Association between height-corrected appendicular and regional skeletal muscle mass and insulin resistance in patients with type 2 diabetes

J Phys Ther Sci. 2022 May;34(5):353-359. doi: 10.1589/jpts.34.353. Epub 2022 May 1.

Abstract

[Purpose] The effect of height-corrected skeletal muscle masses on insulin resistance has not been fully investigated in patients with type 2 diabetes. In this study, we aimed to investigate the association between height-corrected appendicular and regional skeletal muscle masses and insulin resistance in patients with type 2 diabetes. [Participants and Methods] We included 136 male and 100 female patients with type 2 diabetes (average age, male 55.7 ± 12.3 years old, female 60.7 ± 11.3 years old, and average height, male 1.67 ± 0.06 m, female 1.54 ± 0.06 m) in this study. Bioelectrical impedance analysis was used to evaluate skeletal muscle mass. We calculated the appendicular skeletal muscle mass index by dividing the appendicular skeletal muscle mass by the square of the patient's height. The upper limb muscle mass, lower limb muscle mass, and trunk muscle mass figures were also divided by the square of the patient's height. We used the homeostasis model assessment of insulin resistance as a marker of insulin resistance. [Results] In multiple regression analysis, the homeostasis model assessment of insulin resistance was inversely associated with appendicular skeletal muscle mass index and lower limb muscle mass/height2 in male patients with type 2 diabetes when adjusted for age and body mass index. Similarly, the homeostasis model assessment of insulin resistance was inversely associated with appendicular skeletal muscle mass index and lower limb muscle mass/height2 in non-obese female patients with type 2 diabetes. [Conclusion] We have confirmed that there is an association between appendicular skeletal muscle mass index and lower limb muscle mass/height2 with insulin resistance in male and female patients with type 2 diabetes, except in females with obesity.

Keywords: Insulin resistance; Skeletal muscle mass; Type 2 diabetes.