More appendicular lean mass relative to body mass index is associated with lower incident diabetes in middle-aged adults in the CARDIA study |
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Affiliation: | 1. Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA;2. Harvard Medical School, Boston, MA, USA;3. Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA;4. Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA;5. School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China;6. Department of Epidemiology, University of Alabama, Birmingham, AL, USA;7. Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA;8. Department of Preventive Medicine, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA |
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Abstract: | Background and aimsAlthough 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 results1893 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.ConclusionAlthough 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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Keywords: | Type 2 diabetes mellitus Diabetes epidemiology Muscle mass DXA" },{" #name" :" keyword" ," $" :{" id" :" kwrd0030" }," $$" :[{" #name" :" text" ," _" :" dual energy x-ray absorptiometry BIA" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040" }," $$" :[{" #name" :" text" ," _" :" bioelectrical impedance analysis MRI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0050" }," $$" :[{" #name" :" text" ," _" :" magnetic resonance imaging CT" },{" #name" :" keyword" ," $" :{" id" :" kwrd0060" }," $$" :[{" #name" :" text" ," _" :" computed tomography ALM/BMI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0070" }," $$" :[{" #name" :" text" ," _" :" appendicular lean mass for body mass index FNIHSP" },{" #name" :" keyword" ," $" :{" id" :" kwrd0080" }," $$" :[{" #name" :" text" ," _" :" Foundation for the National Institutes of Health Sarcopenia Project CARDIA" },{" #name" :" keyword" ," $" :{" id" :" kwrd0090" }," $$" :[{" #name" :" text" ," _" :" Coronary Artery Risk Development in Young Adults |
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