Association between Muscle Mass and Body Mass Index in Elderly Diabetic Patients Attending Tertiary Care Center in Bangalore, India
DOI:
https://doi.org/10.5195/ijms.2016.159Keywords:
Anthropometry, ; Sarcopenia, Obesity, Diabetes Mellitus, Body Mass IndexAbstract
Background: Sarcopenia is a disorder causing age-related loss of muscle mass. Its multifaceted nature has been linked to an increased risk of disability and mortality. Equally, obesity is a well-known risk factor for a host of disorders. A combination of sarcopenia and obesity in elderly diabetics can synergistically lead to increased insulin resistance and risk of metabolic syndrome. This study aimed to identify the association between sarcopenia and obesity in elderly diabetic patients by a cost-effective anthropometric method.
Methods: A case-control study was conducted from January 2016 to April 2016 at Dr. B. R. Ambedkar Medical College in Bangalore. Height, weight, mid-arm circumference, and triceps skin fold thickness of 112 diabetic patients and 131 healthy adults were measured. Descriptive statistical analysis and multiple linear regression analysis were carried out.
Results: 26.8% of male and 76.8% of female diabetic patients were obese (body mass index ?25 kg/m2). Incidence of sarcopenia (muscle mass one standard deviation smaller than healthy reference population, cut-off value for diabetic males being <9.79 kg/m2 and for diabetic females <8.53 kg/m2) were 12.5% in male diabetic patients and 5.4% in female diabetic patients.
Conclusion: Sarcopenia and obesity are co-morbid illnesses which can cause functional and metabolic impairments in elderly diabetic patients. There exists a moderate association between muscle mass and body mass index. Loss of muscle strength (dynapenia), rather than loss of muscle mass (sarcopenia), is closely associated with disabilities in these patients.
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References
2. Jain A, Paranjape S. Prevalence of type 2 diabetes mellitus in elderly in a primary care facility: an ideal facility. Indian J Endocrinol Metab. 2013 Oct;17(Suppl1): S318-22.
3. Stenholm S, Harris TB, Rantanen T, Visser M, Kritchevsky SB, Ferrucci L. Sarcopenic obesity: definition, cause and consequences. Curr Opin Clin Nutr Metab Care. 2008 Nov;11(6):693-700.
4. Srikanthan P, Hevener AL, Karlamangla AS. Sarcopenia exacerbates obe¬sity-associated insulin resistance and dysglycemia: findings from the Na¬tional Health and Nutrition Examination Survey III. PLoS One. 2010 May 26;5(5):e10805.
5. Kuriyan R, Krupad AV. Prediction of total body mass from simple an¬thropometric measurements in young Indian males. Indian J Med Res. 2004 Mar;119(3):121-8.
6. Heymsfield SB, McMannus C, Smith J, Stevens V, Niscon DW. Anthropo¬metric measurement of muscle mass: revised equations for calculating bo¬ne-free arm muscle area. Am J Clin Nutr. 1982 Oct;36(4):680-90.
7. Villani AM, Crotty M, Cameron ID, Kurrle SE, Skuza PP, Cleland LG, et al. Appendicular skeletal muscle in hospitalised hip-fracture patients: develo¬pment and cross-validation of anthropometric prediction equations against dual-energy X-ray absorptiometry. Age Ageing. 2014 Nov;43(6):857-62.
8. Snehalatha C, Viswanathan V, Ramachandran A. Cutoff values for nor¬mal anthropometric variables in asian Indian adults. Diabetes Care. 2003 May;26(5):1380-4.
9. McIntosh EI, Smale KB, Vallis LA. Predicting fat-free mass index and sarco¬penia: a pilot study in community-dwelling older adults. Age (Dordr). 2013 Dec;35(6):2423-34.
10. Yu S, Appleton S, Chapman I, Adams R, Wittert G, Visvanathan T, et al. An anthropometric prediction equation for appendicular skeletal muscle mass in combination with a measure of muscle function to screen for sarcopenia in primary and aged care. J Am Med Dir Assoc. 2015 Jan;16(1):25-30.
11. Lim S, Kim JH, Yoon JW, Kang SM, Choi SH, Park YJ, et al. Sarcopenic obesity: prevalence and association with metabolic syndrome in the Ko¬rean Longitudinal Study on Health and Aging (KLoSHA). Diabetes Care. 2010
Jul;33(7):1652-4.
12. Han K, Park YM, Kwon HS, Ko SH, Lee SH, Yim HW, et al. Sarcopenia as a determinant of blood pressure in older Koreans: findings from the Korea Na¬tional Health and Nutrition Examination Surveys (KNHANES) 2008-2010. PLoS One. 2014 Jan 29;9(1):e86902.
13. Goodpaster BH, Thaete FL, Simoneau JA, Kelley DE. Subcutaneous abdo¬minal fat and thigh muscle composition predict insulin sensitivity indepen¬dently of visceral fat. Diabetes. 1997 Oct;46(10):1579-85.
14. Ryu M, Jo J, Lee Y, Chung YS, Kim KM, Baek WC. Association of physical activity with sarcopenia and sarcopenic obesity in community-dwelling older adults: the Fourth Korea National Health and Nutrition Examination Survey. Age Ageing. 2013 Nov;42(6):734-40.
15. Unni US, Ramakrishnan G, Raj T, Kishore RP, Thomas T, Vaz M, et al. Mus¬cle mass and functional correlates of insulin sensitivity in lean young Indian men. Eur J Clin Nutr. 2009 Oct;63(10):1206-12.
16. Moon SS. Low skeletal muscle mass is associated with insulin resistance, diabetes, and metabolic syndrome in the Korean population: the Korea Na¬tional Health and Nutrition Examination Survey (KNHANES) 2009-2010. Endocr J. 2014;61(1):61-70.
17. Kim TN, Park MS, Yang SJ, Yoo HJ, Kang HJ, Song W, et al. Prevalence and determinant factors of sarcopenia in patients with type 2 diabetes: the Ko¬rean Sarcopenic Obesity Study (KSOS). Diabetes Care. 2010 Jul;33(7):1497-9.
18. Kalyani RR, Tra Y, Egan JM, Ferrucci L, Brancati F. Hyperglycemia is asso¬ciated with relatively lower lean body mass in older adults. J Nutr Health Aging. 2014;18(8):737-43.
19. Wen X, Wang M, Jiang CM, Zhang YM. Anthropometric equation for esti¬mation of appendicular skeletal muscle mass in Chinese adults. Asia Pac J Clin Nutr. 2011 Jul;20(4):551-6.
20. Lee JS, Auyeung TW, Leung J, Kwok T, Leung PC, Woo J. The effect of dia¬betes mellitus on age-associated lean mass loss in 3153 older adults. Diabet Med. 2010 Dec;27(12):1366-71.
21. Goel K, Gupta N, Misra A, Poddar P, Pandey RM, Vikram NK, et al. Predicti¬ve equations for body fat and abdominal fat With DXA and MRI as reference in Asian Indians. Obesity (Silver Spring). 2008 Feb;16(2):451-6.
22. Lee CC, Glickman SG, Dengel DR, Brown MD, Supiano MA. Abdominal adiposity assessed by dual energy X-ray absorptiometry provides a sex-inde¬pendent predictor of insulin sensitivity in older adults. J Gerontol A Biol Sci Med Sci. 2005 Jul;60(7):872-7.
23. Bijlsma AY, Meskers CG, van Heemst D, Westendorp RG, de Craen AJ, Maier AB. Diagnostic criteria for sarcopenia relate differently to insulin resistance. Age (Dordr). 2013 Dec;35(6):2367-75.
24. Kulkarni B, Kuper H, Taylor A, Wells JC, Radhakrishna KV, Kinra S, et al. Development and validation of anthropometric prediction equations for es¬timation of lean body mass and appendicular lean soft tissue in Indian men and women. J Appl Physiol (1985). 2013 Oct 15;115(8):1156-62.
25. Campbell TM, Vallis LA. Predicting fat-free mass index and sarcopenia in assisted-living older adults. Age (Dordr). 2014 Jul;36(4):9674.
26. Lee CG, Boyko EJ, Barrett-Connor E, Miljkovic I, Hoffman AR, Everson-Rose SA, et al. Insulin sensitizers may attenuate lean mass loss in older men with diabetes. Diabetes Care. 2011 Nov;34(11):2381-6.
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