Excessive Loss of Skeletal Muscle Mass in Older Adults with Type 2 Diabetes
- Seok Won Park, MD, DrPH (spark{at}cha.ac.kr)1,
- Bret H. Goodpaster, PhD2,
- Jung Sun Lee, PhD3,
- Lewis H Kuller, MD, DrPH4,
- Robert Boudreau, PhD4,
- Nathalie de Rekeneire, MD5,
- Tamara B. Harris, MD6,
- Stephen Kritchevsky, PhD7,
- Frances A. Tylavsky, PhD8,
- Michael Nevitt, PhD9,
- Yong-wook Cho, MD, PhD1,
- Anne B. Newman, MD, MPH4 and
- for the Health ABC Study
- 1 Department of Internal Medicine, CHA Univetsity, Sungnam, Korea
- 2 Department of Medicine, University of Pittsburgh, Pittsburgh, PA
- 3 Department of Foods and Nutrition, University of Georgia, Athens, GA
- 4 Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
- 5 Center on Disability and Disabling Disorders, Yale University School of Medicine, New Haven, CT
- 6 Laboratory for Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, MD
- 7 The Sticht Center on Aging, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
- 8 Department of Preventive Medicine, University of Tennessee, Memphis, TN
- 9 Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
Abstract
Objective: A loss of skeletal muscle mass is frequently observed in older adults. The aim of the study was to investigate the impact of type 2 diabetes on the changes in body composition, with particular interest in the skeletal muscle mass.
Research design and methods: We examined total body composition by dual energy X-ray absorptiometry annually for six years in 2,675 older adults. We also measured mid-thigh muscle cross-sectional area (CSA) by computed tomography in Year 1 and Year 6. At baseline, 75g oral glucose challenge test was performed. Diagnosed diabetes (n, 402, 15.0%) was identified by self-report or use of hypoglycemic agents. Undiagnosed diabetes (n, 226, 8.4%) was defined by fasting plasma glucose ≥ 7 mmol/l or 2-hour post-challenge plasma glucose ≥ 11.1 mmol/l. Longitudinal regression models were fit to examine the effect of diabetes on the changes in body composition variables.
Results: Older adults with either diagnosed or undiagnosed type 2 diabetes showed excessive loss of appendicular lean mass and trunk fat mass compared with non-diabetic subjects. Thigh muscle CSA declined two times faster in older women with diabetes than non-diabetic counterpart. These findings remained significant after adjusting for age, sex, race, clinic site, baseline body mass index, weight change intention, and actual weight changes over time.
Conclusions: Type 2 diabetes is associated with excessive loss of skeletal muscle and trunk fat mass in the community-dwelling older adults. Older women with type 2 diabetes are at especially high risk for loss of skeletal muscle mass.
Footnotes
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- Received February 11, 2009.
- Accepted June 17, 2009.
- Copyright © American Diabetes Association
