Hyperglycemia predicts persistently lower muscle strength with aging

Rita Rastogi Kalyani, E. Metter, Josephine Egan, Sherita H. Golden, Luigi Ferrucci

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

OBJECTIVE: Persons with diabetes have acceleratedmuscle loss compared with their counterparts. The relationship of hyperglycemia per se to declines in muscle function has not been explored yet has implications for developing appropriate intervention strategies to prevent muscle loss.

RESEARCH DESIGN AND METHODS: We examined 984 participants aged 25-96 years in the Baltimore Longitudinal Study of Aging (2003-2011) with HbA1c, knee extensor strength (isokinetic dynamometer), and lean body mass (DEXA) measured at baseline. Participants had repeated measurements up to 7.5 years later.Muscle quality was defined as knee extensor strength/leg lean mass. Participants were categorized by HbA1c quartile (<5.5, 5.5-5.79, 5.8-6.09, and ≥6.1% or <37, 37-40, 40-43, and ≥43 mmol/mol). Mixed-effects regression models were used to examine the regression of muscle outcomes on HbA1c.

RESULTS: Muscle strength and quality were significantly lower across HbA1c quartiles (both P < 0.001), without differences in muscle mass at baseline. Comparing highest versus lowest HbA1c quartiles and adjusting for age, race, sex, weight, and height, strength was significantly lower (-4.70 ± 2.30 N · m; P value trend = 0.02) and results were unchanged after adjustment for physical activity (P value trend = 0.045) but of borderline significance after additional adjustment for peripheral neuropathy (P value trend = 0.05). Adjusting for demographics, muscle quality was significantly lower (-0.32 ± 0.15 N · m/kg; P value trend = 0.02) in the highest versus lowest HbA1c quartiles, but differences were attenuated after adjusting for weight and height (-0.25 ± 0.15 N · m/kg; P value trend = 0.07). Muscle mass measures were similar across HbA1c quartiles.

CONCLUSIONS: Hyperglycemia is associated with persistently lower muscle strength with aging, but this effectmay be mediated, at least in part, by peripheral neuropathy. Future studies should explore if better glycemic control can preserve muscle function in diabetes.

Original languageEnglish (US)
Pages (from-to)82-90
Number of pages9
JournalDiabetes care
Volume38
Issue number1
DOIs
StatePublished - Jan 1 2015

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Muscle Strength
Hyperglycemia
Muscles
Peripheral Nervous System Diseases
Knee
Weights and Measures
Baltimore
Longitudinal Studies
Leg
Demography
Exercise

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Hyperglycemia predicts persistently lower muscle strength with aging. / Kalyani, Rita Rastogi; Metter, E.; Egan, Josephine; Golden, Sherita H.; Ferrucci, Luigi.

In: Diabetes care, Vol. 38, No. 1, 01.01.2015, p. 82-90.

Research output: Contribution to journalArticle

Kalyani, RR, Metter, E, Egan, J, Golden, SH & Ferrucci, L 2015, 'Hyperglycemia predicts persistently lower muscle strength with aging', Diabetes care, vol. 38, no. 1, pp. 82-90. https://doi.org/10.2337/dc14-1166
Kalyani, Rita Rastogi ; Metter, E. ; Egan, Josephine ; Golden, Sherita H. ; Ferrucci, Luigi. / Hyperglycemia predicts persistently lower muscle strength with aging. In: Diabetes care. 2015 ; Vol. 38, No. 1. pp. 82-90.
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N2 - OBJECTIVE: Persons with diabetes have acceleratedmuscle loss compared with their counterparts. The relationship of hyperglycemia per se to declines in muscle function has not been explored yet has implications for developing appropriate intervention strategies to prevent muscle loss.RESEARCH DESIGN AND METHODS: We examined 984 participants aged 25-96 years in the Baltimore Longitudinal Study of Aging (2003-2011) with HbA1c, knee extensor strength (isokinetic dynamometer), and lean body mass (DEXA) measured at baseline. Participants had repeated measurements up to 7.5 years later.Muscle quality was defined as knee extensor strength/leg lean mass. Participants were categorized by HbA1c quartile (<5.5, 5.5-5.79, 5.8-6.09, and ≥6.1% or <37, 37-40, 40-43, and ≥43 mmol/mol). Mixed-effects regression models were used to examine the regression of muscle outcomes on HbA1c.RESULTS: Muscle strength and quality were significantly lower across HbA1c quartiles (both P < 0.001), without differences in muscle mass at baseline. Comparing highest versus lowest HbA1c quartiles and adjusting for age, race, sex, weight, and height, strength was significantly lower (-4.70 ± 2.30 N · m; P value trend = 0.02) and results were unchanged after adjustment for physical activity (P value trend = 0.045) but of borderline significance after additional adjustment for peripheral neuropathy (P value trend = 0.05). Adjusting for demographics, muscle quality was significantly lower (-0.32 ± 0.15 N · m/kg; P value trend = 0.02) in the highest versus lowest HbA1c quartiles, but differences were attenuated after adjusting for weight and height (-0.25 ± 0.15 N · m/kg; P value trend = 0.07). Muscle mass measures were similar across HbA1c quartiles.CONCLUSIONS: Hyperglycemia is associated with persistently lower muscle strength with aging, but this effectmay be mediated, at least in part, by peripheral neuropathy. Future studies should explore if better glycemic control can preserve muscle function in diabetes.

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