The purpose of this study was to determine whether any young to middle-aged T2DM patients have skeletal muscle mass loss and to examine the factors and characteristics associated with skeletal muscle mass loss.
This cross-sectional observational study included 107 T2DM patients (55 males and 52 females) aged 20 to 64 years (mean 51.4 ± 10.4 years) who were admitted to Kumamoto University Hospital from 2015 to 2022 for glycemic control and underwent rehabilitation. The exclusion criteria were patients with preexisting or primary diseases that could affect the skeletal muscle mass index (SMI) by bioelectrical impedance analysis (BIA), including patients. The current study defines outcome as SMI, and the assessment items were age, sex, body mass index (BMI), physical function (grip strength, comfortable walking speed, one-leg standing time with eyes opened), medical history, insulin therapy, blood data (HbA1c, serum albumin, and total cholesterol levels) Pulse Wave Velocity (PWV), and diabetes-related complications (retinopathy, renal impairment, and neuropathy), and skeletal muscle mass loss was defined as SMI 7.0 kg/㎡ in men and 5.7 kg/㎡ in women based on Asian Working Group on Sarcopenia (AWGS) criteria. The association between skeletal muscle mass and each endpoint was evaluated using Pearson's product-rate correlation coefficient or Spearman's rank correlation coefficient and logistic regression models. Statistical analysis was performed using the software EZR (Saitama Medical Center, Jichi Medical University, Saitama, Japan. ver. 1.53), and P0.05 was considered statistically significant.
The overall prevalence of lower SMI was 15% (16[10 males and 6 females]). In relation to SMI by gender, age, history of disease, insulin status, smoking history, PWV, and peripheral neuropathy were negatively correlated with SMI in men, while BMI, and grip strength were positively correlated with SMI. On the other hand, in women, age, and peripheral neuropathy were negatively correlated with SMI, while BMI, grip strength, and one-leg standing, and positively correlated with SMI. Overall, multiple logistic regression analysis showed that BMI and peripheral neuropathy were correlated with lower SMI.
Patients with T2DM, even those who are not older adults, face an elevated risk of muscle weakness and a decline in physical function. In this study, we found a strong association between peripheral neuropathy and decreased skeletal muscle mass in young to middle-aged patients with T2DM. Therefore, the results suggest the importance of rehabilitation to prevent SMI decline while paying attention to symptoms of peripheral neuropathy in young and mature patients with T2DM.
In patients with type 2 Diabetes mellitus, even young adults need to be fully assessed for loss of muscle mass and quality and educated about the importance of strength training in exercise therapy, which can contribute to the prevention of sarcopenia through education from an early stage.
Diabetes Mellitus
Middle-aged adults
