prevention of sarcopenia using blood glucose-lowering therapy is limited. We aimed to examine the relationship between changes in glycemic control and sarcopenia and the effect of antidiabetic agents against sarcopenia in patients with type 2 diabetes. DESIGN: We conducted an observational longitudinal study. SETTING AND PARTICIPANTS: In total, 588 Japanese patients with diabetes of an ongoing multicenter study completed 1-year follow-up measurements for sarcopenia and clinical data. METHODS: The data set of the Multicenter Study for Clarifying Evidence for Sarcopenia in patients with Diabetes Mellitus (the MUSCLES-DM study) was analyzed. RESULTS: During the follow-up period, the frequency of sarcopenia marginally increased, and the means of skeletal muscle mass index (SMI), handgrip strength, and gait speed did not show any changes. However, on dividing into 5 groups depending on the degree of changes in glycated hemoglobin (HbA1c) value, the patients with a decrease of ≥1% in HbA1c exhibited a significant increase in SMI. Our analysis revealed similar results for gait speed but not handgrip strength. Using the multiple linear regression model, we identified that a ≥1% decrease in HbA1c value was an independent determinant of the changes in SMI and gait speed. We also determined that insulin use at baseline was an independent factor for the changes in SMI. CONCLUSIONS AND IMPLICATIONS: Correction of poor glycemic control and use of insulin were significantly associated with the increase in skeletal muscle mass or gait speed in Japanese patients with type 2 diabetes. The current finding increases our understanding of the importance of glycemic control for the prevention of cardiovascular diseases and sarcopenia.
Authors: Hawra Bin Maan; Sultan Ayoub Meo; Fawziah Al Rouq; Imran Muhammad Umar Meo; Milagros E Gacuan; Joud Mohammed Alkhalifah Journal: Int J Environ Res Public Health Date: 2021-06-29 Impact factor: 3.390