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1
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Zhi-Wen G, Zhong-Xin H. The triglyceride-glucose index, metabolic biomarkers, and olive oil in diabetic patients: Real-world evidence from a propensity-score matched study. Clinics (Sao Paulo) 2025; 80:100618. [PMID: 40354753 DOI: 10.1016/j.clinsp.2025.100618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 11/28/2024] [Accepted: 03/01/2025] [Indexed: 05/14/2025] Open
Abstract
OBJECTIVES Using the Triglyceride-Glucose (TyG) index to categorize patients and to compare the effects of different oils on metabolic biomarkers among diabetic patients. METHODS A total of 98 diabetic patients were included in this retrospective hospital-based study of which data were obtained from medical and dietary records. The participants were divided into soybean oil groups or olive oil groups according to the dietary packages they chose during hospitalization, which merely differed in the kinds of cooking oil (olive oil vs. soybean oil). After being matched based on propensity scores in a 1:1 ratio with a 0.2 caliber width, 70 subjects were finally included in the analysis. RESULTS Compared to admission, blood pressure, lipids, and postprandial blood glucose were decreased at discharge in both groups. Grip strength levels of both hands increased in the olive oil group, while no statistical differences were found for these measures in the soybean oil group. In both the soybean oil and olive oil groups, metabolic biomarkers showed broader improvements at discharge for participants with high TyG levels compared to those with low TyG levels. Additionally, patients with high TyG levels in the olive oil group experienced the greatest benefits in terms of blood glucose, lipids, blood pressure, and handgrip strength before and after hospitalization. CONCLUSIONS Olive oil may have more advantages in improving metabolic risk factors among diabetic patients. The TyG index can be a valuable tool for clinically screening and categorizing patients for personalized precision treatment.
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Affiliation(s)
- Ge Zhi-Wen
- Department of Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Hong Zhong-Xin
- Department of Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
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Abad-González ÁL, Veses S, Argente Pla M, Civera M, García-Malpartida K, Sánchez C, Artero A, Palmas F, Perelló E, Salom C, Yun Wu Xiong N, Joaquim C. Medical Nutrition Therapy and Physical Exercise for Acute and Chronic Hyperglycemic Patients with Sarcopenia. Nutrients 2025; 17:499. [PMID: 39940355 PMCID: PMC11820730 DOI: 10.3390/nu17030499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Revised: 01/21/2025] [Accepted: 01/22/2025] [Indexed: 02/16/2025] Open
Abstract
A wide range of factors contribute to the overlap of hyperglycemia-acute or chronic-and sarcopenia, as well as their associated adverse consequences, which can lead to impaired physical function, reduced quality of life, and increased mortality risk. These factors include malnutrition (both overnutrition and undernutrition) and low levels of physical activity. Hyperglycemia and sarcopenia are interconnected through a vicious cycle of events that mutually reinforce and worsen each other. To explore this association, our review compiles evidence on: (i) the impact of hyperglycemia on motor and muscle function, with a focus on the mechanisms underlying biochemical changes in the muscles of individuals with or at risk of diabetes and sarcopenia; (ii) the importance of the clinical assessment and control of sarcopenia under hyperglycemic conditions; and (iii) the potential benefits of medical nutrition therapy and increased physical activity as muscle-targeted treatments for this population. Based on the reviewed evidence, we conclude that a regular intake of key functional nutrients, together with structured and supervised resistance and/or aerobic physical activity, can help maintain euglycemia and improve muscle status in all patients with hyperglycemia and sarcopenia.
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Affiliation(s)
- Ángel Luis Abad-González
- Endocrinology and Nutrition Department, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain;
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Silvia Veses
- Endocrinology and Nutrition Department, Hospital Universitario Doctor Peset, 46017 Valencia, Spain; (S.V.); (K.G.-M.); (C.S.)
| | - María Argente Pla
- Endocrinology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain;
| | - Miguel Civera
- Endocrinology and Nutrition Department, University Clinical Hospital, Valencia, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain;
| | - Katherine García-Malpartida
- Endocrinology and Nutrition Department, Hospital Universitario Doctor Peset, 46017 Valencia, Spain; (S.V.); (K.G.-M.); (C.S.)
- School of Health Sciences, Universidad Cardenal Herrera-CEU, CEU Universities, Calle Grecia 31, 12006 Castellón, Spain
| | - Carlos Sánchez
- Endocrinology and Nutrition Department, Consorcio Hospital General Universitario de Valencia, Departamento de Medicina, University of Valencia, 46016 Valencia, Spain; (C.S.); (A.A.)
| | - Ana Artero
- Endocrinology and Nutrition Department, Consorcio Hospital General Universitario de Valencia, Departamento de Medicina, University of Valencia, 46016 Valencia, Spain; (C.S.); (A.A.)
| | - Fiorella Palmas
- Endocrinology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain;
| | - Eva Perelló
- Endocrinology Department, Hospital Universitario San Juan de Alicante, 03550 Alicante, Spain;
| | - Christian Salom
- Endocrinology and Nutrition Department, Hospital Universitario Doctor Peset, 46017 Valencia, Spain; (S.V.); (K.G.-M.); (C.S.)
| | - Ning Yun Wu Xiong
- Endocrinology Department, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain;
| | - Clara Joaquim
- Endocrinology Department, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain
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Shimura K, Miura J, Shen Z, Asanuma T, Takagi S, Hoshina S, Takaike H, Uchigata Y, Babazono T. Prevalence and risk factors for skeletal muscle mass loss in individuals with type 1 diabetes. Diabetol Int 2025; 16:92-99. [PMID: 39877446 PMCID: PMC11769926 DOI: 10.1007/s13340-024-00770-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Accepted: 10/21/2024] [Indexed: 01/31/2025]
Abstract
This study aimed to the investigate prevalence and factors associated with reduced skeletal muscle mass in non-elderly adults with type 1 diabetes (T1D). Ninety-nine patients (65 women, mean age: 43 ± 11 years, range 20-65 years) with acute-onset T1D who underwent body component analysis between October 2016 and April 2018 were studied. Bioelectrical impedance analysis was used to calculate the skeletal muscle mass index (SMI) of the limbs. A multivariate logistic regression analysis was employed to identify factors related to SMI reduction. Seventeen participants (17.1%) exhibited decreased SMI. There were no significant differences in sex, age, or HbA1c between the low and normal SMI groups. The prevalence of diabetic retinopathy was 58.8% in the low SMI group, which was significantly higher than that in the normal SMI group (15.9%; p < 0.05). The duration of T1D was significantly longer in the low SMI group (25.6 ± 11.3 years) than that in the normal SMI group (20.0 ± 10.0 years, p < 0.04). Multivariate logistic regression analysis revealed that retinopathy, male sex, and body mass index were independent risk factors for low SMI (all p < 0.05). Thus, the factors associated with decreased skeletal muscle mass in non-elderly adult patients with T1D were identified.
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Affiliation(s)
- Kanako Shimura
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| | - Junnosuke Miura
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| | - Zhuo Shen
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| | - Takuya Asanuma
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| | - Satoshi Takagi
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| | - Sari Hoshina
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| | - Hiroko Takaike
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| | - Yasuko Uchigata
- Adachi Medical Center, Tokyo Women’s Medical University, Tokyo, Japan
| | - Tetsuya Babazono
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
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Naruse A, Yamada Y, Miyamoto T. Skeletal Muscle Mass Loss and Physical Function in Young to Middle-Aged Adult Patients With Diabetes: Cross-Sectional Observational Study. Interact J Med Res 2024; 13:e58038. [PMID: 39693147 DOI: 10.2196/58038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 09/22/2024] [Accepted: 10/15/2024] [Indexed: 12/19/2024] Open
Abstract
BACKGROUND Recently, it has been reported that older adults with type 2 diabetes mellitus (T2DM) have lower skeletal muscle mass than healthy individuals. Although skeletal muscle mass in older adults with diabetes is occasionally reported, similar reports on young to middle-aged adults are limited. OBJECTIVE This study aims to assess the prevalence of skeletal muscle loss in young to middle-aged adults with diabetes, examine the relationship between skeletal muscle loss and physical function in these patients, and examine whether there are differences in these characteristics between men and women. METHODS This cross-sectional, observational study included patients younger than 65 years with T2DM who were admitted to our hospital between 2014 and 2022 for educational admission for glycemic control and requested rehabilitation by the Department of Metabolic Medicine. The control group consisted of patients who received rehabilitation during their hospitalization at our hospital and did not have diabetes. The main parameters included skeletal muscle mass, muscle strength, physical function, and activities of daily living. RESULTS The prevalence of skeletal muscle mass loss in this study was 18.2% (10/55) in men and 7.7% (4/52) in women. The skeletal muscle mass index (SMI) was 7.7 (SD 0.8) and 8.4 (SD 0.5) for men in the T2DM and control groups, respectively, and 7.0 (SD 0.9) and 6.8 (SD 0.7) for women in the T2DM and control groups, respectively. Therefore, compared with the nondiabetes group, a significant difference was observed in men but not in women (men: P<.001, women: P=.35). Nonetheless, the diabetes group exhibited significantly lower physical functions, such as a walking speed of 1.3 (SD 0.2) m/s and 1.2 (SD 0.43) m/s for men and women in the T2DM group and 1.6 (SD 0.2) m/s and 1.5 (SD 0.1) m/s for men and women in the control group, respectively (men: P<.001, women: P<.001). One-leg standing time was measured as 30.7 (SD 26.9) seconds and 29.4 (SD 25.5) seconds for men and women in the T2DM group, compared with 100.5 (SD 30.6) seconds and 82.5 (SD 39.8) seconds for men and women in the control group, respectively, with the T2DM group's times being significantly lower (men: P<.001, women: P<.001). Univariate logistic regression analysis showed that SMI was significantly associated with age, BMI, and peripheral neuropathy (all P≤.002). Multiple logistic regression analysis showed that BMI exhibited the strongest association (odds ratio 1.15, 95% CI 1.07-1.23; P<.001), and peripheral neuropathy was also significantly associated with SMI (P=.009). CONCLUSIONS Patients with diabetes, even those who are not older adults, face an elevated rate of skeletal muscle mass loss, muscle weakness, and a decline in physical function; moreover, they are susceptible to dynapenia and presarcopenia. Therefore, early intervention focusing on muscle evaluation and exercise is crucial.
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Affiliation(s)
- Aki Naruse
- Division of Medical Technology, Department of Rehabilitation Technology, Kumamoto University Hospital, Kumamoto, Japan
| | - Yuka Yamada
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takeshi Miyamoto
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Wang X, Gao S. Development and Validation of a Risk Prediction Model for Sarcopenia in Chinese Older Patients with Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2024; 17:4611-4626. [PMID: 39635500 PMCID: PMC11616483 DOI: 10.2147/dmso.s493903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Accepted: 11/07/2024] [Indexed: 12/07/2024] Open
Abstract
Purpose Sarcopenia is a common prevalent age-related disorder among older patients with type 2 diabetes mellitus (T2DM). This study aimed to develop and validate a nomogram model to assess the risk of incident sarcopenia among older patients with T2DM. Patients and methods A total of 1434 older patients (≥ 60 years) diagnosed with T2DM between May 2020 and November 2023 were recruited. The study cohort was randomly divided into a training set (n = 1006) and a validation set (n = 428) at the ratio of 7:3. The best-matching predictors of sarcopenia were incorporated into the nomogram model. The accuracy and applicability of the nomogram model were measured by using the area under the receiver operating characteristic curve (AUC), calibration curve, Hosmer-Lemeshow test, and decision curve analysis (DCA). Results 571 out of 1434 participants (39.8%) had sarcopenia. Nine best-matching factors, including age, body mass index (BMI), diabetic duration, glycated hemoglobin A1c (HbA1c), 25 (OH)Vitamin D, nephropathy, neuropathy, nutrition status, and osteoporosis were selected to construct the nomogram prediction model. The AUC values for training and validation sets were 0.800 (95% CI = 0.773-0.828) and 0.796 (95% CI = 0.755-0.838), respectively. Furthermore, the agreement between predicted and actual clinical probability of sarcopenia was demonstrated by calibration curves, the Hosmer-Lemeshow test (P > 0.05), and DCA. Conclusion Sarcopenia was prevalent among older patients with T2DM. A visual nomogram prediction model was verified effectively to evaluate incident sarcopenia in older patients with T2DM, allowing targeted interventions to be implemented timely to combat sarcopenia in geriatric population with T2DM.
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Affiliation(s)
- Xinming Wang
- Department of the Endoscope Center, The First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, People’s Republic of China
| | - Shengnan Gao
- Hunnan International Department VIP Ward Section, The First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, People’s Republic of China
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Lin CL, Yu NC, Wu HC, Liu YC, Chiu IY, Lin WC, Chien WC. Associated factors of low muscle mass in community-dwelling patients with type 2 diabetes. Medicine (Baltimore) 2024; 103:e38629. [PMID: 38905419 PMCID: PMC11191938 DOI: 10.1097/md.0000000000038629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 05/29/2024] [Indexed: 06/23/2024] Open
Abstract
This study aims to analyze the prevalence of low muscle mass (LMM) and its associated factors among community-dwelling patients with type 2 diabetes (T2D). A retrospective design was employed to analyze the body composition of 2404 adults with T2D aged 18 years and older. LMM was defined as a skeletal muscle index < 7.0 kg/m2 for males and skeletal muscle index < 5.7 kg/m2 for females by bioelectrical impedance analyzer (InBody 770, Korea). Multivariable logistic regression was used to identify the factors related to LMM. The overall prevalence of LMM was 28%. After adjusting for multivariate odds ratios, factors significantly associated with LMM in patients with diabetes include being older than 75 years, female, having a body mass index of <18 kg/m2, and increased percent body fat. We recommend regular LMM evaluations for T2D patients with the previously mentioned characteristics as part of diabetes care.
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Affiliation(s)
- Chia-Ling Lin
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | | | - Hsueh-Ching Wu
- Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan
| | | | | | | | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Department of Medical Research, Tri-Service General Hospital, Taipei, Taiwan
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Ofori EK, Nketiah-Dwomo I, Tagoe EA, Amponsah SK, Adams I, Nyarko ENY, Amanquah SD. Comparative Determination of Glomerular Filtration Rate Estimation Formulae in Type 2 Diabetic Patients: An Observational Study. BIOMED RESEARCH INTERNATIONAL 2024; 2024:9532236. [PMID: 38903148 PMCID: PMC11189678 DOI: 10.1155/2024/9532236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 03/02/2024] [Accepted: 05/02/2024] [Indexed: 06/22/2024]
Abstract
Assessing glomerular filtration rate (GFR) involves collecting timed urine samples for 24 hours, requiring significant time and resources in the clinical setting. Using predictive GFR formulae to assess renal function may be a better alternative. Our goal was to determine which predictive GFR formula had the highest level of concordance with the GFR that has been measured in a resource-poor setting. This is an observational study. We selected fifty (50) individuals diagnosed with type 2 diabetes (T2DM) in Kumasi, Ghana. The sociodemographic and clinical characteristics were obtained using a structured questionnaire. Urine was obtained from each subject over 24 hours. The levels of glucose (FBG) and creatinine in patients' blood, as well as the levels of creatinine in their urine, were measured after the patients had fasted overnight. Participants had a mean age of 57.4 ± 10.7 (years), BMI of 27.8 ± 4.1 (kg/m2), FBG of 9.0 ± 3.1 (mmol/L), and creatinine concentrations of 95.6 ± 29.1 (μmol/L). A Krouwer plot was used to compare the measured GFR with three formulae: Chronic Kidney Disease Epidemiology (CKD-EPI), Modification of Diet in Renal Disease (MDRD), and Cockroft-Gault (CG) for GFR prediction. Among the 3 estimates, CG showed nonsignificance (p > 0.05) with the measured GFR. The primary finding was that the GFR calculated using the CG formula was not different from the GFR measured, suggesting that CG is the most appropriate alternative GFR estimate among a cross-section of T2DM patients in Ghana.
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Affiliation(s)
| | | | | | | | - Ismaila Adams
- Department of Medical PharmacologyU.G.M.S.University of Ghana, Accra, Ghana
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Espino-Gonzalez E, Dalbram E, Mounier R, Gondin J, Farup J, Jessen N, Treebak JT. Impaired skeletal muscle regeneration in diabetes: From cellular and molecular mechanisms to novel treatments. Cell Metab 2024; 36:1204-1236. [PMID: 38490209 DOI: 10.1016/j.cmet.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/10/2024] [Accepted: 02/22/2024] [Indexed: 03/17/2024]
Abstract
Diabetes represents a major public health concern with a considerable impact on human life and healthcare expenditures. It is now well established that diabetes is characterized by a severe skeletal muscle pathology that limits functional capacity and quality of life. Increasing evidence indicates that diabetes is also one of the most prevalent disorders characterized by impaired skeletal muscle regeneration, yet underlying mechanisms and therapeutic treatments remain poorly established. In this review, we describe the cellular and molecular alterations currently known to occur during skeletal muscle regeneration in people with diabetes and animal models of diabetes, including its associated comorbidities, e.g., obesity, hyperinsulinemia, and insulin resistance. We describe the role of myogenic and non-myogenic cell types on muscle regeneration in conditions with or without diabetes. Therapies for skeletal muscle regeneration and gaps in our knowledge are also discussed, while proposing future directions for the field.
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Affiliation(s)
- Ever Espino-Gonzalez
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
| | - Emilie Dalbram
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
| | - Rémi Mounier
- Institut NeuroMyoGène, Unité Physiopathologie et Génétique du Neurone et du Muscle, Université Claude Bernard Lyon 1, CNRS UMR 5261, Inserm U1315, Univ Lyon, Lyon, France
| | - Julien Gondin
- Institut NeuroMyoGène, Unité Physiopathologie et Génétique du Neurone et du Muscle, Université Claude Bernard Lyon 1, CNRS UMR 5261, Inserm U1315, Univ Lyon, Lyon, France
| | - Jean Farup
- Department of Biomedicine, Aarhus University, Aarhus 8000, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Niels Jessen
- Department of Biomedicine, Aarhus University, Aarhus 8000, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus 8200, Denmark; Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Jonas T Treebak
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark.
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Cui H, Hu D, Liu Y, Zhao J. Identifying Acss1, Mtfp1 and Oxct1 as key regulators and promising biomarkers of sarcopenia in various models. Gene 2024; 896:148053. [PMID: 38042218 DOI: 10.1016/j.gene.2023.148053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/18/2023] [Accepted: 11/29/2023] [Indexed: 12/04/2023]
Abstract
Mitochondrial dysfunction plays a critical role in muscular homeostasis, but the molecular mechanism underlying mitochondrial dynamics and sarcopenia awaits to be uncovered. We all know that malnutrition, cachexia, and type 2 diabetes are significant contributors to the development of sarcopenia.Therefore, we analyzed a bioinformatic analysis on cathectic differentially expressed genes (cDEGs), fasted differentially genes (fDEGs) and mitochondria-related genes. The overlapping genes identified were then validated by RT-qPCR and Western blotting experiments in various sarcopenia mice models and used to predict aging-related muscle loss in humans. First, the correlation analysis and PPI network indicated 6 overlapping candidates (Bdh1, Gdap1, Acss1, Mtfp1, Idh2, Oxct1) may constitute a regulatory effect in mitochondrial dynamics and muscle wasting. Next, we successfully established fasted, Lewis lung carcinoma (LLC) and Diabetes Mellitus (DM) induced sarcopenia mice models and verified that Acss1, Mtfp1 and Oxct1 shared common and significant variation tendency in these sarcopenia mice models. Further-more, Pearson correlation analysis showed that Acss1 was negatively related to the weight of gastrocnemius while Mtfp1 and Oxct1 displayed a significantly positive correlation with gastrocnemius weight in sarcopenic mice model induced by LLC, fasting and DM. What's more, ROC analysis based on human aging-related datasets indicated Acss1, Mtfp1, Oxct1 had outstanding diagnostic capabilities for sarcopenia. In general, we identified three hub genes (Acss1, Mtfp1 and Oxct1) that are strongly associated with mitochondrial dysfunction in sarcopenia and may provide novel and reliable indicators for screening, diagnosis, and prognosis, as well as potential therapeutic targets for patients with sarcopenia.
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Affiliation(s)
- Hailong Cui
- The Key Laboratory of Metabolism and Molecular Medicine of the Ministry of Education, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450001, China
| | - Die Hu
- The Key Laboratory of Metabolism and Molecular Medicine of the Ministry of Education, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Yanling Liu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
| | - Jiejie Zhao
- The Key Laboratory of Metabolism and Molecular Medicine of the Ministry of Education, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Department of Endocrinology and Metabolism, Shanghai Geriatric Medical Center, Zhongshan Hospital, Fudan University, Shanghai 200030, China.
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Wang S, Xu X, Cao S, Cheng J, Wang Y, Dong Y. Sonographic methods to predict type 2 diabetes patients with sarcopenia: B mode ultrasound and shear wave elastography. Clin Hemorheol Microcirc 2024; 87:13-26. [PMID: 38393892 DOI: 10.3233/ch-231822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
BACKGROUND Type 2 diabetes accelerates the loss of muscle mass and strength. Sarcopenia is also one of the chronic complications of diabetes. OBJECTIVE To investigate the clinical value of B mode ultrasound (BMUS) and shear wave elastography (SWE) for predicting type 2 diabetic sarcopenia. METHODS We recorded Skeletal Muscle Mass Index (ASMI), grip strength, muscle thickness (MT), pinna angle (PA), fascicle length (FL), and the difference of Young's modulus in the relaxed states and tense states (ΔSWE). The correlations between clinical indicators and ultrasound characteristics were compared. A diagnostic model of sarcopenia was developed to assess the independent correlates and evaluate the diagnostic efficacy of sarcopenia. RESULTS ASMI was significantly and positively correlated with MT and ΔSWE (r = 0.826, 0.765, P < 0.01), and grip strength was significantly and positively correlated with MT and ΔSWE (r = 0.797, 0.818, P < 0.01). MT was the most significant predictor of sarcopenia (OR = 4.576, P < 0.001), and the cut-off value of MT was 11.4 mm (AUC: 0.952). CONCLUSION BMUS and SWE can quantitatively assess muscle mass and strength, and are effective methods to predict the occurrence of sarcopenia in elderly patients with type 2 diabetes.
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Affiliation(s)
- Shengqiao Wang
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinliang Xu
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Siqi Cao
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juan Cheng
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Wang
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Dong
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Yogesh M, Mody M, Makwana N, Rabadiya S, Patel J, Shah S. The Hidden Battle Within: Shedding Light on the Co-existence of Sarcopenia and Sarcopenic Obesity among Participants with Type 2 Diabetes in a Tertiary Care Hospital, Gujarat. Indian J Endocrinol Metab 2024; 28:80-85. [PMID: 38533285 PMCID: PMC10962775 DOI: 10.4103/ijem.ijem_321_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/23/2023] [Accepted: 12/10/2023] [Indexed: 03/28/2024] Open
Abstract
Introduction Type 2 diabetes (T2DM) is characterised by chronic hyperglycaemia due to abnormal insulin secretion and/or utilisation. Currently, sarcopenia has emerged as a new complication of T2DM, which increases the risk of physical disability, and even death. The study aims to estimate the prevalence of sarcopenia and sarcopenic obesity (SO) as well as their association with various other factors related to T2DM. Methods The study was an observational hospital-based cross-sectional study conducted among diabetic patients who came to the non-communicable diseases (NCD) clinic of a tertiary care hospital in Gujarat, India, from April 2023 to June 2023. Adult patients with T2DM attending follow-ups were included, with a diagnosis of T2DM for at least 1 year from the date of their electronic medical records, regardless of their mode of therapeutic treatment. They were on regular medical reviews with two or more visits to the study site in the past 1 year. Then a self-structured standard questionnaire was used to collect the data, containing socio-demographic characteristics, clinical profiles, anthropometric assessment (comprising weight, height and body mass index [BMI]), bio-impedance indices like body fat%, skeletal muscle% and handgrip by hand dynamometer. Results In the study, a total of 404 participants participated. Their mean age was 55 ± 13.5 years and their mean body fat (BF) % was 30 ± 7.4%. BF%-defined obesity was found in 260 (64.4%) participants. A total of 362 (89.6%) had possible sarcopenia, 183 (45.3%) had sarcopenia and 124 (30.7%) had SO. Age (OR: 2.6, CI: 1.7-3.9), duration of diabetes for more than 7 years (OR: 7.5, CI: 3.65-15.4) and BF%-defined obesity (OR: 2.2, CI: 3.6-15) were statistically associated with Sarcopenia, in similar pattern age (OR: 2.4, CI: 1.5-3.7), and duration of diabetes more than 7 years (OR: 18.9, CI: 5.7-62) were associated with SO (P < 0.05). Conclusion Older age, longer diabetes duration and BF%-defined obesity are associated with an increased likelihood of developing sarcopenia and sarcopenic obesity. Healthcare providers should prioritise regular screening for sarcopenia and SO in elderly individuals with diabetes to facilitate early detection and intervention.
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Affiliation(s)
- M Yogesh
- Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
| | - Mansi Mody
- Department of Internal Medicine, Final Year Medical Student, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
| | - Naresh Makwana
- Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
| | - Samarth Rabadiya
- Department of Internal Medicine, Intern Doctor, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
| | - Jenish Patel
- Department of Internal Medicine, Final Year Medical Student, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
| | - Samyak Shah
- Second Year Medical Student, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
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12
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Bi LN, Zheng X, Qi YY, Hu S, Li C, Zhang Y. Prevalence and influencing factors of muscle mass loss in adults with diabetes and a high body fat percentage: A cross-sectional study. J Back Musculoskelet Rehabil 2024; 37:175-181. [PMID: 37661869 DOI: 10.3233/bmr-230065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
BACKGROUND In adults with type 2 diabetes (T2DM), sarcopenia and obesity are two common body composition issues. OBJECTIVE We investigated the associated influencing factors of muscle mass loss in obese adults with T2DM, to provide a theoretical basis for the prevention of sarcopenic obesity in patients with T2DM. METHODS We recruited 315 participants in this study. The participants underwent body composition assessment and clinical information was collected. Dual-energy X-ray absorptiometry was used to verify the accuracy of the body composition data. Based on their body fat percentage, 189 patients with T2DM were classified as obese. Patients with T2DM and obesity were grouped into the muscle mass loss group and non-muscle mass loss group based on gender. We collected demographic and clinical information about patients with T2DM who were obese, including their age, gender, body mass index (BMI), appendicular skeletal muscle index (ASMI), and body fat percentage (PBF). RESULTS Among the participants who were obese and had T2DM, 56.61% (107/189) experienced muscle mass loss, with a detection rate of 43.42% (33/76) among females and 65.49% (74/113) among males. Body mass index, fat index, Android fat, Gynoid fat, limb fat, trunk fat, and total body bone mineral content were all lower in the muscle mass loss group compared to the non-muscle mass loss group, regardless of gender (all P< 0.001). Muscle mass loss in obese adults with T2DM was affected by BMI, body fat index, and limb fat. CONCLUSION Muscle mass loss is more prevalent in adults with T2DM and a high PBF. Body mass index, body fat index, and limb fat are the protective factors of muscle mass loss in adult patients with T2DM and obesity.
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Alfaro-Alvarado FA, Rosas-Barrientos JV, Ocharan-Hernández ME, Díaz-Chiguer D, Vargas-De-León C. Association between Sarcopenia and Poor Glycemic Control in Older Adults with Type 2 Diabetes Mellitus. Diseases 2023; 11:175. [PMID: 38131980 PMCID: PMC10743183 DOI: 10.3390/diseases11040175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Aging is associated with a decrease in muscle mass. Insulin resistance and hyperglycemia accelerate muscle loss, leading to a deterioration in strength, muscle mass, and physical capacity in older adults. This study was conducted to determine the association between sarcopenia and poor glycemic control in older adults with type 2 diabetes mellitus (T2D). METHODS A cross-sectional study was carried out in older adults with T2D in geriatric outpatient clinics. Sarcopenia was diagnosed as per the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. According to glycosylated hemoglobin (HbA1c) levels, participants were classified into glycemic control (HbA1c ≤ 7.5%) and poor glycemic control (HbA1c ≥ 7.5%) groups. RESULTS Older adults with sarcopenia were found to have poor glycemic control compared to adults without sarcopenia (62.3% vs. 47.9%, p = 0.007). Logistic regression analysis showed an association between poor glycemic control and the presence of sarcopenia (odds ratio (OR): 1.79, 95% confidence interval (CI): 1.17-2.75) and low muscle mass (OR: 1.73, 95% CI: 1.07-2.73). CONCLUSIONS Poor glycemic control is associated with the presence of sarcopenia and low muscle mass, which highlights the need to implement better treatment strategies in order to reduce the loss of muscle mass.
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Affiliation(s)
- Fabián Alonso Alfaro-Alvarado
- Laboratorio de Modelación Bioestadística para la Salud, Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico; (F.A.A.-A.); (M.E.O.-H.)
- Clínica Hospital No. 24, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad Guzmán 49097, Mexico
| | - José Vicente Rosas-Barrientos
- Hospital Regional 1° de Octubre, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Ciudad de México 07760, Mexico;
| | - María Esther Ocharan-Hernández
- Laboratorio de Modelación Bioestadística para la Salud, Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico; (F.A.A.-A.); (M.E.O.-H.)
| | - Dylan Díaz-Chiguer
- Dirección Normativa de Salud, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Ciudad de México 06030, Mexico;
| | - Cruz Vargas-De-León
- Laboratorio de Modelación Bioestadística para la Salud, Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico; (F.A.A.-A.); (M.E.O.-H.)
- División de Investigación, Hospital Juárez de México, Ciudad de México 07760, Mexico
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Teaney NA, Cyr NE. FoxO1 as a tissue-specific therapeutic target for type 2 diabetes. Front Endocrinol (Lausanne) 2023; 14:1286838. [PMID: 37941908 PMCID: PMC10629996 DOI: 10.3389/fendo.2023.1286838] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/06/2023] [Indexed: 11/10/2023] Open
Abstract
Forkhead box O (FoxO) proteins are transcription factors that mediate many aspects of physiology and thus have been targeted as therapeutics for several diseases including metabolic disorders such as type 2 diabetes mellitus (T2D). The role of FoxO1 in metabolism has been well studied, but recently FoxO1's potential for diabetes prevention and therapy has been debated. For example, studies have shown that increased FoxO1 activity in certain tissue types contributes to T2D pathology, symptoms, and comorbidities, yet in other tissue types elevated FoxO1 has been reported to alleviate symptoms associated with diabetes. Furthermore, studies have reported opposite effects of active FoxO1 in the same tissue type. For example, in the liver, FoxO1 contributes to T2D by increasing hepatic glucose production. However, FoxO1 has been shown to either increase or decrease hepatic lipogenesis as well as adipogenesis in white adipose tissue. In skeletal muscle, FoxO1 reduces glucose uptake and oxidation, promotes lipid uptake and oxidation, and increases muscle atrophy. While many studies show that FoxO1 lowers pancreatic insulin production and secretion, others show the opposite, especially in response to oxidative stress and inflammation. Elevated FoxO1 in the hypothalamus increases the risk of developing T2D. However, increased FoxO1 may mitigate Alzheimer's disease, a neurodegenerative disease strongly associated with T2D. Conversely, accumulating evidence implicates increased FoxO1 with Parkinson's disease pathogenesis. Here we review FoxO1's actions in T2D conditions in metabolic tissues that abundantly express FoxO1 and highlight some of the current studies targeting FoxO1 for T2D treatment.
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Affiliation(s)
- Nicole A. Teaney
- Stonehill College, Neuroscience Program, Easton, MA, United States
| | - Nicole E. Cyr
- Stonehill College, Neuroscience Program, Easton, MA, United States
- Stonehill College, Department of Biology, Easton, MA, United States
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Jung SY, Lee MJ, Lee SY. Analysis of the Relationship Between Lower leg Muscle Mass and Preservation of Lower Extremity in Patients with Diabetic Foot Ulcer. INT J LOW EXTR WOUND 2023; 22:503-508. [PMID: 34096804 DOI: 10.1177/15347346211024493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to determine how the muscle mass of the lower leg affects the preservation of the lower extremities in patients with diabetic foot ulcer. This study analyzed patients with diabetic foot ulcer between January 2014 and June 2018 with a follow-up of at least 2 years. Of these 181 patients whose ulcer is located distal to the metatarsophalangeal joint, which was categorized as grade ≤2 by the Wagner classification were classified into 4 grades: grade 0 (treated without amputation), grade 1 (amputation distal to the metatarsophalangeal joint), grade 2 (Ray, transmetatarsal, Lisfranc, and Chopart amputation), and grade 3 (Syme, below-knee, and above-knee amputation) according to the final amputation degree. The muscles of the lower leg were classified into 4 compartments: anterior, lateral, deep posterior, and superficial posterior. The cross-sectional area and attenuation to estimate the muscle volume and density were measured at the axial image of computed tomography (CT) angiography. No significant differences were observed in the sex ratio and mean age among the grades (P = .966 and .962). The cross-sectional area of the anterior, lateral, and posterior compartments demonstrated no significant differences, but that of the superficial posterior compartment exhibited significant differences among the grades (P < .001). Moreover, the attenuation of the anterior, lateral, and deep posterior compartments showed no significant differences, but that of the posterior compartment showed significant differences among the grades (P = .003). The muscle mass of the superficial posterior compartment of the lower leg could be a good indicator of the preservation of the lower extremity in patients with diabetic foot ulcer. Therefore, a strengthening exercise for the triceps surae and plantaris muscles in the early stage could help preserve as much of the lower extremities as possible.
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Affiliation(s)
- Sung Y Jung
- Department of Orthopedic Surgery, College of Medicine, Dong-A University, Busan, Korea
| | - Myoung J Lee
- Department of Orthopedic Surgery, College of Medicine, Dong-A University, Busan, Korea
| | - Sang Y Lee
- Department of Orthopedic Surgery, College of Medicine, Dong-A University, Busan, Korea
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Fang Z, Chen X, Liu M, Zuo L, Zhou B, Zheng G, Chen H, Hao G. Associations of pyrethroid exposure with skeletal muscle strength and mass. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:89651-89660. [PMID: 37454383 DOI: 10.1007/s11356-023-28784-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
This study aimed to examine the associations of pyrethroid exposure with handgrip strength and skeletal muscle mass and potential modification effects in US adults. The data from the National Health and Nutrition Examination Survey was used. Handgrip strength was determined with a handgrip dynamometer, and we quantified muscle mass by using the appendicular skeletal muscle index (ASMI). Urinary 3-Phenoxybenzoic Acid (3-PBA), a validated biomarker for pyrethroid exposure, was used in the primary analysis. After adjusting for other covariates, participants exposed to the highest tertile of 3-PBA exposure had significantly lower handgrip strength (β = -1.88, 95% CI: -3.29, -0.23, P = 0.026) than those exposed to the lowest tertile of 3-PBA. Similarly, the 3-PBA exposure was marginally significantly associated with ASMI (Tertile 3 vs. Tertile 1: β = -0.07, 95% CI: -0.14, -0.01, P = 0.056). Significant interactions were found between 3-PBA and body mass index (BMI) on handgrip strength and ASMI (P interaction < 0.05), which indicated a potential moderation effect of BMI on the associations. In conclusion, pyrethroid exposure was adversely associated with handgrip strength and skeletal muscle mass, especially in overweight and obese populations. Further studies are warranted to confirm our results and to explore the potential mechanisms.
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Affiliation(s)
- Zhenger Fang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xia Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Mingliang Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Lei Zuo
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Biying Zhou
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Guangjun Zheng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Haiyan Chen
- Department of Parasitic Disease and Endemic Disease Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Guang Hao
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Guangzhou, 510632, Guangdong, China.
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Fahrner A, Alchus Laiferová N, Ukropcová B, Ukropec J, Krützfeldt J. Activation of PDGF Signaling in the Adult Muscle Stem Cell Niche in Patients With Type 2 Diabetes Mellitus. J Clin Endocrinol Metab 2023; 108:2052-2064. [PMID: 36702759 PMCID: PMC10348470 DOI: 10.1210/clinem/dgad041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 01/07/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023]
Abstract
CONTEXT Type 2 diabetes mellitus (T2D) negatively affects muscle mass and function throughout life. Whether adult muscle stem cells contribute to the decrease in muscle health is not clear and insights into the stem cell niche are difficult to obtain. OBJECTIVE To establish the upstream signaling pathway of microRNA (miR)-501, a marker of activated myogenic progenitor cells, and interrogate this pathway in muscle biopsies from patients with T2D. METHODS Analysis of primary muscle cell cultures from mice and 4 normoglycemic humans and muscle biopsies from 7 patients with T2D and 7 normoglycemic controls using gene expression, information on histone methylation, peptide screening, and promoter assays. RESULTS miR-501 shares the promoter of its host gene, isoform 2 of chloride voltage-gated channel 5 (CLCN5-2), and miR-501 expression increases during muscle cell differentiation. We identify platelet-derived growth factor (PDGF) as an upstream regulator of CLCN5-2 and miR-501 via Janus kinase/signal transducer and activator of transcription. Skeletal muscle biopsies from patients with T2D revealed upregulation of PDGF (1.62-fold, P = .002), CLCN5-2 (2.85-fold, P = .03), and miR-501 (1.73-fold, P = .02) compared with normoglycemic controls. In addition, we observed a positive correlation of PDGF and miR-501 in human skeletal muscle (r = 0.542, P = .045, n = 14). CONCLUSIONS We conclude that paracrine signaling in the adult muscle stem cells niche is activated in T2D. Expression analysis of the PDGF-miR-501 signaling pathway could represent a powerful tool to classify patients in clinical trials that aim to improve muscle health and glucose homeostasis in patients with diabetes.
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Affiliation(s)
- Alexandra Fahrner
- Division of Endocrinology, Diabetes, and Clinical Nutrition, University Hospital Zurich, 8091 Zurich, Switzerland
- Life Science Zurich Graduate School, Biomedicine, University of Zurich, 8057 Zurich, Switzerland
| | - Nikoleta Alchus Laiferová
- Department of Metabolic Disease Research, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, 84505 Bratislava, Slovakia
| | - Barbara Ukropcová
- Department of Metabolic Disease Research, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, 84505 Bratislava, Slovakia
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, 81108 Bratislava, Slovakia
| | - Jozef Ukropec
- Department of Metabolic Disease Research, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, 84505 Bratislava, Slovakia
| | - Jan Krützfeldt
- Division of Endocrinology, Diabetes, and Clinical Nutrition, University Hospital Zurich, 8091 Zurich, Switzerland
- Life Science Zurich Graduate School, Biomedicine, University of Zurich, 8057 Zurich, Switzerland
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Chen ZT, Jin FS, Guo LH, Li XL, Wang Q, Zhao H, Sun LP, Xu HX. Value of conventional ultrasound and shear wave elastography in the assessment of muscle mass and function in elderly people with type 2 diabetes. Eur Radiol 2023; 33:4007-4015. [PMID: 36648552 DOI: 10.1007/s00330-022-09382-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/01/2022] [Accepted: 12/12/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVES We assessed muscle mass and function using ultrasound (US) and shear wave elastography (SWE) for sarcopenia in elderly patients with type 2 diabetes. METHODS There were 84 patients with type 2 diabetes enrolled in this study; of these, 30 had sarcopenia and 54 did not. We measured appendicular skeletal muscle mass index (ASMI), handgrip strength, calf circumference, 6-m walking speed, and 5-time chair stand test. All patients were in the supine position with their knees in straight and bent poses in turn. The US-derived thickness (Tstraight, Tbent), cross-sectional area (CSAstraight, CSAbent), and SWE (SWEstraight, SWEbent) of the rectus femoris muscle (RFM) were measured and the differences (ΔT, ΔCSA, ΔSWE) were calculated. We assessed the correlations of clinical indicators with US and SWE features. We then compared the clinical indicators and US and SWE features between patients with and without sarcopenia to determine independent predictors. Diagnostic models were established based on these independent predictors. RESULTS The ASMI was correlated with Tbent (r = 0.57, p < 0.001) and CSAbent (r = 0.50, p < 0.001). Handgrip strength was correlated with Tbent (r = 0.53, p < 0.001) and CSAbent (r = 0.51, p < 0.001). Between patients with and without sarcopenia, the indicators of age, ΔCSA, and ΔSWE were statically different (all p ≤ 0.001). Based on these results, a diagnostic model for sarcopenia was established with 83.3% sensitivity, 83.3% specificity, and 83.3% accuracy. CONCLUSIONS In elderly people with type 2 diabetes, sarcopenia patients had smaller muscle CSA and less stiffness than non-sarcopenia patients. US and SWE might be useful to screen them. KEY POINTS • Sarcopenia is common in elderly people with type 2 diabetes. • Ultrasound and shear wave elastography might be useful methods for quantitatively assessing muscle mass and strength. • Ultrasound and shear wave elastography might be useful methods for screening sarcopenia in elderly patients with type 2 diabetes.
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Affiliation(s)
- Zi-Tong Chen
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Feng-Shan Jin
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Le-Hang Guo
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China.
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China.
- National Clinical Research Center for Interventional Medicine, Shanghai, China.
| | - Xiao-Long Li
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qiao Wang
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Hui Zhao
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Li-Ping Sun
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Hui-Xiong Xu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
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Nakajima H, Okada H, Kobayashi A, Takahashi F, Okamura T, Hashimoto Y, Nakanishi N, Senmaru T, Ushigome E, Hamaguchi M, Fukui M. Leucine and Glutamic Acid as a Biomarker of Sarcopenic Risk in Japanese People with Type 2 Diabetes. Nutrients 2023; 15:2400. [PMID: 37242283 PMCID: PMC10222500 DOI: 10.3390/nu15102400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
This study aimed to identify the serum metabolites associated with sarcopenic risk in Japanese patients with type 2 diabetes, determine the effect of dietary protein intake on the serum metabolic profile, and examine its association with sarcopenia. Ninety-nine Japanese patients with type 2 diabetes were included, and sarcopenic risk was defined as low muscle mass or strength. Seventeen serum metabolites were quantified after gas chromatography-mass spectrometry analysis. The relationship between dietary protein intake and the metabolites concerning sarcopenia was analyzed, and the factors affecting sarcopenic risk were clarified. Twenty-seven patients were classified as being at risk of sarcopenia, the same as the general risk, which was associated with older age, a longer duration of the disease, and a lower body mass index. Low levels of leucine and glutamic acid were significantly associated with low muscle strength (p = 0.002 and p < 0.001, respectively), and leucine was also associated with muscle mass (p = 0.001). Lower levels of glutamic acid had higher odds of sarcopenic risk after being adjusted for age and HbA1c (adjusted OR 4.27, 95% CI 1.07-17.11, p = 0.041), but not for leucine. Leucine and glutamic acid can serve as useful biomarkers for sarcopenia, highlighting potential targets for its prevention.
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Affiliation(s)
- Hanako Nakajima
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-0841, Japan; (H.N.)
| | - Hiroshi Okada
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-0841, Japan; (H.N.)
| | - Ayaka Kobayashi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-0841, Japan; (H.N.)
| | - Fuyuko Takahashi
- Nutrition Division, Saiseikai Suita Hospital, Osaka 564-0013, Japan
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-0841, Japan; (H.N.)
| | - Yoshitaka Hashimoto
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Osaka 570-8540, Japan
| | - Naoko Nakanishi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-0841, Japan; (H.N.)
| | - Takafumi Senmaru
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-0841, Japan; (H.N.)
| | - Emi Ushigome
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-0841, Japan; (H.N.)
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-0841, Japan; (H.N.)
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-0841, Japan; (H.N.)
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Moloto MR, Akinola SA, Seke F, Shoko T, Sultanbawa Y, Shai JL, Remize F, Sivakumar D. Influence of Fermentation on Functional Properties and Bioactivities of Different Cowpea Leaf Smoothies during In Vitro Digestion. Foods 2023; 12:foods12081701. [PMID: 37107496 PMCID: PMC10137366 DOI: 10.3390/foods12081701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/07/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
This study investigated the effects of Lactiplantibacillus plantarum 75 (LAB 75) fermentation at 37 °C for 48 h on the pH, total soluble solids (TSS), colour, total titratable acidity (TTA), carotenoids, and bioactivities of cowpea leaf smoothies from three cultivars (VOP 1, VOP 3, and VOP 4). Fermentation reduced the pH from 6.57 to 5.05 after 48 h. The TTA increased with the fermentation period, whilst the TSS reduced. Fermentation of the smoothies resulted in the least colour changes (∆E) in VOP 1 after 48 h. Fermentation of cowpea smoothies (VOP 1, VOP 3, and VOP 4) improved the antioxidant capacity (FRAP, DPPH, and ABTS), which was attributed to the increase in total phenolic compounds and carotenoid constituents in all of the fermented cowpea smoothies. VOP 1 was further selected for analysis due to its high phenolic content and antioxidant activity. The VOP 1 smoothie fermented for 24 h showed the lowest reduction in TPC (11%) and had the highest antioxidant (FRAP, DPPH, and ABTS) activity. Ltp. plantarum 75 was viable and survived the harsh conditions of the gastrointestinal tract, and, hence, could be used as a probiotic. VOP 1 intestinal digesta showed significantly higher glucose uptake relative to the undigested and the gastric digesta, while the gastric phase had higher levels of α-amylase and α-glucosidase compared to the undigested samples.
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Affiliation(s)
- Mapula R Moloto
- Phytochemical Food Network Group, Department of Crop Sciences, Pretoria 0001, South Africa
| | - Stephen A Akinola
- Phytochemical Food Network Group, Department of Crop Sciences, Pretoria 0001, South Africa
| | - Faith Seke
- Phytochemical Food Network Group, Department of Crop Sciences, Pretoria 0001, South Africa
| | - Tinotenda Shoko
- Phytochemical Food Network Group, Department of Crop Sciences, Pretoria 0001, South Africa
| | - Yasmina Sultanbawa
- Australian Research Council Industrial Transformation Training Centre for Uniquely Australian Foods, Queensland Alliance for Agriculture and Food Innovation, Centre for Food Science and Nutrition, The University of Queensland, Elkhorn Building (#1024), 80 Meiers Road, Indooroopilly, Brisbane, QLD 4068, Australia
| | - Jerry L Shai
- Department of Biomedical Sciences, Tshwane University of Technology, Arcadia, Pretoria 0001, South Africa
| | - Fabienne Remize
- SPO, Université de Montpellier, Université de La Réunion, Institut Agro, INRAE, 2 Place Viala, F-34000 Montpellier, France
| | - Dharini Sivakumar
- Phytochemical Food Network Group, Department of Crop Sciences, Pretoria 0001, South Africa
- Australian Research Council Industrial Transformation Training Centre for Uniquely Australian Foods, Queensland Alliance for Agriculture and Food Innovation, Centre for Food Science and Nutrition, The University of Queensland, Elkhorn Building (#1024), 80 Meiers Road, Indooroopilly, Brisbane, QLD 4068, Australia
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21
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Norris T, Johnson W, Cooper R, Pereira SMP. Associations between diabetes status and grip strength trajectory sub-groups in adulthood: findings from over 16 years of follow-up in the MRC National Survey of Health and Development. BMC Geriatr 2023; 23:213. [PMID: 37016329 PMCID: PMC10074704 DOI: 10.1186/s12877-023-03871-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/03/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Cross-sectional studies suggest a relationship between diabetes status and weaker grip strength (GS) in adulthood and limited evidence from longitudinal studies has focussed on the association with average change in GS. We aimed to investigate whether diabetes status was related to membership of distinct GS trajectories in mid-to-late adulthood in 2,263 participants in the Medical Research Council National Survey of Health and Development. METHODS Grip strength (kg) was measured at 53, 60-64 and 69 years. Pre-/diabetes was defined at 53 years based on HbA1c > 5.6% and/or doctor-diagnosis of diabetes. Sex-specific latent class trajectory models were developed and multinomial logistic regression was used to investigate the association between pre-/diabetes status and membership into GS trajectory classes. RESULTS For both males and females, a 3-class solution ('High', 'Intermediate', 'Low') provided the best representation of the GS data and the most plausible solution. There was no evidence that pre-/diabetes status was associated with class membership in either sex: e.g., adjusted odds ratios of being in the 'Low' class (vs. 'High') for males with pre-/diabetes (vs. no-diabetes) was 1.07 (95% CI:0.45,2.55). CONCLUSION Using a flexible data-driven approach to identify GS trajectories between 53 and 69 years, we observed three distinct GS trajectories, all declining, in both sexes. There was no association between pre-/diabetes status at 53 years and membership into these GS trajectories. Understanding the diabetes status-GS trajectories association is vital to ascertain the consequences that projected increases in pre-/diabetes prevalence's are likely to have.
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Affiliation(s)
- T Norris
- Institute of Sport, Exercise and Health, Division of Surgery & Interventional Science, University College London, London, UK
| | - W Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - R Cooper
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - S M Pinto Pereira
- Institute of Sport, Exercise and Health, Division of Surgery & Interventional Science, University College London, London, UK.
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22
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Butenas ALE, Copp SW, Hageman KS, Poole DC, Musch TI. Effects of comorbid type II diabetes mellitus and heart failure on rat hindlimb and respiratory muscle blood flow during treadmill exercise. J Appl Physiol (1985) 2023; 134:846-857. [PMID: 36825642 PMCID: PMC10042612 DOI: 10.1152/japplphysiol.00770.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/10/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
In rats with type II diabetes mellitus (T2DM) compared with nondiabetic healthy controls, muscle blood flow (Q̇m) to primarily glycolytic hindlimb muscles and the diaphragm muscle are elevated during submaximal treadmill running consequent to lower skeletal muscle mass, a finding that held even when muscle mass was normalized to body mass. In rats with heart failure with reduced ejection fraction (HF-rEF) compared with healthy controls, hindlimb Q̇m was lower, whereas diaphragm Q̇m is elevated during submaximal treadmill running. Importantly, T2DM is the most common comorbidity present in patients with HF-rEF, but the effect of concurrent T2DM and HF-rEF on limb and respiratory Q̇m during exercise is unknown. We hypothesized that during treadmill running (20 m·min-1; 10% incline), hindlimb and diaphragm Q̇m would be higher in T2DM Goto-Kakizaki rats with HF-rEF (i.e., HF-rEF + T2DM) compared with nondiabetic Wistar rats with HF-rEF. Ejection fractions were not different between groups (HF-rEF: 30 ± 5; HF-rEF + T2DM: 28 ± 8%; P = 0.617), whereas blood glucose was higher in HF-rEF + T2DM (209 ± 150 mg/dL) compared with HF-rEF rats (113 ± 28 mg/dL; P = 0.040). Hindlimb muscle mass normalized to body mass was lower in rats with HF-rEF + T2DM (36.3 ± 1.6 mg/g) than in nondiabetic HF-rEF counterparts (40.3 ± 2.7 mg/g; P < 0.001). During exercise, Q̇m was elevated in rats with HF-rEF + T2DM compared with nondiabetic counterparts to the hindlimb (HF-rEF: 100 ± 28; HF-rEF + T2DM: 139 ± 23 mL·min-1·100 g-1; P < 0.001) and diaphragm (HF-rEF: 177 ± 66; HF-rEF + T2DM: 215 ± 93 mL·min-1·100g-1; P = 0.035). These data suggest that the pathophysiological consequences of T2DM on hindlimb and diaphragm Q̇m during treadmill running in the GK rat persist even in the presence of HF-rEF.NEW & NOTEWORTHY Herein, we demonstrate that rats comorbid with heart failure with reduced ejection fraction (HF-rEF) and type II diabetes mellitus (T2DM) have a higher hindlimb and respiratory muscle blood flow during submaximal treadmill running (20 m·min-1; 10% incline) compared with nondiabetic HF-rEF counterparts. These data may carry important clinical implications for roughly half of all patients with HF-rEF who present with T2DM.
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Affiliation(s)
- Alec L E Butenas
- Department of Kinesiology, Kansas State University, Manhattan, Kansas, United States
| | - Steven W Copp
- Department of Kinesiology, Kansas State University, Manhattan, Kansas, United States
| | - K Sue Hageman
- Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas, United States
| | - David C Poole
- Department of Kinesiology, Kansas State University, Manhattan, Kansas, United States
- Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas, United States
| | - Timothy I Musch
- Department of Kinesiology, Kansas State University, Manhattan, Kansas, United States
- Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas, United States
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23
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Haines MS, Leong A, Porneala BC, Zhong VW, Lewis CE, Schreiner PJ, Miller KK, Meigs JB, Carnethon MR. More appendicular lean mass relative to body mass index is associated with lower incident diabetes in middle-aged adults in the CARDIA study. Nutr Metab Cardiovasc Dis 2023; 33:105-111. [PMID: 36435699 PMCID: PMC9812900 DOI: 10.1016/j.numecd.2022.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/07/2022] [Accepted: 09/27/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Although lower lean mass is associated with greater diabetes prevalence in cross-sectional studies, prospective data specifically in middle-aged Black and White adults are lacking. Relative appendicular lean mass (ALM), such as ALM adjusted for body mass index (BMI), is important to consider since muscle mass is associated with overall body size. We investigated whether ALM/BMI is associated with incident type 2 diabetes in the Coronary Artery Risk Development in Young Adults study. METHODS AND RESULTS 1893 middle-aged adults (55% women) were included. ALM was measured by DXA in 2005-06. Incident type 2 diabetes was defined in 2010-11 or 2015-16 as fasting glucose ≥7 mmol/L (126 mg/dL), 2-h glucose on OGTT ≥11.1 mmol/L (200 mg/dL) (2010-11 only), HbA1C ≥48 mmol/mol (6.5%) (2010-11 only), or glucose-lowering medications. Cox regression models with sex stratification were performed. In men and women, ALM/BMI was 1.07 ± 0.14 (mean ± SD) and 0.73 ± 0.12, respectively. Seventy men (8.2%) and 71 women (6.8%) developed type 2 diabetes. Per sex-specific SD higher ALM/BMI, unadjusted diabetes risk was lower by 21% in men [HR 0.79 (0.62-0.99), p = 0.04] and 29% in women [HR 0.71 (0.55-0.91), p = 0.008]. After adjusting for age, race, smoking, education, physical activity, and waist circumference, the association was no longer significant. Adjustment for waist circumference accounted for the attenuation in men. CONCLUSION Although more appendicular lean mass relative to BMI is associated with lower incident type 2 diabetes in middle-aged men and women over 10 years, its effect may be through other metabolic risk factors such as waist circumference, which is a correlate of abdominal fat mass.
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Affiliation(s)
- Melanie S Haines
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Aaron Leong
- Harvard Medical School, Boston, MA, USA; Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA; Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Bianca C Porneala
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Victor W Zhong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Cora E Lewis
- Department of Epidemiology, University of Alabama, Birmingham, AL, USA
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Karen K Miller
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - James B Meigs
- Harvard Medical School, Boston, MA, USA; Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
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24
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Saw EL, Werner LD, Zamani P, Chirinos JA, Valero-Muñoz M, Sam F. Skeletal muscle phenotypic switching in heart failure with preserved ejection fraction. Front Cardiovasc Med 2022; 9:1016452. [PMID: 36531739 PMCID: PMC9753550 DOI: 10.3389/fcvm.2022.1016452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
Background Skeletal muscle (SkM) phenotypic switching is associated with exercise intolerance in heart failure with preserved ejection fraction (HFpEF). Patients with HFpEF have decreased type-1 oxidative fibers and mitochondrial dysfunction, indicative of impaired oxidative capacity. The SAUNA (SAlty drinking water/Unilateral Nephrectomy/Aldosterone) mice are commonly used in HFpEF pre-clinical studies and demonstrate cardiac, lung, kidney, and white adipose tissue impairments. However, the SkM (specifically the oxidative-predominant, soleus muscle) has not been described in this preclinical HFpEF model. We sought to characterize the soleus skeletal muscle in the HFpEF SAUNA mice and investigate its translational potential. Methods HFpEF was induced in mice by uninephrectomy, d-aldosterone or saline (Sham) infusion by osmotic pump implantation, and 1% NaCl drinking water was given for 4 weeks. Mice were euthanized, and the oxidative-predominant soleus muscle was collected. We examined fiber composition, fiber cross-sectional area, capillary density, and fibrosis. Molecular analyses were also performed. To investigate the clinical relevance of this model, the oxidative-predominant, vastus lateralis muscle from patients with HFpEF was biopsied and examined for molecular changes in mitochondrial oxidative phosphorylation, vasculature, fibrosis, and inflammation. Results Histological analyses demonstrated a reduction in the abundance of oxidative fibers, type-2A fiber atrophy, decreased capillary density, and increased fibrotic area in the soleus muscle of HFpEF mice compared to Sham. Expression of targets of interest such as a reduction in mitochondrial oxidative-phosphorylation genes, increased VEGF-α and an elevated inflammatory response was also seen. The histological and molecular changes in HFpEF mice are consistent and comparable with changes seen in the oxidative-predominant SkM of patients with HFpEF. Conclusion The HFpEF SAUNA model recapitulates the SkM phenotypic switching seen in HFpEF patients. This model is suitable and relevant to study SkM phenotypic switching in HFpEF.
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Affiliation(s)
- Eng Leng Saw
- Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, United States
| | - Louis Dominic Werner
- Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, United States
| | - Payman Zamani
- Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
| | - Julio A. Chirinos
- Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
| | - María Valero-Muñoz
- Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, United States
| | - Flora Sam
- Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, United States,Eli Lilly and Co, Indianapolis, IND, United States,*Correspondence: Flora Sam,
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25
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Sinclair AJ, Abdelhafiz AH. Multimorbidity, Frailty and Diabetes in Older People-Identifying Interrelationships and Outcomes. J Pers Med 2022; 12:1911. [PMID: 36422087 PMCID: PMC9695437 DOI: 10.3390/jpm12111911] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 08/11/2023] Open
Abstract
Multimorbidity and frailty are highly prevalent in older people with diabetes. This high prevalence is likely due to a combination of ageing and diabetes-related complications and other diabetes-associated comorbidities. Both multimorbidity and frailty are associated with a wide range of adverse outcomes in older people with diabetes, which are proportionally related to the number of morbidities and to the severity of frailty. Although, the multimorbidity pattern or cluster of morbidities that have the most adverse effect are not yet well defined, it appears that mental health disorders enhance the multimorbidity-related adverse outcomes. Therefore, comprehensive diabetes guidelines that incorporate a holistic approach that includes screening and management of mental health disorders such as depression is required. The adverse outcomes predicted by multimorbidity and frailty appear to be similar and include an increased risk of health care utilisation, disability and mortality. The differential effect of one condition on outcomes, independent of the other, still needs future exploration. In addition, prospective clinical trials are required to investigate whether interventions to reduce multimorbidity and frailty both separately and in combination would improve clinical outcomes.
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Affiliation(s)
- Alan J. Sinclair
- Foundation for Diabetes Research in Older People (fDROP), King’s College, London WC2R 2LS, UK
- Rotherham General Hospital Foundation Trust, Rotherham S60 2UD, UK
| | - Ahmed H. Abdelhafiz
- Foundation for Diabetes Research in Older People (fDROP), King’s College, London WC2R 2LS, UK
- Department of Geriatric Medicine, Rotherham General Hospital, Rotherham S60 2UD, UK
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26
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Choi JH, Kim HR, Song KH. Musculoskeletal complications in patients with diabetes mellitus. Korean J Intern Med 2022; 37:1099-1110. [PMID: 36300322 PMCID: PMC9666255 DOI: 10.3904/kjim.2022.168] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/16/2022] [Indexed: 11/27/2022] Open
Abstract
Musculoskeletal conditions are common in patients with diabetes. Several musculoskeletal disorders are viewed as chronic complications of diabetes because epidemiological studies have revealed high correlations between such complications and diabetes, but the pathophysiological links with diabetes remains unclear. Genetic predispositions, shared risk factors, microvascular impairments, progressive accumulation of advanced glycation end-products, and diabetic neuropathy may underlie the development of musculoskeletal disorders. Musculoskeletal complications of diabetics have received less attention than life-threatening microvascular or macrovascular complications. Here, we review several diabetic musculoskeletal complications with a focus on the clinical importance of early recognition and management, which would improve quality of life and physical function.
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Affiliation(s)
- Jong Han Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Konkuk University School of Medicine, Seoul,
Korea
| | - Hae-Rim Kim
- Division of Rheumatology, Department of Internal Medicine, Konkuk University School of Medicine, Seoul,
Korea
| | - Kee-Ho Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Konkuk University School of Medicine, Seoul,
Korea
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27
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The Genetic Variability of Members of the SLC38 Family of Amino Acid Transporters ( SLC38A3, SLC38A7 and SLC38A9) Affects Susceptibility to Type 2 Diabetes and Vascular Complications. Nutrients 2022; 14:nu14214440. [PMID: 36364703 PMCID: PMC9654215 DOI: 10.3390/nu14214440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 01/25/2023] Open
Abstract
Type 2 Diabetes (T2D) is a metabolic disease associated with long-term complications, with a multifactorial pathogenesis related to the interplay between genetic and modifiable risk factors, of which nutrition is the most relevant. In particular, the importance of proteins and constitutive amino acids (AAs) in disease susceptibility is emerging. The ability to sense and respond to changes in AA supplies is mediated by complex networks, of which AA transporters (AATs) are crucial components acting also as sensors of AA availability. This study explored the associations between polymorphisms in selected AATs genes and T2D and vascular complications in 433 patients and 506 healthy controls. Analyses revealed significant association of SLC38A3-rs1858828 with disease risk. Stratification of patients based on presence/absence of vascular complications highlighted significant associations of SLC7A8-rs3783436 and SLC38A7-rs9806843 with diabetic retinopathy. Additionally, the SLC38A9-rs4865615 resulted associated with chronic kidney disease. Notably, these genes function as AAs sensors, specifically glutamine, leucine, and arginine, linked to the main nutrient signaling pathway mammalian target of rapamycin complex 1 (mTORC1). Thus, their genetic variability may contribute to T2D by influencing the ability to properly transduce a signal activating mTORC1 in response to AA availability. In this scenario, the contribution of dietary AAs supply to disease risk may be relevant.
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28
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Park CH, Yoon KJ, Lee YT, Jin SM, Lee SH, Kim TH. Impact of Low Skeletal Muscle Mass and Obesity on Hearing Loss in Asymptomatic Individuals: A Population-Based Study. Healthcare (Basel) 2022; 10:healthcare10102022. [PMID: 36292469 PMCID: PMC9601859 DOI: 10.3390/healthcare10102022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/01/2022] [Accepted: 10/11/2022] [Indexed: 11/04/2022] Open
Abstract
The relationship between low muscle mass (LMM) with obesity and hearing loss has been poorly studied. We aimed to investigate the association of LMM and obesity on hearing loss in the general population. A total of 265,792 adults who underwent a hearing test and body composition analyses were included. Pre-sarcopenia was defined as having an appendicular muscle mass index <5.7 kg/m2 for women and <7.0 kg/m2 for men, and obesity as a body mass index ≥25 kg/m2, while pre-sarcopenic obesity was defined as the co-presence of LMM and obesity. Participants were divided into four groups according to the presence of pre-sarcopenia and/or obesity. The prevalence of hearing loss was 1.8% in the control, 2.5% in the pre-sarcopenia alone, 3.0% in the obesity alone, and 6.2% in the pre-sarcopenic obesity group (p < 0.001). Hearing Thresholds were the highest in the pre-sarcopenic obesity group compared with the other three groups. In multivariable-adjusted models, the risk of hearing loss was the highest in the pre-sarcopenic obesity group (odds ratio: 1.30 [95% confidence interval: 1.10−1.56]), followed by the obesity alone (1.20 [1.12−1.28]) and pre-sarcopenia alone (1.19 [1.06−1.34]) group compared with the control group (p < 0.001). Pre-sarcopenic obesity was independently associated with a higher prevalence of hearing loss, supporting pre-sarcopenic obesity itself as a risk for the decline in hearing function.
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Affiliation(s)
- Chul-Hyun Park
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
| | - Kyung Jae Yoon
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
| | - Yong-Taek Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
| | - Sung Min Jin
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
| | - Sang Hyuk Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
| | - Tae Hwan Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
- Correspondence: ; Tel.: +82-2-3410-3579
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29
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González-Martos R, Aparicio-Ugarriza R, Alcazar J, Ramirez-Castillejo C, Reihmane D, Menéndez-Rey A, González-Gross M, Guadalupe-Grau A. Circulating Sestrins and Force Velocity Profiling in Older Adults with Type 2 Diabetes. Eur J Sport Sci 2022:1-10. [PMID: 35876123 DOI: 10.1080/17461391.2022.2106158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ABSTRACTType 2 diabetes mellitus (T2DM) in old age affects the musculoskeletal system causing loss of muscle mass, strength, and physical function. Stress-inducible proteins named sestrins are potential novel biomarkers of muscle function due to their ability to suppress oxidative stress and prevent muscle degeneration. Our aim was to determine the association between different force-velocity (F-V) profiles with body composition, physical performance, and glucose control in older adults with T2DM. We also intended to determine the potential utility of sestrin 1 (Sesn1) and 2 (Sesn2) as biomarkers of physical functionality. Fifty-nine participants (69-79 years) were classified in 3 groups according to their F-V profile based on the leg press exercise: nondeficit (NDEF = 40.7%), force deficit (FDEF = 28.8%), and velocity deficit (VDEF = 30.5%). Both VDEF and FDEF groups showed lower muscle power than NDEF (Cohen's d 0.87 and 0.75 for effect size, respectively). Serum Sesn2 levels, maximal dynamic strength, arms and legs fat-free mass were reduced in FDEF compared to the NDEF group (p < 0.05), whereas glycated hemoglobin (HbA1c) and fasting glucose levels were similar among groups. ROC analysis revealed the distinction between the NDEF and FDEF group based on Sesn2 concentrations (<0.72 ng/mL), suggesting their potential use as functional biomarkers for early intervention through exercise. Older adults with T2DM show different F-V profiles, related to low levels of Sesn2, impaired body composition and physical performance, and may be taken into consideration to target exercise training in this specific population.
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Affiliation(s)
- Raquel González-Martos
- ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Madrid, 28040, Spain.,Cancer Stem Cell Research Group. Department of Biotechnology-Vegetal Biology. Centro de Tecnología Biomédica. Universidad Politécnica de Madrid. Madrid, 28223, Spain.,GENUD Toledo Research Group, Universidad Castilla-La Mancha. Toledo, 45071, Spain
| | - Raquel Aparicio-Ugarriza
- ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Madrid, 28040, Spain.,CIBER of Biomedical Research Networking Center on Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII). Madrid, 28222, Spain
| | - Julian Alcazar
- GENUD Toledo Research Group, Universidad Castilla-La Mancha. Toledo, 45071, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, ISCIII. Madrid, 28222, Spain
| | - Carmen Ramirez-Castillejo
- Cancer Stem Cell Research Group. Department of Biotechnology-Vegetal Biology. Centro de Tecnología Biomédica. Universidad Politécnica de Madrid. Madrid, 28223, Spain
| | - Dace Reihmane
- Department of Human Physiology and Biochemistry, Riga Stradiņš University. Riga, LV-1007, Latvia
| | - Adrian Menéndez-Rey
- Cancer Stem Cell Research Group. Department of Biotechnology-Vegetal Biology. Centro de Tecnología Biomédica. Universidad Politécnica de Madrid. Madrid, 28223, Spain
| | - Marcela González-Gross
- ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Madrid, 28040, Spain.,CIBER of Biomedical Research Networking Center on Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII). Madrid, 28222, Spain
| | - Amelia Guadalupe-Grau
- ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Madrid, 28040, Spain.,GENUD Toledo Research Group, Universidad Castilla-La Mancha. Toledo, 45071, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, ISCIII. Madrid, 28222, Spain
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Zhao D, Shi W, Bi L, Qi Y, Hu S, Li C, Zhang Y, Zheng X. Effect of short-term acute moderate-intensity resistance exercise on blood glucose in older patients with type 2 diabetes mellitus and sarcopenia. Geriatr Gerontol Int 2022; 22:653-659. [PMID: 35841217 DOI: 10.1111/ggi.14437] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 06/02/2022] [Accepted: 06/14/2022] [Indexed: 11/28/2022]
Abstract
AIM To investigate the effects of short-term acute moderate-intensity resistance exercise on blood glucose in older patients with type 2 diabetes mellitus and sarcopenia using ambulatory glucose monitoring technology. METHODS This is a prospective intervention of an own-controlled before-and-after cohort study. A total of 24 older type 2 diabetes mellitus patients who met the enrollment criteria were selected, including 12 cases in the sarcopenia and 12 in the non-sarcopenia groups. First, they wore ambulatory glucose monitoring devices (Medtronic, Ipro2) and retained baseline data. Then they wore Ipro2 again and carried out two sessions of resistance exercise on alternate days. Blood glucose level, blood glucose fluctuation, and time in target range on the contrast and exercise days were compared and analyzed in both groups. RESULTS The area under the curve of glucose level across 24 h and the mean blood glucose post exercise decreased (P < 0.05) in the sarcopenia group. On the exercise day, the coefficient of variation of glucose, the largest amplitude of glycemic excursions, amplitude of postprandial glucose excursions and low blood glucose index decreased, whereas the time in target range increased (P < 0.05). CONCLUSIONS Short-term acute moderate-intensity resistance exercise is an effective and safe exercise modality, which can reduce blood glucose levels, blood glucose fluctuations and the risk of hypoglycemia, as well as improve the time in target range for older patients with type 2 diabetes mellitus and sarcopenia. Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Dan Zhao
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Wenli Shi
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Lina Bi
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Yanyan Qi
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Su Hu
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Chang Li
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Yan Zhang
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Xin Zheng
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
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Qiu S, Cai X, Yuan Y, Xie B, Sun Z, Wu T. Is imaging-based muscle quantity associated with risk of diabetes? A meta-analysis of cohort studies. Diabetes Res Clin Pract 2022; 189:109939. [PMID: 35662615 DOI: 10.1016/j.diabres.2022.109939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/01/2022] [Accepted: 05/30/2022] [Indexed: 11/03/2022]
Abstract
AIMS Greater muscle quantity (muscle mass and area) is associated with better glycemic control in adults, but its longitudinal association with risk of diabetes remains debatable. We therefore conducted this meta-analysis to address this issue. METHODS We performed a literature search and included cohort studies that measured muscle quantity objectively by imaging-based approaches and reported their association with risk of diabetes. Study-specific data were pooled using a random-effects model. RESULTS Thirty-three unique datasets, with 10 on total muscle quantity, and 23 on regional (8 on appendicular, 4 on leg, 6 on thigh, and 5 on abdominal) muscle quantity, were included. Muscle quantity was all measured by dual energy x-ray absorptiometry or computed tomography. Most datasets revealed nonsignificant outcomes. Meta-analysis showed collectively that the risk of diabetes was not related to total or regional muscle quantity in either normalized or unnormalized form, with the hazard ratios ranged from 0.92 to 1.09 per every 1 standard deviation higher of corresponding muscle quantity in general (all P > 0.10). Neither sex nor weight status affected the relationship. CONCLUSIONS Our study did not provide adequate evidence to support the concept that large muscle quantity was associated with low risk of diabetes in population-based cohort studies.
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Affiliation(s)
- Shanhu Qiu
- Department of General Practice, Zhongda Hospital, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China; Research and Education Centre of General Practice, Zhongda Hospital, Southeast University, Nanjing, China; The First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, China(1)
| | - Xue Cai
- Department of Nursing Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yang Yuan
- Department of Endocrinology, Zhongda Hospital; Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Bo Xie
- Department of General Practice, Zhongda Hospital, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China; Research and Education Centre of General Practice, Zhongda Hospital, Southeast University, Nanjing, China.
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital; Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China.
| | - Tongzhi Wu
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia
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Argyropoulou D, Geladas ND, Nomikos T, Paschalis V. Exercise and Nutrition Strategies for Combating Sarcopenia and Type 2 Diabetes Mellitus in Older Adults. J Funct Morphol Kinesiol 2022; 7:48. [PMID: 35736019 PMCID: PMC9225431 DOI: 10.3390/jfmk7020048] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022] Open
Abstract
Medical and technology development have drastically the improved quality of life and, consequently, life expectancy. Nevertheless, the more people who enter the third-age, the more geriatric syndromes expand in the elderly. Sarcopenia and Type 2 diabetes mellitus (T2DM) are common diseases among the elderly and the literature has extensively studied these two diseases separately. Recent evidence, however, revealed that there is a bidirectional relationship between sarcopenia and T2DM. The aims of the present review were: (1) to present diet and exercise interventions for the management of sarcopenia and T2DM and (2) identify which diet and exercise interventions can be used simultaneously in order to effectively deal with these two disorders. Exercise and a balanced diet are used as effective countermeasures for combating sarcopenia and T2DM in older adults based on their bidirectional relationship. Lifestyle changes such as exercise and a balanced diet seem to play an important role in the remission of the diseases. Results showed that chronic exercise can help towards glycemic regulation as well as decrease the incidence rate of muscle degradation, while diet interventions which focus on protein or amino acids seem to successfully treat both disorders. Despite the fact that there are limited studies that deal with both disorders, it seems that a combined exercise regime (aerobic and resistance) along with protein intake > 1gr/kg/d is the safest strategy to follow in order to manage sarcopenia and T2DM concurrently.
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Affiliation(s)
- Dionysia Argyropoulou
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (D.A.); (N.D.G.)
| | - Nikolaos D. Geladas
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (D.A.); (N.D.G.)
| | - Tzortzis Nomikos
- Department of Nutrition and Dietetics, Harokopio University, 17676 Athens, Greece;
| | - Vassilis Paschalis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (D.A.); (N.D.G.)
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Tan S, Gunendi Z, Meray J, Yetkin İ. The evaluation of muscle strength and architecture in type 1 diabetes mellitus: a cross-sectional study. BMC Endocr Disord 2022; 22:153. [PMID: 35668406 PMCID: PMC9172182 DOI: 10.1186/s12902-022-01062-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 02/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The aim of this study is to compare muscle strength and architecture between type 1 diabetes patients and healthy volunteers and to assess whether there is an ultrasonographic structural change in this population. METHODS Thirty-two patients with T1D (23 female, 9 male) with an age average of 31.3 ± 8.7 years, matched in terms of age, gender, height, weight and physical activity were included in the study. In the T1D and control group, ultrasonographic measurements of quadriceps femoris muscle (RF, VI, VM, VL) and pennate angle (VI, VM, VL) were performed. Muscle strength values were measured using isokinetic dynamometer system at angular velocities of 60º/s and 180º/s in both groups. RESULTS Initially, both groups were similar in demographic and clinical characteristics (p > 0.05). In the T1D group, there was a statistically significant difference in flexion/extension peak torque measurements at an angular velocity of 60º/s compared to the control group (p < 0.05). In support of these isokinetic measurements, RF, VI, VM, VL muscle thicknesses and VI, VM pennate angle measurements in T1Ds were significantly lower (p < 0.05). When the T1D group was subgrouped according to HbA1C and diabetes duration, there was no significant difference in ultrasonographic and isokinetic measurements between the two groups (p > 0.05). When the T1D group was subgrouped, in the group that used insulin pump RF, VI, VM muscle thickness measurements were significantly higher (p < 0.05) than the group using subcutaneous insulin. CONCLUSIONS This study supports that muscle strength and architecture are adversely affected in the T1D patient group, insulin deficiency is a risk factor for sarcopenia and this can be shown through ultrasonography. It can also be said that insulin pump use has more positive effects in terms of diabetic myopathy than subcutaneous insulin, and diabetic myopathy develops independently of other diabetic complications. As a result, the muscle architecture of T1D people is adversely affected by insulin deprivation, so regular physical activity should be an integral part of diabetes treatment.
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Affiliation(s)
- Sefa Tan
- Department of Physical Medicine and Rehabilitation, Polatli Duatepe State Hospital, Ankara, Turkey.
| | - Zafer Gunendi
- Department of Physical Medicine and Rehabilitation, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Jale Meray
- Department of Physical Medicine and Rehabilitation, Gazi University Faculty of Medicine, Ankara, Turkey
| | - İlhan Yetkin
- Department of Endocrinology, Gazi University Faculty of Medicine, Ankara, Turkey
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Fu J, Sun L, Mu Z, Xiu S. Free fatty acids are associated with muscle dysfunction in Chinese adults with type 2 diabetes. Endocrine 2022; 77:41-47. [PMID: 35438440 DOI: 10.1007/s12020-022-03053-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 04/04/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Muscle dysfunction is considered a sign of poor prognosis in patients with type 2 diabetes (T2D). Thus, early detection of muscle disorders is particularly important in the T2D population. Free fatty acids (FFAs) are clinical indicators of metabolic diseases and muscle function; hence, we aimed to investigate the association between FFAs and muscle function. METHODS A total of 160 adult subjects with T2D were characterized and analyzed in this study. Muscle mass and function were measured by walking speed, grip strength and height-adjusted appendicular skeletal muscle mass (ASMM). Partial correlation was applied to explore the correlations between FFAs and muscle indicators. Receiver operating characteristic (ROC) curves were utilized to determine the diagnostic value of FFAs in muscle mass and function. RESULTS The FFAs levels were negatively correlated with ASMM (r = -0.347, P = 1.0E-05), grip strength (r = -0.313, P = 7.1E-05) and walking speed (r = -0.167, P = 0.039). Notably, the relationships between FFAs levels and ASMM and walking speed remained significant even after adjusting for age, sex, body mass index (BMI), diabetes duration, and hemoglobin A1C (HbA1c). The combination of conventional indicators, including age, BMI, and HbA1c levels, provided a discrimination of low grip strength with an AUC of 0.648, and low walking speed with an AUC of 0.714. Importantly, when FFAs levels were added to the model, the value of the ROC curve was further improved, with an AUC of 0.785 for low grip strength and 0.755 for low walking speed. CONCLUSIONS The current study demonstrated a negative correlation between FFAs and muscle indicators in adult patients with T2D after adjusting for HbA1c levels. FFAs may play an important role in the pathological processes of muscle dysfunction in adults with T2D.
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Affiliation(s)
- Junling Fu
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Lina Sun
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Zhijing Mu
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Shuangling Xiu
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
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Tan NC, Sankari U, Ng CE, Koh YLE. Longitudinal study on the progression of muscle status among community-dwelling ambulatory older multiethnic Asians with type 2 diabetes mellitus. BMC Geriatr 2022; 22:446. [PMID: 35597919 PMCID: PMC9122804 DOI: 10.1186/s12877-022-03098-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Muscle health decline with age, but its deterioration in older persons with type-2 diabetes mellitus (T2DM) over time is not well-established. This study aimed to determine the change in muscle mass, handgrip strength and gait speed over time among community-dwelling ambulatory older multi-ethnic Asian patients with T2DM and their associated factors. METHODS Among 387 eligible patients aged 60-89 years who were recruited at baseline, 348 (89.9%) were reviewed at a public primary care clinic in Singapore in the subsequent 9 to 34 months. The change in their clinical and functional status, levels of physical activity and muscle status (mass, grip strength and gait speed based on the Asian Working Group for Sarcopenia criteria) were recorded and compared. Their physical activity levels were assessed using the Physical Activity Scale for the Elderly (PASE) and International Physical Activity Questionnaire (IPAQ). Their quality of life was evaluated based on the World Health Organization Quality of Life (WHOQOL) domains. Linear regression analysis was used to identify the factors associated with muscle health change. RESULTS The study population comprised men (52.9%), Chinese (69.3%), mean age of 68.4 ± SD5.6 years and had at least secondary education (76.4%). Their mean muscle mass significantly decreased by 0.03 ± SD0.06 kg/m2/month, mean handgrip strength by 0.06 ± SD0.26 kg/month and negligible change in gait speed of 0.002 ± SD0.01 m/sec/month. Their mean weight significantly decreased by 0.5 ± SD3.9 kg, waist and hip circumferences by 2.5 ± SD6cm and 3.2 ± SD5.1 cm respectively, with no change in BMI. Linear regression shows significant associations between muscle mass change and education level (β = 0.36,p = 0.012, 95% CI = 0.08-0.64), BMI (β = 0.11,p = < 0.001, 95% CI = 0.05-0.17), change in medication class (β = 0.39,p = < 0.001, 95% CI = 0.06-0.71) and review interval (β = - 0.003, p < 0.001, 95% CI = -0.004--0.002). Gait speed change was associated with singlehood (β = - 0.13,p = 0.029, 95% CI = -0.25--0.01) and WHOQOL physical health (β = 0.01,p = 0.024, 95% CI = 0.00-0.02) domain. No factor was associated with handgrip strength change. CONCLUSIONS The study population with T2DM showed significant decline in their mean weight, waist and hip circumferences, mean muscle mass and mean grip strength but gait speed was unaffected. Muscle mass change was associated with education level, BMI and length of review interval. Handgrip strength change was not significantly correlated with any factor. Gait speed change was associated with singlehood and physical health.
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Affiliation(s)
- Ngiap Chuan Tan
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One Tower 5 #15-10, Singapore, 150167, Singapore. .,Duke NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
| | - Usha Sankari
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One Tower 5 #15-10, Singapore, 150167, Singapore
| | - Chiat Eng Ng
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One Tower 5 #15-10, Singapore, 150167, Singapore
| | - Yi Ling Eileen Koh
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One Tower 5 #15-10, Singapore, 150167, Singapore
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Low S, Wang J, Moh A, Ang SF, Ang K, Shao YM, Ching J, Wee HN, Lee LS, Kovalik JP, Tang WE, Lim Z, Subramaniam T, Sum CF, Lim SC. Amino acid profile of skeletal muscle loss in type 2 diabetes: Results from a 7-year longitudinal study in asians. Diabetes Res Clin Pract 2022; 186:109803. [PMID: 35218850 DOI: 10.1016/j.diabres.2022.109803] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/19/2022] [Accepted: 02/19/2022] [Indexed: 12/20/2022]
Abstract
AIMS Little is known about pathophysiology of sarcopenia in diabetes. We aimed to study amino acid profile associated with skeletal muscle mass loss longitudinally in Type 2 Diabetes Mellitus (T2DM). METHODS This is a prospective study of 1140 patients aged 56.6 ± 10.6 years from the SMART2D cohort. Skeletal muscle mass was measured using bio-impedance analysis at baseline and follow-up. Amino acids were measured by mass spectrometry. RESULTS Over a period of up to 7.9 years, 43.9% experienced skeletal muscle mass loss. Lower baseline valine, leucine and isoleucine levels were associated with decreased skeletal muscle mass index (SMI) with corresponding coefficient 0.251(95 %CI 0.009 to 0.493), 0.298(95 %CI 0.051 to 0.544)) and 0.366(95 %CI 0.131 to 0.600). Higher baseline valine, leucine, isoleucine, alanine and tryptophan levels were associated with reduced odds of muscle mass loss with corresponding odds ratio (OR)0.797 (95 %CI 0.690 to 0.921), 0.825 (95 %CI 0.713 to 0.955), 0.826 (95 %CI 0.718-0.950), 0.847 (95 %CI 0.739-0.969) and 0.835 (95 %CI 0.720-0.979). CONCLUSION The branched-chain amino acids valine, leucine and isoleucine were positively associated with change in SMI and reduced odds of muscle mass loss longitudinally. Further studies should be conducted to elucidate the pathophysiological mechanisms underlying the relationship between these amino acids and muscle mass loss in T2DM.
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Affiliation(s)
- Serena Low
- Diabetes Centre, Admiralty Medical Centre, Singapore; Clinical Research Unit, Khoo Teck Puat Hospital, Singapore; Lee Kong Chian School of Medicine, Singapore
| | - Jiexun Wang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Angela Moh
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Su Fen Ang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Keven Ang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Yi-Ming Shao
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Jianhong Ching
- Duke-NUS Medical School, Singapore; KK Research Centre, KK Women's and Children's Hospital, Singapore
| | | | | | | | - Wern Ee Tang
- National Healthcare Group Polyclinics, Singapore
| | - Ziliang Lim
- National Healthcare Group Polyclinics, Singapore
| | | | - Chee Fang Sum
- Diabetes Centre, Admiralty Medical Centre, Singapore
| | - Su Chi Lim
- Diabetes Centre, Admiralty Medical Centre, Singapore; Clinical Research Unit, Khoo Teck Puat Hospital, Singapore; Lee Kong Chian School of Medicine, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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Bell KE, Paris MT, Avrutin E, Mourtzakis M. Altered features of body composition in older adults with type 2 diabetes and prediabetes compared with matched controls. J Cachexia Sarcopenia Muscle 2022; 13:1087-1099. [PMID: 35174664 PMCID: PMC8978006 DOI: 10.1002/jcsm.12957] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/08/2021] [Accepted: 02/01/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Ageing is accompanied by muscle loss and fat gain, which may elevate the risk of type 2 diabetes (T2D). However, there is a paucity of data on the distribution of regional lean and fat tissue in older adults with T2D or prediabetes compared with healthy controls. The objective of this study was to compare regional body composition [by dual-energy x-ray absorptiometry (DXA)], muscle and subcutaneous adipose tissue (SAT) thicknesses (by ultrasound), and ultrasound-based muscle texture features in older adults with T2D or prediabetes compared with normoglycaemic controls. METHODS Eighteen adults > 60 years with T2D or prediabetes (T2D group) were individually matched to normoglycaemic participants [healthy matched (HM) group] for age (±5 years), sex, and body fat (±2.5%). In a single study visit, all participants received a whole-body DXA scan and ultrasound assessment of the abdomen and anterior thigh. At these two landmarks, we used ultrasound to measure muscle and SAT thickness, as well as texture features of the rectus femoris and rectus abdominis. We also conducted an exploratory subanalysis on a subset of participants (n = 14/18 in the T2D group and n = 10/18 in the HM group) who underwent additional assessments including strength testing of the knee extensors (using a Biodex dynamometer), and a fasting blood sample for the measurement of circulating markers of glucose metabolism [glucose, insulin, c-peptide, and the homoeostatic model assessment of insulin resistance (HOMA-IR)]. RESULTS The T2D group was 72 ± 8 years old (mean ± SD), predominantly male (n = 15/18; 83%), and overweight (BMI: 27.8 ± 4.2 kg/m2 , 33.2 ± 5.3% body fat). DXA-derived upper arm lean mass was 0.4 kg greater (P = 0.034), and leg fat mass was 1.4 kg lower (P = 0.048), in the T2D vs. HM group. Ultrasound-based texture features were distinct between the groups [rectus abdominis blob size: 0.07 ± 0.06 vs. 0.30 ± 0.43 cm2 , P = 0.045; rectus femoris local binary pattern (LBP) entropy: 4.65 ± 0.05 vs. 4.59 ± 0.08 A.U., P = 0.007]. When all participants who underwent additional assessments were pooled (n = 24), we observed that certain ultrasound-based muscle texture features correlated significantly with muscle strength (rectus abdominis histogram skew vs. power during an isokinetic contraction at 60°/s: r = 0.601, P = 0.003) and insulin resistance (rectus femoris LBP entropy vs. HOMA-IR: r = 0.419, P = 0.042). CONCLUSIONS Our findings suggest a novel body composition phenotype specific to older adults with T2D or prediabetes. We are also the first to report that ultrasound-based texture features correspond with functional outcomes. Future larger scale studies are needed to uncover the mechanisms underpinning these regional body composition differences.
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Affiliation(s)
- Kirsten E Bell
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Michael T Paris
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Egor Avrutin
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Marina Mourtzakis
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Filgueiras JR, Sales CP, da Silva IG, Dos Santos CM, Neto EDCM, da Rocha RB, Cardoso VS. Morphological and functional changes in skeletal muscle in type 2 diabetes mellitus: A systematic review and meta-analysis. Physiother Theory Pract 2022:1-27. [PMID: 35345979 DOI: 10.1080/09593985.2022.2057375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Changes in the skeletal muscle are common in patients with type 2 diabetes mellitus (T2DM). These changes impair your motor skills. OBJECTIVE This systematic review aimed to investigate changes in skeletal muscle in patients with T2DM. METHODS The search was carried out in the PubMed, Scopus, and Web of Science databases until December 1, 2021. Observational studies that evaluated musculoskeletal changes in people with T2DM were included. The review was based on PRISMA recommendations. The primary parameters analyzed were muscle strength, muscle mass, muscle power, and muscle endurance. RESULTS Forty-eight studies were included, with a total of 26,042 participants. The results revealed that T2DM is associated with a reduction in handgrip [-2.64 (CI 95% = -3.33 to -1.95, Z = -7.50, p < .0001], and knee extension muscle strength [-0.56 (CI 95% = -0.76 to -0.36, Z = -5.64, p < .0001)], a higher percentage of type II fibers [11.74 (CI 95% = 6.24 to 17.25, Z = 4.18, p < .0001)], and a lower percentage of type I fibers [-15.69 (CI 95% = -18.22 to -13.16, Z = -12.16, p < .0001], in addition to a greater thickness of the calcaneus tendon (p < .0001). CONCLUSION Individuals with T2DM present skeletal muscle impairments, mainly reduced muscle strength, mass, and endurance; increase in the thickness of the calcaneus tendon, and alteration in the proportion of type I and II fibers, even in the initial stage of the disease.
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Affiliation(s)
- Jardeson Rocha Filgueiras
- BioSignal Laboratory, School of Physical Therapy, Parnaiba Delta Federal University (UFDPar). Av. São Sebastião, Parnaíba-Piauí, Brazil
| | - Cleudiane Pereira Sales
- BioSignal Laboratory, School of Physical Therapy, Parnaiba Delta Federal University (UFDPar). Av. São Sebastião, Parnaíba-Piauí, Brazil
| | - Ivanilson Gomes da Silva
- BioSignal Laboratory, School of Physical Therapy, Parnaiba Delta Federal University (UFDPar). Av. São Sebastião, Parnaíba-Piauí, Brazil
| | - Cristiana Maria Dos Santos
- BioSignal Laboratory, School of Physical Therapy, Parnaiba Delta Federal University (UFDPar). Av. São Sebastião, Parnaíba-Piauí, Brazil.,Postgraduate Program in Biomedical Sciences, Parnaiba Delta Federal University (UFDPar). Av. São Sebastião, Parnaíba-Piauí, Brazil
| | | | | | - Vinicius Saura Cardoso
- BioSignal Laboratory, School of Physical Therapy, Parnaiba Delta Federal University (UFDPar). Av. São Sebastião, Parnaíba-Piauí, Brazil.,Postgraduate Program in Biomedical Sciences, Parnaiba Delta Federal University (UFDPar). Av. São Sebastião, Parnaíba-Piauí, Brazil.,Center of Medical Specialties. Av. Capitão Claro, Parnaíba-Piauí, Brazil
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Katsuhara S, Yokomoto-Umakoshi M, Umakoshi H, Matsuda Y, Iwahashi N, Kaneko H, Ogata M, Fukumoto T, Terada E, Sakamoto R, Ogawa Y. Impact of Cortisol on Reduction in Muscle Strength and Mass: A Mendelian Randomization Study. J Clin Endocrinol Metab 2022; 107:e1477-e1487. [PMID: 34850018 DOI: 10.1210/clinem/dgab862] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Indexed: 01/11/2023]
Abstract
CONTEXT Prolonged exposure to pathological cortisol, as in Cushing's syndrome causes various age-related disorders, including sarcopenia. However, it is unclear whether mild cortisol excess, for example, accelerates sarcopenia due to aging or chronic stress. OBJECTIVE We used Mendelian randomization (MR) analysis to assess whether cortisol was causally associated with muscle strength and mass. METHODS Three single-nucleotide polymorphisms associated with plasma cortisol concentrations in the CORtisol NETwork consortium (n = 12 597) were used as instrumental variables. Summary statistics with traits of interest were obtained from relevant genome-wide association studies. For the primary analysis, we used the fixed-effects inverse-variance weighted analysis accounting for genetic correlations between variants. RESULTS One SD increase in cortisol was associated with SD reduction in grip strength (estimate, -0.032; 95% CI -0.044 to -0.020; P = 3e-04), whole-body lean mass (estimate, -0.032; 95% CI, -0.046 to -0.017; P = 0.004), and appendicular lean mass (estimate, -0.031; 95% CI, -0.049 to -0.012; P = 0.001). The results were supported by the weighted-median analysis, with no evidence of pleiotropy in the MR-Egger analysis. The association of cortisol with grip strength and lean mass was observed in women but not in men. The association was attenuated after adjusting for fasting glucose in the multivariable MR analysis, which was the top mediator for the association in the MR Bayesian model averaging analysis. CONCLUSION This MR study provides evidence for the association of cortisol with reduced muscle strength and mass, suggesting the impact of cortisol on the development of sarcopenia.
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Affiliation(s)
- Shunsuke Katsuhara
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Maki Yokomoto-Umakoshi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hironobu Umakoshi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yayoi Matsuda
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Norifusa Iwahashi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroki Kaneko
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masatoshi Ogata
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tazuru Fukumoto
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eriko Terada
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryuichi Sakamoto
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Ogawa
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Picca A, Coelho-Junior HJ, Calvani R, Marzetti E, Vetrano DL. Biomarkers shared by frailty and sarcopenia in older adults: A systematic review and meta-analysis. Ageing Res Rev 2022; 73:101530. [PMID: 34839041 DOI: 10.1016/j.arr.2021.101530] [Citation(s) in RCA: 177] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/04/2021] [Accepted: 11/21/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Physical frailty and sarcopenia show extensive clinical similarities. Whether biomarkers exist that are shared by the two conditions is presently unclear. METHODS We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association of frailty and/or sarcopenia with biomarkers as a primary or secondary outcome in adults aged 60 years and older. Only studies published in English that defined frailty using a validated scale and/or questionnaire and diagnosed sarcopenia according to the presence of muscle atrophy plus dynapenia or low physical function were included. Studies were identified from a systematic search of MEDLINE and SCOPUS databases from inception through August 2020. The quality of reporting of each study was assessed by using the Quality Assessment Tool for Observational Cohort, Cross-Sectional and Case-Control studies of the National Institute of Health. A meta-analysis was conducted when at least three studies investigated the same biomarker in both frailty and sarcopenia. Pooled effect size was calculated based on standard mean differences and random-effect models. Sensitivity analysis was performed based on age and the setting where the study was conducted. RESULTS Eighty studies (58 on frailty and 22 on sarcopenia) met the inclusion criteria and were included in the qualitative analysis. Studies on frailty included 33,160 community-dwellers, hospitalized, or institutionalized older adults (60-88 years) from 21 countries. Studies on sarcopenia involved 4904 community-living and institutionalized older adults (68-87.6 years) from 9 countries. Several metabolic, inflammatory, and hematologic markers were found to be shared between the two conditions. Albumin and hemoglobin were negatively associated with both frailty and sarcopenia. Interleukin 6 was associated with frailty and sarcopenia only in people aged < 75. Community-dwelling older adults with frailty and sarcopenia had higher levels of tumor necrosis factor alpha compared with their robust and non-sarcopenic counterparts. CONCLUSIONS A set of metabolic, hematologic, and inflammatory biomarkers was found to be shared by frailty and sarcopenia. These findings fill a knowledge gap in the quest of biomarkers for these conditions and provide a rationale for biomarker selection in studies on frailty and sarcopenia.
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Affiliation(s)
- Anna Picca
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | | | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Department of Geriatrics and Orthopedics, Rome, Italy
| | - Davide Liborio Vetrano
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Chen LY, Xia MF, Wu L, Li Q, Hu Y, Ma H, Gao X, Lin HD. Skeletal muscle loss is associated with diabetes in middle-aged and older Chinese men without non-alcoholic fatty liver disease. World J Diabetes 2021; 12:2119-2129. [PMID: 35047125 PMCID: PMC8696641 DOI: 10.4239/wjd.v12.i12.2119] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/05/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Skeletal muscle, a key insulin target organ, has been reported to be associated with diabetes mellitus (DM). Compared to non-diabetic patients, diabetic patients have decreased muscle mass and a higher prevalence of sarcopenia, and patients with sarcopenia may be at increased risk of developing diabetes. In individuals with nonalcoholic fatty liver disease (NAFLD), sarcopenia is associated with the severity of fibrosis and steatosis. Previous studies have demonstrated that NAFLD is strongly associated with DM and sarcopenia.
AIM To determine the relationship between skeletal muscle mass and DM in Chinese middle-aged and elderly men, and whether the association is affected by NAFLD.
METHODS Skeletal muscle mass was calculated as appendicular skeletal muscle mass (ASM) in kg/body weight × 100%. Liver fat content (LFC) was measured using a quantitative ultrasound method.
RESULTS As the ASM decreased, fasting blood glucose (FBG), 2-h postprandial blood glucose (2hBG), and LFC increased in both genders, as did the prevalence of DM and NAFLD. Spearman analysis showed that the ASM was negatively correlated with the FBG, 2hBG, and LFC. Stepwise logistic regression analysis showed that after adjustments, the ASM quartile was negatively associated with the presence of DM in males, but not in females. Subgroup analysis showed that the ASM quartiles remained negatively correlated with the presence of DM in the non-NAFLD population (including males and females), but no correlation was found between ASM quartiles and the presence of DM in the NAFLD population. When stratified by LFC quartiles, ASM was negatively correlated with the presence of DM in the first and second LFC quartiles in males.
CONCLUSION Skeletal muscle mass loss was shown to be associated with the presence of DM in males, but not in females; NAFLD weakens this association. The results suggested that the stratified management of diabetes mellitus should be considered according to skeletal muscle mass and NAFLD.
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Affiliation(s)
- Ling-Yan Chen
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Ming-Feng Xia
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Li Wu
- Fudan Institute for Metabolic Diseases, Shanghai 200032, China
| | - Qian Li
- Fudan Institute for Metabolic Diseases, Shanghai 200032, China
| | - Yu Hu
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Hui Ma
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Xin Gao
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Huan-Dong Lin
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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Mu ZJ, Fu JL, Sun LN, Chan P, Xiu SL. Associations between homocysteine, inflammatory cytokines and sarcopenia in Chinese older adults with type 2 diabetes. BMC Geriatr 2021; 21:692. [PMID: 34911470 PMCID: PMC8672561 DOI: 10.1186/s12877-021-02622-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 11/08/2021] [Indexed: 01/06/2023] Open
Abstract
Background Sarcopenia, an age-related disease, has been implicated as both a cause and consequence of type 2 diabetes mellitus (T2DM) and a symbol of poor prognosis in older adults with T2DM. Therefore, early detection and effective treatment of sarcopenia are particularly important in older adults with T2DM. We aimed to investigate the prevalence of sarcopenia in Chinese older T2DM patients and explore whether homocysteine and inflammatory indexes could serve as biomarkers and participate in the development process of sarcopenia. Methods T2DM patients aged over 60 years were consecutively recruited from the ward of department of Endocrinology, Xuanwu Hospital between April 2017 and April 2019. Sarcopenia was defined based on the standard of the Asian Working Group of Sarcopenia, including muscle mass, grip strength and gait speed. Logistic regression was used to explore the association between biochemical indicators and sarcopenia. Receiver operating characteristic (ROC) curves were applied to determine the diagnostic effect of these clinical indicators. Results Totally 582 older adults with T2DM were characterized and analyzed in the study. Approximately 8.9% of the older T2DM patients had sarcopenia. After adjusting for age, sex, body mass index (BMI) and hemoglobin A1c (HbA1c), increased concentrations of homocysteine [odds ratio (OR): 2.829; 95% confidence interval (CI), 1.064–7.525] and high-sensitive C-reactive protein (hs-CRP) (OR: 1.021; 95% CI, 1.001–1.042) were independent predictors of sarcopenia; but not interleukin-6. The combination of age, sex, BMI and HbA1c provided a discriminatory effect of sarcopenia with an area under the curve (AUC) of 0.856, when homocysteine was added to the model, the value of the ROC curve was further improved, with an AUC of 0.861. Conclusion In the current study, we demonstrated a positive correlation of homocysteine, hs-CRP with sarcopenia in older adults with T2DM and the relationship remained significant even after adjustment for HbA1c. These biomarkers (homocysteine and hs-CRP) may play important roles in the pathological process of sarcopenia.
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Affiliation(s)
- Zhi-Jing Mu
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Jun-Ling Fu
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Li-Na Sun
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Piu Chan
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, 100053, China. .,Clinical Center for Parkinson's Disease, Capital Medical University, Beijing, China. .,Key Laboratory for Neurodegenerative Disease of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China. .,National Clinical Research Center for Geriatric Disorders, Beijing, China. .,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Shuang-Ling Xiu
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
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Taha M, AlNaam YA, Al Maqati T, Almusallam L, Altalib G, Alowfi D, Haider N. Impact of muscle mass on blood glucose level. J Basic Clin Physiol Pharmacol 2021; 33:779-787. [PMID: 34856088 DOI: 10.1515/jbcpp-2021-0316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/09/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES At present, diabetes is one of the leading causes of mortality across the world. It was hypothesized that muscle mass could have a significant influence on blood glucose level and this corelation if established successfully could pave way for novel treatment modalities for type 2 diabetes mellitus (T2DM). In the present study, the association between muscle mass and blood glucose level was examined in a healthy population who was not having T2DM at baseline and was undergoing a regular course of exercise. METHODS The clinical study was performed involving 53 healthy male populations between 10 and 60 years of age. The participants were sampled in accordance with the quantitative experimental study design, using nonprobability sampling techniques. The independent variable measured among the subjects included muscle mass and blood glucose level, using bioelectrical impedance and a simple glucometer respectively. Subgroup analysis amongst different substantial parameters including body mass index (BMI), myostatin inhibitor usage, and age factor that could affect the muscle mass and glucose level correlation were also studied simultaneously. RESULTS The study findings demonstrated a negative correlation between muscle mass and glucose utilization levels. There was a significant difference in the mean muscle mass of the participants which was 36.2453, and the mean glucose utilization level which was 15.1493%. Pearson correlation between the muscle mass and percentage of glucose utilization of the participants indicated a significant difference (since p-value <0.05) between these two studied parameters. CONCLUSIONS The study finding suggests an inverse association of the skeletal muscle mass with blood glucose level which encourages the implication of muscle-building exercises as the preventive measure for T2DM.
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Affiliation(s)
- Murtada Taha
- Department of Clinical Laboratory Science, Prince Sultan Military College of Health Sciences, Dhahran, Kingdom of Saudi Arabia
| | - Yaser A AlNaam
- Department of Clinical Laboratory Science, Prince Sultan Military College of Health Sciences, Dhahran, Kingdom of Saudi Arabia
| | - Thekra Al Maqati
- Department of Clinical Laboratory Science, Prince Sultan Military College of Health Sciences, Dhahran, Kingdom of Saudi Arabia
| | - Lenah Almusallam
- Department of Clinical Laboratory Science, Prince Sultan Military College of Health Sciences, Dhahran, Kingdom of Saudi Arabia
| | - Gharam Altalib
- Department of Clinical Laboratory Science, Prince Sultan Military College of Health Sciences, Dhahran, Kingdom of Saudi Arabia
| | - Deema Alowfi
- Department of Clinical Laboratory Science, Prince Sultan Military College of Health Sciences, Dhahran, Kingdom of Saudi Arabia
| | - Nafish Haider
- Basic Medical Science Unit, Prince Sultan Military College of Health Sciences, Dhahran, Kingdom of Saudi Arabia
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Tilves C, Zmuda JM, Kuipers AL, Nair S, Carr JJ, Terry JG, Peddada S, Wheeler V, Miljkovic I. Relative associations of abdominal and thigh compositions with cardiometabolic diseases in African Caribbean men. Obes Sci Pract 2021; 7:738-750. [PMID: 34877013 PMCID: PMC8633926 DOI: 10.1002/osp4.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 04/16/2021] [Accepted: 05/02/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Regional body compositions are differentially associated with cardiometabolic risk factors. Simultaneous inclusion of both upper and lower body composition predictors in models is not often done, and studies which do include both measures (1) tend to exclude some tissue(s) of potential metabolic relevance, and (2) have used study populations with underrepresentation of individuals with African ancestries. Further, most body composition analyses do not employ compositional data analytic approaches, which may result in spurious associations. OBJECTIVE The objective of this analysis was to assess associations of abdominal and thigh adipose (AT) and muscle tissues with hypertension and type 2 diabetes using compositional data analytic methods. RESEARCH DESIGN AND METHODS This cross-sectional analysis included 610 African Caribbean men (median age: 62 years; mean BMI: 27.8 kg/m2). Abdominal (three components: subcutaneous [ASAT] and visceral [VAT] AT, 'other' abdominal tissue) and mid-thigh (four components: subcutaneous and intermuscular AT, muscle, bone) compositions were measured by computed tomography; additive log ratio transformations were applied to each composition. Regression models were used to simultaneously assess associations of abdominal and thigh component ratios with continuous risk factors (blood pressures, fasting glucose and insulin, HOMA-IR) and disease categories. RESULTS A two-fold increase in ASAT:'Other' ratio was associated with higher continuous risk factors and with odds of being in a higher hypertension (OR: 1.77, 95%CI: 1.10-2.84) or diabetes (OR: 1.81, 95%CI: 1.06-3.10) category. A two-fold increased VAT ratio was only associated with higher log-insulin and log-HOMA-IR (β = 0.10, p < 0.05 for both), while a two-fold increased thigh muscle:bone ratio was associated with a lower diabetes category (OR: 0.37, 95%CI: 0.14-1.01). CONCLUSIONS These findings support ASAT as a significant driver of cardiometabolic disease in African Ancestry populations, independent of other abdominal and thigh tissues.
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Affiliation(s)
- Curtis Tilves
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Joseph M. Zmuda
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Allison L. Kuipers
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Sangeeta Nair
- Department of RadiologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - John Jeffrey Carr
- Department of RadiologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - James G. Terry
- Department of RadiologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Shyamal Peddada
- Department of BiostatisticsUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Victor Wheeler
- Tobago Health Studies OfficeScarboroughTobagoTrinidad and Tobago
| | - Iva Miljkovic
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
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Tey SL, Huynh DTT, Berde Y, Baggs G, How CH, Low YL, Cheong M, Chow WL, Tan NC, Chew STH. Prevalence of low muscle mass and associated factors in community-dwelling older adults in Singapore. Sci Rep 2021; 11:23071. [PMID: 34845250 PMCID: PMC8630119 DOI: 10.1038/s41598-021-02274-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 11/08/2021] [Indexed: 12/25/2022] Open
Abstract
The population is rapidly aging worldwide, and there is an age-related decline in muscle mass. Therefore, it is important to examine the prevalence and associated factors of low appendicular skeletal muscle mass index (ASMI) in older adults. The objectives of this cross-sectional study were (i) to determine the prevalence of low ASMI (ASM/height2) and (ii) to identify factors associated with low ASMI. This study included 1211 community-dwelling adults aged ≥ 65 years. Low ASMI was defined as < 7.0 kg/m2 in males and < 5.7 kg/m2 in females (bioelectrical impedance analysis). Gender-specific cut-off values of calf circumference for low ASMI were determined. The prevalence of low ASMI in the overall cohort was 59.9%, i.e., 57.0% among males and 61.8% among females, with no significant difference between genders (P = 0.1068). The prevalence of low ASMI was 81.3% in individuals at risk of malnutrition compared to 20.6% in their counterparts with normal nutritional status (P < 0.0001). Participants with low ASMI were older, had lower physical activity scores, and greater likelihood of hospitalization in prior 6 months compared with normal ASMI (all P < 0.0001). Low ASMI was associated with risk of malnutrition (odds ratio: 3.58 for medium risk, odds ratio: 12.50 for high risk), older age, smoking, drinking, smaller calf circumference, and lower bone mass (all P ≤ 0.0328). Cut-off values of calf circumference for low ASMI for males was 33.4 cm and for females was 32.2 cm. In conclusion, we found that low ASMI was highly prevalent among community-dwelling older adults at risk of malnutrition. Other significant factors associated with low ASMI were age, smoking, drinking, calf circumference, and bone mass. Screening community-dwelling older adults for risk of malnutrition can prevent or delay onset of low ASMI.
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Affiliation(s)
- Siew Ling Tey
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore, 138668, Singapore.
| | - Dieu Thi Thu Huynh
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore, 138668, Singapore
| | - Yatin Berde
- Statistical Services, Cognizant Technologies Solution Pvt. Ltd., Mumbai, India
| | - Geraldine Baggs
- Abbott Nutrition Research and Development, Columbus, OH, 43219, USA
| | - Choon How How
- Care and Health Integration, Changi General Hospital, Singapore, 529889, Singapore.,SingHealth-Duke NUS Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, 169857, Singapore
| | - Yen Ling Low
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore, 138668, Singapore
| | - Magdalin Cheong
- Department of Dietetic & Food Services, Changi General Hospital, Singapore, 529889, Singapore
| | - Wai Leng Chow
- Health Services Research, Changi General Hospital, Singapore, 529889, Singapore
| | - Ngiap Chuan Tan
- SingHealth-Duke NUS Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, 169857, Singapore.,SingHealth Polyclinics, Singapore, 150167, Singapore
| | - Samuel Teong Huang Chew
- Department of Geriatric Medicine, Changi General Hospital, Singapore, 529889, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
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Song BK, Kim GH, Kim JW, Lefferts EC, Brellenthin AG, Lee DC, Kim YM, Kim MK, Choi BY, Kim YS. Association Between Relative Quadriceps Strength and Type 2 Diabetes Mellitus in Older Adults: The Yangpyeong Cohort of the Korean Genome and Epidemiology Study. J Phys Act Health 2021; 18:1539-1546. [PMID: 34697251 DOI: 10.1123/jpah.2021-0361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/06/2021] [Accepted: 08/25/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND To examine the independent and combined association between relative quadriceps strength and the prevalence of type 2 diabetes mellitus (T2DM) in older adults. METHODS Among 1441 Korean older adults aged ≥65 years (71 [4.7] y) recruited between 2007 and 2016, 1055 older adults with no history of myocardial infarction, stroke, or cancer were included in the analysis. Cases of T2DM were identified by self-reported physician diagnosis, use antihyperglycemic medication or insulin, or fasting blood glucose ≥126 mg/dL. Logistic regression was used to calculate the odds ratios and 95% confidence intervals of T2DM by quartiles of relative quadriceps strength. RESULTS There were 162 T2DM cases (15%). Compared with the lowest quartile (weakest), the odds ratios (95% confidence intervals) of T2DM were 0.56 (0.34-0.90), 0.60 (0.37-0.96), and 0.47 (0.28-0.80) in the second, third, and fourth quartiles, respectively, after adjusting for possible confounders, including body mass index. In the joint analysis, compared with the "weak and overweight/obese" group, the odds (odds ratios [95% confidence intervals]) of T2DM was only lower in the "strong and normal weight" group (0.36 [0.22-0.60]) after adjusting for possible confounders. CONCLUSIONS Greater relative quadriceps strength is associated with reduced odds of T2DM in older adults after adjusting for potential confounders including body mass index.
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Wang P, Liu Y, Zhang T, Yin C, Kang SY, Kim SJ, Park YK, Jung HW. Effects of Root Extract of Morinda officinalis in Mice with High-Fat-Diet/Streptozotocin-Induced Diabetes and C2C12 Myoblast Differentiation. ACS OMEGA 2021; 6:26959-26968. [PMID: 34693116 PMCID: PMC8529596 DOI: 10.1021/acsomega.1c03372] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/29/2021] [Indexed: 05/15/2023]
Abstract
Type 2 diabetes is the most common type of diabetes and causes a decline in muscle quality. In this study, we investigated the effects of the root extract of Morinda officinalis (MORE) on skeletal muscle damage in mice with high-fat-diet (HFD)/streptozotocin (STZ)-induced diabetes and the expression of myogenic and biogenesis regulatory proteins in C2C12 myoblast differentiation. An in vivo model comprised C57BL/6N mice fed HFD for 8 weeks, followed by a single injection of STZ at 120 mg/kg. MORE was administered at 100 and 200 mg/kg once daily (p.o.) for 4 weeks. The changes in body weight, calorie intake, and serum levels of glucose, insulin, total cholesterol (TCHO), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), aspartate transaminase (AST), and alanine aminotransferase (ALT) were investigated in diabetic mice. The histological changes in the gastrocnemius muscle were observed by H&E staining, and then the myofiber size was measured. The expression of the myogenic (MHC, myogenin, and MyoD) and biogenesis (PGC-1α, SIRT1, NRF1, and TFAM) regulatory proteins was examined in the muscle tissues and differentiated C2C12 myoblasts by Western blot, respectively. The administration of MORE at 200 mg/kg in mice with HFD/STZ-induced diabetes significantly reduced weight gains, calorie intake, insulin resistance, and serum levels of glucose, TCHO, LDL-C, AST, and ALT. MORE administration at 100 and 200 mg/kg significantly increased serum insulin and HDL-C levels in diabetic mice. In addition, MORE significantly increased the expression of MHC, myogenin, MyoD, PGC-1α, SIRT1, NRF1, and TFAM in muscle tissues as well as increased the myofiber size in diabetic mice. In C2C12 myoblast differentiation, MORE treatment at 0.5, 1, and 2 mg/mL significantly increased the expression of myogenic and biogenesis regulatory proteins in a dose-dependent manner. MORE improves diabetes symptoms in mice with HFD/STZ-induced diabetes by improving muscle function. This suggests that MORE could be used to prevent or treat diabetes along with muscle disorders.
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Affiliation(s)
- Piao Wang
- Department
of Herbology, College of Korean Medicine, Dongguk University, 38066 Gyeongju, Korea
| | - Yi Liu
- Department
of Herbology, College of Korean Medicine, Dongguk University, 38066 Gyeongju, Korea
| | - Tong Zhang
- Department
of Herbology, College of Korean Medicine, Dongguk University, 38066 Gyeongju, Korea
| | - Cheng Yin
- Department
of Herbology, College of Korean Medicine, Dongguk University, 38066 Gyeongju, Korea
| | - Seok Yong Kang
- Korean
Medicine R&D Center, Dongguk University, 38066 Gyeongju, Korea
| | - Su Jin Kim
- Department
of Anesthesiology and Pain Medicine, College of Medicine, Dongguk University, 38066 Gyeongju, Korea
| | - Yong-Ki Park
- Department
of Herbology, College of Korean Medicine, Dongguk University, 38066 Gyeongju, Korea
- Korean
Medicine R&D Center, Dongguk University, 38066 Gyeongju, Korea
| | - Hyo Won Jung
- Department
of Herbology, College of Korean Medicine, Dongguk University, 38066 Gyeongju, Korea
- Korean
Medicine R&D Center, Dongguk University, 38066 Gyeongju, Korea
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Tiainen K, Raitanen J, Strandberg T, Koskinen S, Stenholm S. Type 2 Diabetes as a Predictor of Muscle Strength Decline over 11 years among Men and Women Aged 55 Years and Older. Gerontology 2021; 68:635-643. [PMID: 34818235 DOI: 10.1159/000518268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 07/04/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Long-term associations between type 2 diabetes, prediabetes, and muscle strength are obscure in older adults. The aim of this study was to examine type 2 diabetes as a predictor of handgrip strength decline during an 11-year follow-up among men and women aged 55 years. METHODS We used Finnish population-based Health 2000 Survey and its follow-up measurements in 2011. The study population consisted of 1,200 individuals, aged 55-86 years at baseline. Baseline fasting glucose level or use of diabetes medication was used to categorize the participants into diabetes (≥7.0 mmol/L), prediabetes (≥6.1 mmol/L but <7.0 mmol/L), and nondiabetes (<6.1 mmol/L) groups. Handgrip strength was measured at baseline and during 11-year follow-up. RESULTS Mean handgrip strength at baseline did not differ between diabetes groups in men or women. Among men during the 11-year follow-up, decline in muscle strength was significantly greater among diabetes group (-131.5 Newtons [N], 95% confidence interval (CI) -182.7 to -80.4) than nondiabetes group (-98.9 N, 95% CI -139.5 to -58.3) after adjusting for age, education, lifestyle factors, chronic conditions, and diabetes status at follow-up. Among women, muscle strength decline did not differ between diabetes, prediabetes, or nondiabetes groups after adjusting for all potential covariates, the results being -45.0 N (95% CI -73.2 to -16.7), -29.4 N (95% CI -59.7 to 0.9), and -42.3 N (95% CI -70.5 to -14.1), respectively. CONCLUSIONS The presence of type 2 diabetes was associated with greater muscle strength decline among older men but not among older women.
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Affiliation(s)
- Kristina Tiainen
- Faculty of Social Sciences, Unit of Health Sciences and Gerontology Research Center, Tampere University, Tampere, Finland
| | - Jani Raitanen
- Faculty of Social Sciences, Unit of Health Sciences and Gerontology Research Center, Tampere University, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Timo Strandberg
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Clinicum, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Seppo Koskinen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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O'Reilly CL, Uranga S, Fluckey JD. Culprits or consequences: Understanding the metabolic dysregulation of muscle in diabetes. World J Biol Chem 2021; 12:70-86. [PMID: 34630911 PMCID: PMC8473417 DOI: 10.4331/wjbc.v12.i5.70] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/21/2021] [Accepted: 08/03/2021] [Indexed: 02/06/2023] Open
Abstract
The prevalence of type 2 diabetes (T2D) continues to rise despite the amount of research dedicated to finding the culprits of this debilitating disease. Skeletal muscle is arguably the most important contributor to glucose disposal making it a clear target in insulin resistance and T2D research. Within skeletal muscle there is a clear link to metabolic dysregulation during the progression of T2D but the determination of culprits vs consequences of the disease has been elusive. Emerging evidence in skeletal muscle implicates influential cross talk between a key anabolic regulatory protein, the mammalian target of rapamycin (mTOR) and its associated complexes (mTORC1 and mTORC2), and the well-described canonical signaling for insulin-stimulated glucose uptake. This new understanding of cellular signaling crosstalk has blurred the lines of what is a culprit and what is a consequence with regard to insulin resistance. Here, we briefly review the most recent understanding of insulin signaling in skeletal muscle, and how anabolic responses favoring anabolism directly impact cellular glucose disposal. This review highlights key cross-over interactions between protein and glucose regulatory pathways and the implications this may have for the design of new therapeutic targets for the control of glucoregulatory function in skeletal muscle.
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Affiliation(s)
| | - Selina Uranga
- Health and Kinesiology, Texas A&M University, TX 77843, United States
| | - James D Fluckey
- Health and Kinesiology, Texas A&M University, TX 77843, United States
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Synergic association of diabetes mellitus and chronic kidney disease with muscle loss and cachexia: results of a 16-year longitudinal follow-up of a community-based prospective cohort study. Aging (Albany NY) 2021; 13:21941-21961. [PMID: 34528898 PMCID: PMC8507303 DOI: 10.18632/aging.203539] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/31/2021] [Indexed: 12/17/2022]
Abstract
Muscle loss is a serious complication in patients with diabetes mellitus (DM) and chronic kidney disease (CKD). However, studies on a long-term change in muscle mass presence or absence of DM and CKD are scarce. We included 6247 middle-aged adults from the Korean Genome and Epidemiology Study (KoGES) between 2001 and 2016. Bioimpedance analysis (BIA) was performed biennially. Patients were classified into four groups according to the presence or absence of DM and CKD. The primary outcome was muscle depletion, which was defined as a decline in fat-free mass index (FFMI) below the 10th percentile of all subjects. The secondary outcomes included the occurrence of cachexia, all-cause mortality, and the slopes of changes in fat-free mass and weight. During 73,059 person-years of follow-up, muscle depletion and cachexia occurred in 460 (7.4%) and 210 (3.4%), respectively. In the multivariable cause-specific hazards model, the risk of muscle depletion was significantly higher in subjects with DM alone than in those without DM and CKD (HR, 1.37; 95% CI, 1.04-1.80) and was strongly pronounced in subjects with both conditions (HR, 3.38; 95% CI, 1.30-8.75). The secondary outcome analysis showed consistent results. The annual decline rates in FFMI, fat mass, and body mass index (BMI) were the steepest in subjects with DM and CKD among the four groups. DM and CKD are synergically associated with muscle loss over time. In addition, the mortality risk is higher in individuals with muscle loss.
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