Accelerated Loss of Skeletal Muscle Strength in Older Adults With Type 2 Diabetes

The Health, Aging, and Body Composition Study

  1. Seok Won Park, MD, DRPH12,
  2. Bret H. Goodpaster, PHD3,
  3. Elsa S. Strotmeyer, PHD2,
  4. Lewis H. Kuller, MD, DRPH2,
  5. Robert Broudeau, PHD2,
  6. Candace Kammerer, PHD4,
  7. Nathalie de Rekeneire, MD5,
  8. Tamara B. Harris, MD6,
  9. Ann V. Schwartz, PHD7,
  10. Frances A. Tylavsky, PHD8,
  11. Yong-wook Cho, MD1,
  12. Anne B. Newman, MD, MPH2 and
  13. for the Health, Aging, and Body Composition Study
  1. 1Department of Internal Medicine, Pochon CHA University, Pochon, Korea
  2. 2Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
  3. 3Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
  4. 4Department of Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania
  5. 5Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia
  6. 6Laboratory for Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland
  7. 7Department of Epidemiology and Biostatistics, University of California, San Francisco, California
  8. 8Department of Preventive Medicine, University of Tennessee, Memphis, Tennessee
  1. Address correspondence and reprint requests to Seok Won Park, MD, DrPH, Department of Internal Medicine, Pochon CHA University, 351 Yatap-dong, Sungnam, 463-712, Korea. E-mail: spark{at}


OBJECTIVE—It has been shown that adults with either long-standing type 1 or type 2 diabetes had lower skeletal muscle strength than nondiabetic 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 3 years later in 1,840 older adults aged 70–79 years in the Health, Aging, and Body Composition Study. Regional muscle mass was measured by dual energy X-ray absorptiometry, and muscle strength was measured using isokinetic and isometric dynamometers.

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 maximal strength per unit of muscle mass (Newton meters per kilogram), 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-α.

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


  • Published ahead of print at on 15 March 2007. DOI: 10.2337/dc06-2537.

    Additional information for this article can be found in an online appendix at

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted March 5, 2007.
    • Received December 15, 2006.
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  1. Diabetes Care vol. 30 no. 6 1507-1512
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