Relationship between Diabetes Status and Sarcopenia in Community-Dwelling Older Adults

Kazuhei Nishimoto; Takehiko Doi; Kota Tsutsumimoto; Sho Nakakubo; Satoshi Kurita; Yuto Kiuchi; Hiroyuki Shimada

doi:10.1016/j.jamda.2022.07.020

Relationship between Diabetes Status and Sarcopenia in Community-Dwelling Older Adults

J Am Med Dir Assoc. 2022 Oct;23(10):1718.e7-1718.e12. doi: 10.1016/j.jamda.2022.07.020. Epub 2022 Aug 31.

Authors

Kazuhei Nishimoto¹, Takehiko Doi², Kota Tsutsumimoto², Sho Nakakubo², Satoshi Kurita², Yuto Kiuchi³, Hiroyuki Shimada²

Affiliations

¹ Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan; Department of Medical Sciences, Medical Science Division, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan. Electronic address: kazuhei-n@ncgg.go.jp.
² Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
³ Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan; Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan.

PMID: 36055368
DOI: 10.1016/j.jamda.2022.07.020

Abstract

Objectives: Diabetes mellitus (DM) is associated with risk of sarcopenia. However, whether glycated hemoglobin (HbA1c) levels are associated with sarcopenia has not reached a consensus. The purpose of this study was to examine the association between diabetes status based on HbA1c levels and sarcopenia indices in community-dwelling older adults stratified by body mass index (BMI) status.

Design: An observational cross-sectional study.

Setting and participants: General community setting. The participants were 18,940 community-dwelling older adults (mean age 73.7 ± 5.7 years, 45.0% men).

Methods: According to their medical history for diabetes mellitus and blood HbA1c levels the participants were classified into the control group (no DM history and HbA1c ≤5.6%), pre-DM group (no DM history and HbA1c 5.7%-6.4%), or DM group (DM history or HbA1c ≥6.5%). For assessments of sarcopenia, muscle mass and muscle strength were measured based on the clinical definition.

Results: A multiple logistic regression analysis showed that the DM group did not have a clear association with sarcopenia [odds ratio (OR) 1.06, 95% confidence interval (CI) 0.82-1.38] or low muscle mass (OR 1.15, 95% CI 0.94-1.39), and was associated with low muscle strength (OR 1.21, 95% CI 1.08-1.36) in the adjusted model including BMI. There was a positive correlation between BMI and skeletal muscle index (r = 0.57, P < .001). Stratified by BMI, the DM group was associated with low muscle mass among the underweight participants (OR 1.87, 95% CI 1.03-3.39), and low muscle strength among the overweight participants (OR 1.22, 95% CI 1.04-1.43).

Conclusions and implications: Diabetes status was associated with low muscle mass and low muscle strength, and the association depended on BMI. Our findings could be helpful for identifying older adults with a high risk of sarcopenia, although further study is needed.

Keywords: BMI; Diabetes status; older adults; sarcopenia.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cross-Sectional Studies
Diabetes Mellitus* / epidemiology
Female
Glycated Hemoglobin
Hand Strength
Humans
Independent Living
Male
Muscle Strength
Muscle, Skeletal / pathology
Sarcopenia* / epidemiology

Substances

Glycated Hemoglobin A