purpose: This study aimed to investigate the direct impact of visceral adiposity on skeletal muscle mass in T2DM patients using structural equation modeling (SEM).
Methods: A cross-sectional study was conducted involving 795 T2DM patients. SEM was employed to examine the relationships among observed variables (skeletal muscle index, grip strength, HbA1c, and ABSI) and a latent variable representing whole-body skeletal muscle mass (WSM). Measurement models were specified to assess the relationships between the observed variables and the latent variable, while structural models were used to estimate the causal relationships among the latent variables.
Results: The results revealed a significant negative direct effect of ABSI on WSM (standardized path coefficient = -0.10, p 0.001), indicating that higher levels of visceral fat were associated with lower skeletal muscle mass. Additionally, HbA1c (standardized path coefficient = -0.05, p = 0.03) and age (standardized path coefficient = -0.16, p 0.001) were negatively associated with WSM. The overall model fit was excellent (χ²=123.4, df=98, p=0.08; CFI=0.95, RMSEA=0.04、R²＝0.52).
Conclusions: This study provides robust evidence of a direct causal relationship between visceral adiposity and reduced skeletal muscle mass in individuals with T2DM. The findings underscore the importance of targeting visceral fat as a potential strategy for preventing muscle loss and improving outcomes in this population. Our results highlight the utility of ABSI as a specific marker of visceral adiposity in elucidating the underlying mechanisms of muscle wasting in T2DM.
Implications: The findings of this study may inform the development of novel interventions aimed at reducing visceral adiposity and preserving muscle mass in individuals with T2DM.
absi
skeletal muscle
