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Diabetes Care Publish Ahead of Print published online ahead of print March 15, 2007
DOI: 10.2337/dc06-2537
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Original Research

Accelerated Loss of Skeletal Muscle Strength in Older Adults with Type 2 Diabetes: The Health, Aging and Body Composition Study

Seok Won Park, MD, DrPH1,2, Bret H. Goodpaster, PhD3, Elsa S. Strotmeyer, PhD2, Lewis H. Kuller, MD, DrPH2, Robert Broudeau, PhD2, Candace Kammerer, PhD4, Nathalie de Rekeneire, MD5, Tamara B. Harris, MD6, Ann V. Schwartz, PhD7, Frances A. Tylavsky, PhD8, Yong-wook Cho, MD1, Anne B. Newman, MD, MPH for the Health ABC Study2

1Department of Internal Medicine, Pochon CHA University, Pochon, Korea
2Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
3Department of Medicine, University of Pittsburgh, Pittsburgh, PA
4Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA
5Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA
6Laboratory for Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, MD
7Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
8Department of Preventive Medicine, University of Tennessee, Memphis, TN

spark{at}cha.ac.kr

ABSTRACT

Objective:: It has been shown that adults with either long-standing type 1 or type 2 diabetes had lower skeletal muscle strength than non-diabetic adults in cross-sectional studies. The aim of the study was to investigate longitudinal changes of muscle mass and strength in community dwelling older adults with and without type 2 diabetes.

Research Design and Methods:: We examined leg and arm muscle mass and strength at baseline and three years later in 1,840 older adults aged 70 to 79 years in the Health, Aging and Body Composition Study. Regional muscle mass was measured by dual energy X-ray absoptiometry and muscle strength was measured using isokinetic and isometric dynamometer.

Results:: Older adults with type 2 diabetes (n, 305) showed greater declines in the leg muscle mass (-0.29 ± 0.03 vs. -0.23 ± 0.01 kg, p<0.05) and strength (-16.5 ± 1.2 vs. -12.4 ± 0.5 Nm, p=0.001) compared with older adults without diabetes. Leg muscle quality, expressed as a maximal strength per unit muscle mass (Nm/kg), also declined more rapidly in older adults with diabetes (-1.6 ± 0.2 vs. -1.2 ± 0.1 Nm/kg, p<0.05). Changes in arm muscle strength and quality were not different between those with and without diabetes. Rapid declines in leg muscle strength and quality were attenuated but remained significant after controlling for demographics, body composition, physical activity, combined chronic diseases, interleukin-6 and tumor necrosis factor-{alpha}.

Conclusion:: In older adults, type 2 diabetes is associated with accelerated loss of leg muscle strength and quality.


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