Reduction in Muscle Function may Predict Risk of Abnormal Renal Function in Type 2 Diabetes Mellitus among the Elderly Community

The aim of the present study is to determine whether there is relationship between sarcopenia (loss of muscle mass and strength) and abnormal renal function in impaired fasting glucose (IFG) and type 2 diabetes mellitus among community-dwelling elderly.

Our study population comprised of six hundred and forty community elderly without sarcopenia (mean±SD age: 68.0±6.1 years; 57.0% women) from Tianjin, China. IFG is defined by having fasting plasma glucose (FPG) levels ≥100mg/dl (5.6mmol/L) but 126mg/dl (7.0mmol/L); type 2 diabetes mellitus is defined by self-reported or FPG≥126mg/dl (7.0mmol/L). According to the Asian Working Group for Sarcopenia criteria (2019 Consensus Update), loss of muscle mass (LMM) was defined by ASM/Ht²7.0kg/m² in men and 5.7kg/m² in women, loss of muscle function (LMF) was defined by grip strength28kg for men and 18kg for women or walking speed 1.0m/s or repeated chair stand ≥12s or SPPB≤9. Estimated glomerular filtration rate (eGFR) is defined by using the Japanese Society of Nephrology equation as eGFRcrear (mL/min/1.73m²)= 194×Cre^-1.094×age^-0.287(×0.739 if female).

After multivariate adjustments for all the concomitants, including sex, age, body composition variables (BMI, waist hip ratio, T value, % body fat, visceral fat area), lifestyle-variables (history of fall, physical activity, nutritional status and emotion status), health status variables (total cholesterol, triglycerides, kidney disease, hypertension, dyslipidemia, stoke, coronary heart disease, duration of diabetes, medication use), we found that the lowest quarter of eGFR was associated with LMF in subjects with IFG (OR 4.70, P=0.039) and type 2 diabetes mellitus (OR 9.19, P=0.036). However, we did not find the relationship between LMM or LMM+LMF and renal function in IFG and type 2 diabetes mellitus.

Our findings suggest that poor physical function maybe more related with renal dysfunction than muscle mass loss among the elderly community with IFG and type 2 diabetes mellitus.

The present study indicates that a positive relationship among skeletal muscle weakness and renal dysfunction in IFG and type 2 diabetes mellitus. This result may imply that assessment of muscle functionality may provide additional diagnostic and prognostic information about renal function to muscle-mass evaluation among community elderly with IFG and type 2 diabetes mellitus.