scholarly journals The Relationship of Lean Body Mass With Aging to the Development of Diabetes

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Rita R Kalyani ◽  
E Jeffrey Metter ◽  
Qian-Li Xue ◽  
Josephine M Egan ◽  
Chee W Chia ◽  
...  

Abstract Context Older adults have the greatest burden of diabetes; however, the contribution of age-related muscle loss to its development remains unclear. Objective We assessed the relationship of lean body mass with aging to incident diabetes in community-dwelling adults. Design and Setting We studied participants in the Baltimore Longitudinal Study of Aging with median follow-up of 7 years (range 1-16). Cox proportional hazard models with age as the time scale were used. Time-dependent lean body mass measures were updated at each follow-up visit available. Participants Participants included 871 men and 984 women without diabetes who had  ≥ 1 assessment of body composition using dual x-ray absorptiometry. Main Outcomes Incident diabetes, defined as self-reported history and use of glucose-lowering medications; or fasting plasma glucose ≥ 126 mg/dL and 2-hour oral glucose tolerance test glucose ≥ 200 mg/dL either at the same visit or 2 consecutive visits. Results The baseline mean [standard deviation] age was 58.9  [17.3] years. Men and women with a higher percentage of total lean body mass had lower fasting and 2-hour glucose levels, and less prediabetes (all P < 0.01). Among men, comparing highest versus lowest quartiles, percentage of total lean body mass (hazard ratio [HR],  0.46; 95% confidence interval, 0.22-0.97), percentage leg lean mass (HR, 0.38; 0.15-0.96), and lean-to-fat mass ratio (HR, 0.39; 0.17-0.89) were inversely associated with incident diabetes after accounting for race and attenuated after adjustment for height and weight. Conversely, absolute total lean body mass was positively associated with incident diabetes among women, with similar trends in men. No associations were observed with muscle strength or quality. Conclusions Relatively lower lean body mass with aging is associated with incident diabetes in men and partially related to anthropometrics, but not so in women.

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Bingyang Liu ◽  
Yue Li ◽  
Jiamei Guo ◽  
Yuting Fan ◽  
Ling Li ◽  
...  

Aims. To investigate the influence of body mass index (BMI) and its change from adolescence to adulthood (ΔBMI) on the risk of metabolic syndrome (MetS) in early adulthood. Methods. We selected 931 students from 12 to 16 years of age in Liaoyang City, China. Ninety-three participants from 18 to 22 years of age with complete baseline data were available for follow-up after 5 years. Statistical analysis determined the relationship of MetS at follow-up with baseline BMI (BMIb), ΔBMI, and follow-up BMI (BMIf). Results. ΔBMI was positively correlated with the change of waist circumference (ΔWC), systolic blood pressure (ΔSBP), triglycerides (ΔTG), uric acid, and glycosylated hemoglobin (ΔHbA1c) in follow-up ( p < 0.05 ). For every 1 kg/m2 increase in BMIb, ΔBMI, and BMIf, the risk of MetS at follow-up increased 1.201-fold, 1.406-fold, and 1.579-fold, respectively. Both BMIb and ΔBMI were predictive of MetS at follow-up, with prediction thresholds of 23.47 kg/m2 and 1.95 kg/m2. The participants were divided by the predicted BMIb and ΔBMI threshold values into four study groups. Interestingly, the group with lower BMI but a higher increase in BMI presented the same metabolic derangements and Mets% of the group with higher BMI but lower Δ BMI. Conclusion. Both BMI of adolescence and ΔBMI were predictive of MetS and cardiovascular risk factors in adulthood. Control of both variables in adolescents would be more effective in decreasing the risk of MetS in young adults than control of BMI alone.


2001 ◽  
Vol 86 (3) ◽  
pp. 1020-1025 ◽  
Author(s):  
Martin Brochu ◽  
André Tchernof ◽  
Isabelle J. Dionne ◽  
Cynthia K. Sites ◽  
Georgia H. Eltabbakh ◽  
...  

Although obesity is often associated with insulin resistance and a cluster of metabolic disturbances, the existence of a subgroup of healthy but obese individuals has been postulated. It is unclear why some obese individuals fail to show traditional risk factors associated with the insulin resistance syndrome despite having a very high accumulation of body fat. To address this issue, we identified and studied a subgroup of metabolically normal but obese (MNO) postmenopausal women to gain insight into potential physiological factors that may protect them against the development of obesity-related comorbidities. We carefully examined the metabolic characteristics of 43 obese, sedentary postmenopausal women (mean ± sd, 58.0± 6.0 yr). Subjects were classified as MNO or as metabolically abnormal obese (MAO) based on an accepted cut-point for insulin sensitivity (measured by the hyperinsulinemic/euglycemic clamp technique). Thereafter, we determined 1) body composition (fat mass and lean body mass), 2) body fat distribution (abdominal visceral and sc adipose tissue areas, midthigh sc adipose tissue and muscle attenuation), 3) plasma lipid-lipoprotein levels, 4) plasma glucose and insulin concentrations, 5) resting blood pressure, 6) peak oxygen consumption, 7) physical activity energy expenditure, and 8) age-related onset of obesity with a questionnaire as potential modulators of differences in the risk profile. We identified 17 MNO subjects who displayed high insulin sensitivity (11.2 ± 2.6 mg/min·kg lean body mass) and 26 MAO subjects with lower insulin sensitivity (5.7 ± 1.1 mg/min·kg lean body mass). Despite comparable total body fatness between groups (45.2 ± 5.3% vs. 44.8 ± 6.6%; P = NS), MNO individuals had 49% less visceral adipose tissue than MAO subjects (141 ± 53 vs. 211 ± 85 cm2; P &lt; 0.01). No difference was noted between groups for abdominal sc adipose tissue (453 ± 126 vs. 442 ± 144 cm2; P = NS), total fat mass (38.1 ± 10.6 vs. 40.0 ± 11.8 kg), muscle attenuation (42.2± 2.6 vs. 43.6 ± 4.8 Houndsfield units), and physical activity energy expenditure (1060 ± 323 vs. 1045 ± 331 Cal/day). MNO subjects had lower fasting plasma glucose and insulin concentrations and lower insulin levels during the oral glucose tolerance test (P values ranging between 0.01–0.001). No difference was observed between groups for 2-h glucose levels and glucose area during the oral glucose tolerance test. MNO subjects showed lower plasma triglycerides and higher high density lipoprotein cholesterol concentrations than MAO individuals (P &lt; 0.01 in both cases). Results from the questionnaire indicated that 48% of the MNO women presented an early onset of obesity (&lt;20 yr old) compared with 29% of the MAO subjects (P = 0.09). Stepwise regression analysis showed that visceral adipose tissue and the age-related onset of obesity explained 22% and 13%, respectively, of the variance observed in insulin sensitivity (total r2 = 0.35; P &lt; 0.05 in both cases). Our results support the existence of a subgroup of obese but metabolically normal postmenopausal women who display high levels of insulin sensitivity despite having a high accumulation of body fat. This metabolically normal profile is associated with a lower accumulation of visceral adipose tissue and an earlier age-related onset of obesity.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Nandakumar Mooppil ◽  
Seema Aithal ◽  
Tripti Singh ◽  
Rajiva Ibakkanavar

Abstract Background and Aims Studies have suggested that higher lean body mass (LBM) is associated with increased longevity among haemodialysis (HD) patients. It has been shown that creatinine index is a surrogate marker of lean body mass and can be estimated using a simplified equation based on age, gender, serum creatinine and KT/V(sp). The present study was conducted to investigate the association between estimated creatinine index and all-cause mortality in a large racially diverse cohort of incident HD patients. We also examined the relationship between creatinine index and hospitalisation incidence in this cohort. Method Incident patients (aged≥18 years) between January, 2010 and December, 2018 who survived six months of HD were included in this retrospective observational study. Baseline demographic data was collected at study commencement, followed by clinical and laboratory data during the 6 month exposure period. Patients were followed from the index date (last day of exposure period) until first of the following – death, withdrawal or end of study (June 30, 2019). The exposure of interest was Creatinine Index (CI) estimated using a simplified formula (Canaud et al 2014) based on patient demographics (age and gender), pre-dialysis serum creatinine and KT/V(sp). Patients were stratified into 4 groups based on CI quartiles - Q1(&lt;=17.48), Q2(17.49-18.91), Q3(18.92-20.54) and Q4(20.55+). Primary outcome was all-cause mortality during the overall follow-up. Adjusted hazard ratios were estimated using a Cox regression model for association between CI quartiles and mortality. Negative binomial regression models were used to assess the relationship between CI quartiles and hospitalisation. Results A total of 3172 incident HD patients (mean age 60.4±11.5 years, 56.2% male, 57.4% Chinese and 70.4% with diabetes as cause of ESRD) were included in the study. During the median follow-up of 2.8 (1.4-4.7) years, 755 (23.8%) patients died. The mean creatinine index for entire cohort was 19.1±2.3 mg/kg/day. The patients in the lowest CI quartile (Q1) were older, females, had higher incidence of diabetes and comorbidity but lower levels of albumin, haemoglobin, BMI and SGA scores compared to higher quartiles (p&lt;0.001). Following multivariate analysis the adjusted hazard of death were as follows - Q4 (aHR-1, reference), Q1 (aHR-2.14, 95%CI 1.56-2.94), Q2 (aHR-1.58, 95%CI 1.21-2.05), Q3 (aHR-1.33, 95%CI 1.05-1.68), p&lt;0.001. Patients in the lowest quartile of CI (Q1) had 64% higher incidence of hospitalisation (IRR 1.64, 95%CI 1.36–1.98, p&lt;0.001) compared with patients in Q4 (IRR-1, reference). Conclusion Creatinine index derived from a simplified equation is useful in predicting mortality and hospitalisation among Southeast Asian incident HD patients. Low CI was associated with increased risk of all-cause mortality and hospitalisation in our cohort. The present study is limited by the lack of data on residual renal function which might confound the results.


2003 ◽  
Vol 11 (2) ◽  
pp. 167-188 ◽  
Author(s):  
Bradley D. Hatfield ◽  
Thomas W. Spalding ◽  
Ross J. Apparies ◽  
Amy J. Haufler ◽  
D. Laine Santa Maria

Latencies and peak-to-peak amplitudes of pattern-reversal evoked-potential (PREP) components of active and inactive community-dwelling healthy 61- to 77-year-olds were compared with those of active and inactive 18- to 31-year-olds to determine whether long-term physical activity involvement was associated with attenuation of age-related changes in sensory processes. Binocular PREPs were derived for each of 2 check sizes (22 × 15 ft and 41 × 30 ft of visual angle) to provide increasing challenge of spatial resolution. Analyses of the latencies revealed significant effects for age, gender, and check size such that latencies were longer for older than for young participants, men than for women, and small than for larger check sizes. Amplitudes were larger in older adults for the P100-N150 peak-to-peak difference, but physical activity history was not associated with reduction of the observed age-related increases in component latencies and amplitude. As such, physical activity does not appear to attenuate age-related decline in visual sensory processing.


2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 187-187
Author(s):  
Kelly Hyland ◽  
Alyssa L Fenech ◽  
Diane Portman ◽  
Kristine A. Donovan

187 Background: Cancer anorexia-cachexia syndrome (CACS) in patients is associated with decreases in lean body mass and body weight. Self-reported lack of appetite may be an important indicator for early identification of CACS. The current analyses examined the relationship of perceived lack of appetite to patient characteristics and overall symptom burden in a large mixed cancer sample referred to a palliative care clinic. Methods: We conducted a retrospective review of patients newly referred to an outpatient palliative care clinic over a two-year period. Data on demographic and clinical characteristics and patient-reported symptom scores on the Edmonton Symptom Assessment Scale (ESAS) were abstracted. Pearson’s correlations and ANOVAs were used to assess relationships between variables. Multiple regression analysis was used to evaluate the relative contribution of variables that were significantly correlated with lack of appetite at the univariate level. Results: Data on 544 patients ( M=53.7 years) showed that older age (r=12, p<.01), not being married or in a marriage-like relationship (r=.09, p=.04), having insurance other than managed care insurance (r=.10, p=.02), lower body mass index (BMI; r=.11, p<.01), marijuana use (r=.18, p<.0001), and overall symptom burden (ESAS total score r=.52, p < .0001) were associated with worse lack of appetite ( M=3.5, SD=3.1). Patients who were underweight (BMI <18.5, 46.7%) reported significantly worse lack of appetite than patients who were normal weight, overweight, or obese ( M=3.9, SD=3.2, p<.01). The final hierarchical regression model accounted for 34% of the variance in lack of appetite, with age, marital status, BMI, marijuana use, and total symptom burden remaining significant independent correlates (p’ s <.01). Conclusions: Contrary to expectations, relatively few clinical correlates were associated with self-reported lack of appetite. Future research should explore inter-individual genetic factors to explain alterations in lean body mass and body weight that may contribute to poor appetite in patients. Such factors may be important indicators for early identification of CACS.


2010 ◽  
Vol 163 (1) ◽  
pp. 89-95 ◽  
Author(s):  
A G Tabák ◽  
M Kivimäki ◽  
E J Brunner ◽  
G D Lowe ◽  
M Jokela ◽  
...  

ObjectiveProspective studies show that high C-reactive protein (CRP) levels predict diabetes and cardiovascular disease (CVD), but changes in this marker preceding disease onset are not well characterized. This study describes CRP trajectories prior to type 2 diabetes onset and fatal CVD.MethodsIn a prospective cohort of 7350 British civil servants (70% male, mean age 51 years), 558 incident type 2 diabetes cases (75-g oral glucose tolerance test, doctor's diagnosis, or self-report) and 125 certified fatal cardiovascular events were observed during a median follow-up of >14 years. Trajectories of logarithmically transformed CRP levels prior to incident diabetes or fatal cardiovascular event (cases), or the end of follow-up (controls) were calculated using multilevel modeling.ResultsBaseline CRP levels were higher among participants who developed diabetes (median (interquartile range) 1.44 (2.39) vs 0.78 (1.21) mg/l) or fatal CVD (1.49 (2.47) vs 0.84 (1.30) mg/l) compared with controls (bothP<0.0001). In models adjusted for age, sex, body mass index, ethnicity, and employment grade, CRP levels increased with time among both incident diabetes cases and controls (P<0.0001), but this increase was less steep for cases group (P<0.05). CRP levels followed increasing linear trajectories in fatal cardiovascular cases and controls (P<0.0001) with no slope difference between the groups.ConclusionsCRP levels were higher among those who subsequently developed diabetes or died from CVD. For type 2 diabetes, age-related increase in CRP levels was less steep in the cases group than in controls, whereas for fatal CVD these trajectories were parallel.


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