Decreased muscle strength and thigh muscle area assessed with CT imaging in older Chinese adults with long duration of type 2 diabetes

• Published in: The Journal of nutrition, health & aging Vol. 29; no. 4; p. 100506
• Main Authors: Yuan, Yi, Li, Sidong, Yin, Lu, Su, Yongbin, Guo, Zhe, Liu, Yandong, Blake, Glen M., Wang, Ling, Liu, Yajun, Cheng, Xiaoguang, Engelke, Klaus, Vlug, Annegreet G.
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.04.2025; Elsevier
• Subjects: Aged; Brief Report; China; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - physiopathology; East Asian People; Female; Grip strength; Hand Strength; Humans; Male; Middle Aged; Muscle density; Muscle size; Muscle Strength - physiology; Muscle, Skeletal - diagnostic imaging; Muscle, Skeletal - physiopathology; Sarcopenia - diagnostic imaging; Thigh - diagnostic imaging; Timed up and go test; Tomography, X-Ray Computed; Type 2 diabetes; China; Type 2 diabetes; T2DM; EQ-5D; Timed up and go test; QCT; CTXA; pQCT; TUG; FN; AGEs; DXA; CASH; Muscle size; CSA; CT; OA; TH; HGS; aBMD; BMD; Muscle density; Grip strength; BMI
• ISSN: 1279-7707; 1760-4788; 1760-4788
• DOI: 10.1016/j.jnha.2025.100506

We aimed to compare muscle strength, physical performance, and muscle parameters in non-diabetic and type 2 diabetes mellitus (T2DM) older adults and to determine the association of the duration of diabetes with these outcomes. A cross-sectional study. The China Action on Spine and Hip Status study (CASH). 301 participants enrolled from a subcohort of CASH, of which 114 were diagnosed with well-controlled type 2 diabetes mellitus, We measured physical performance and muscle strength with the timed up-and-go test (TUG) and handgrip strength (HGS) and measured the area and density of the thigh, gluteus and trunk muscles (core muscles) using quantitative CT scans. Participants with long-term (≥10 years) diabetes had a longer TUG (β coefficient: 0.64 [95% CI, 0.06, 1.22]; P = 0.030) and a lower HGS (−2.29 [−4.48, −0.10]; P = 0.041) as well as a lower muscle area of the thigh (−7.10 [−13.44, −0.76]; P = 0.028). The lower HGS among patients with long-term (≥10 years) diabetes was largely mediated by muscle area of the thigh (compared with non-diabetic controls: percentage mediated, 38.3%; P = 0.023; compared with <10 years diabetes: percentage mediated, 51.8%; P = 0.039). Older adults with long-term (≥10 years) diabetes had lower TUG and HGS than either non-diabetic participants, and the difference in HGS was largely mediated by a decrease in muscle area of the thigh muscles. Our finding suggested that long duration of diabetes, even in well-controlled subjects, may be associated with poor physical functions.