scholarly journals Clinical and Dietary Determinants of Muscle Mass in Patients with Type 2 Diabetes: Data from the Diabetes and Lifestyle Cohort Twente

2021 ◽  
Vol 10 (22) ◽  
pp. 5227
Author(s):  
Annis C. Jalving ◽  
Milou M. Oosterwijk ◽  
Ilse J. M. Hagedoorn ◽  
Gerjan Navis ◽  
Stephan J. L. Bakker ◽  
...  

Low muscle mass in patients with type 2 diabetes is associated with a progressively higher risk of morbidity and mortality. The aim of this study was to identify modifiable targets for intervention of muscle mass in type 2 diabetes. Cross-sectional analyses were performed in 375 patients of the Diabetes and Lifestyle Cohort Twente-1 study. Muscle mass was estimated by 24 h urinary creatinine excretion rate (CER, mmol/24 h). Patients were divided in sex-stratified tertiles of CER. To study determinants of CER, multivariable linear regression analyses were performed. Protein intake was determined by Maroni formula and by a semi-quantitative Food Frequency Questionnaire. The mean CER was 16.1 ± 4.8 mmol/24 h and 10.9 ± 2.9 mmol/24 h in men and women, respectively. Lower CER was significantly associated with older age (p < 0.001) as a non-modifiable risk factor, whereas higher BMI (p = 0.015) and lower dietary protein intake (both methods p < 0.001) were identified as modifiable risk factors for lower CER. Overall body mass index (BMI) was high, even in the lowest CER tertile the mean BMI was 30.9 kg/m2, mainly driven by someone’s body weight (p = 0.004) instead of someone’s height (p = 0.58). In the total population, 28% did not achieve adequate protein intake of >0.8 g/kg/day, with the highest percentage in the lowest CER tertile (52%, p < 0.001). Among patients with type 2 diabetes treated in secondary care, higher BMI and low dietary protein intake are modifiable risk factors for lower muscle mass. Considering the risk associated with low muscle mass, intervention may be useful. To that purpose, dietary protein intake and BMI are potential targets for intervention.

2020 ◽  
Vol 9 (10) ◽  
pp. 3104
Author(s):  
Ilse J. M. Hagedoorn ◽  
Niala den Braber ◽  
Milou M. Oosterwijk ◽  
Christina M. Gant ◽  
Gerjan Navis ◽  
...  

Objective: In order to promote physical activity (PA) in patients with complicated type 2 diabetes, a better understanding of daily movement is required. We (1) objectively assessed PA in patients with type 2 diabetes, and (2) studied the association between muscle mass, dietary protein intake, and PA. Methods: We performed cross-sectional analyses in all patients included in the Diabetes and Lifestyle Cohort Twente (DIALECT) between November 2016 and November 2018. Patients were divided into four groups: <5000, 5000–6999, 7000–9999, ≥ 10,000 steps/day. We studied the association between muscle mass (24 h urinary creatinine excretion rate, CER) and protein intake (by Maroni formula), and the main outcome variable PA (steps/day, Fitbit Flex device) using multivariate linear regression analyses. Results: In the 217 included patients, the median steps/day were 6118 (4115–8638). Of these patients, 48 patients (22%) took 7000–9999 steps/day, 37 patients (17%) took ≥ 10,000 steps/day, and 78 patients (36%) took <5000 steps/day. Patients with <5000 steps/day had, in comparison to patients who took ≥10,000 steps/day, a higher body mass index (BMI) (33 ± 6 vs. 30 ± 5 kg/m2, p = 0.009), lower CER (11.7 ± 4.8 vs. 14.8 ± 3.8 mmol/24 h, p = 0.001), and lower protein intake (0.84 ± 0.29 vs. 1.08 ± 0.22 g/kg/day, p < 0.001). Both creatinine excretion (β = 0.26, p < 0.001) and dietary protein intake (β = 0.31, p < 0.001) were strongly associated with PA, which remained unchanged after adjustment for potential confounders. Conclusions: Prevalent insufficient protein intake and low muscle mass co-exist in obese patients with low physical activity. Dedicated intervention studies are needed to study the role of sufficient protein intake and physical activity in increasing or maintaining muscle mass in patients with type 2 diabetes.


Diabetes Care ◽  
2014 ◽  
Vol 37 (7) ◽  
pp. 1854-1862 ◽  
Author(s):  
Monique van Nielen ◽  
Edith J.M. Feskens ◽  
Marco Mensink ◽  
Ivonne Sluijs ◽  
Esther Molina ◽  
...  

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Qiuyi Ke ◽  
Chaogang Chen ◽  
Fengyi He ◽  
Yongxin Ye ◽  
Xinxiu Bai ◽  
...  

2019 ◽  
Vol 1 (2) ◽  
pp. 77-83 ◽  
Author(s):  
Bikash Shrestha ◽  
Bipin Nepal ◽  
Yagya Laxmi Shakya ◽  
Binaya Regmi

 Introduction: Type 2 diabetes mellitus is the commonest form of diabetes affecting more than 90% of the diabetic population worldwide. The prevalence of type 2 diabetes and its complications are increasing in the world, including developing nations like Nepal. This study aimed to determine the association between the lifestyle risk factors and the risk of type 2 diabetes mellitus in Nepalese population. Methods: This is hospital based cross sectional observational study done in the urban area of Nepal. Records of clients coming for the general health checkup in Grande International Hospital were evaluated in this study. Comparisons of the lifestyle factors in participants having and not having type 2 diabetes mellitus were done. Results: Significant associations with diagnosis of diabetes mellitus (DM) type 2 were seen in age (P ≤ 0.001), associated hypertension (P ≤ 0.001), dyslipidemia, family history of DM (P ≤ 0.001), alcohol use (P ≤ 0.001), and tobacco use (P ≤ 0.001). Logistic regression analysis showed that the odds of having diabetes were high in age group above 40 (OR – 6.9, CI 3.82 – 12.47), history of hypertension (OR- 3.84, CI 2.42 – 6.08), tobacco users (OR-2.26, CI 1.12 – 4.53), alcohol users (OR-3.99, CI 2.47 – 6.44), family history of DM (OR-2.44, CI 1.53 – 3.89), and abdominal obesity in both males (OR-3.9, CI 2 – 7.4) and females (OR-9.6, CI 3.78 – 24.35). Conclusions: The modifiable risk factors - obesity, smoking and alcohol use carry significant risks of developing type 2 diabetes. These red flag signs call for urgent attention to look for and rectify the modifiable risk factors in Nepalese population to prevent diabetes.


2016 ◽  
Vol 96 (7) ◽  
pp. 1029-1038 ◽  
Author(s):  
Alexandra M. Boland ◽  
Todd M. Gibson ◽  
Lu Lu ◽  
Sue C. Kaste ◽  
James P. DeLany ◽  
...  

Abstract Background Survivors of childhood acute lymphoblastic leukemia (ALL) are at risk for low lean muscle mass and muscle weakness, which may contribute to inactivity and early development of chronic diseases typically seen in older adults. Although increasing protein intake, in combination with resistance training, improves lean muscle mass in other populations, it is not known whether muscular tissue among survivors of ALL, whose impairments are treatment-related, will respond similarly. Objective The aim of this study was to evaluate associations among dietary protein intake, resistance training, and lean muscle mass in survivors of ALL and age-, sex-, and race-matched controls. Design This was a cross-sectional study. Methods Lean muscle mass was determined with dual-energy x-ray absorptiometry, dietary information with 24-hour recalls, and participation in resistance training with a questionnaire. Participants were 365 survivors of ALL (52% male; 87% white; median age=28.5 years, range=23.6–31.7) and 365 controls with no previous cancer. Results Compared with controls, survivors of ALL had lower lean muscle mass (55.0 versus 57.2 kg, respectively) and lower percentage of lean muscle mass (68.6% versus 71.4%, respectively) than controls. Similar proportions of survivors (71.1%) and controls (69.7%) met recommended dietary protein intake (0.8 g/kg/d). Survivors (45.4%) were less likely to report resistance training than controls (53.8%). In adjusted models, 1-g higher protein intake per kilogram of body mass per day was associated with a 7.9% increase and resistance training ≥1×wk, with a 2.8% increase in lean muscle mass. Limitations The cross-sectional study design limits temporal evaluation of the association between protein intake and lean muscle mass. Conclusions The findings suggest that survivors of childhood ALL with low lean muscle mass may benefit from optimizing dietary protein intake in combination with resistance training. Research is needed to determine whether resistance training with protein supplementation improves lean muscle mass in survivors of childhood ALL.


2016 ◽  
Vol 183 (8) ◽  
pp. 715-728 ◽  
Author(s):  
Vasanti S. Malik ◽  
Yanping Li ◽  
Deirdre K. Tobias ◽  
An Pan ◽  
Frank B. Hu

2018 ◽  
Vol 58 (4) ◽  
pp. 1351-1367 ◽  
Author(s):  
Long-Gang Zhao ◽  
Qing-Li Zhang ◽  
Xiao-Li Liu ◽  
Hua Wu ◽  
Jia-Li Zheng ◽  
...  

Author(s):  
Subha Sankha Kundu ◽  
Kunal Kanti Majumdar ◽  
Dipankar Mukherjee ◽  
Rajib Sikder ◽  
Rituraj Dey ◽  
...  

Background: With the change in lifestyle and behavior among individuals, the prevalence of T2DM is on rise. Many modifiable and non-modifiable risk factors are attributable for the cardiovascular morbidity among the diabetics which is the leading cause of mortality and morbidity among them, also increasing their burden of expenditure. The purpose of this study was to determine the prevailing factors responsible and its associate co morbidities among the Type 2 Diabetes Mellitus patients.Methods: It was a descriptive, observational and cross sectional study conducted for 30 days. 226 patients who visited the diabetes OPD of the Medical College were interviewed using a pre-designed questionnaire, anthropometric measurements, systemic and general examinations were performed. The data was analysed using suitable statistical analysis.Results: Out of 226 patients, 47.8% were suffering from cardiovascular morbidity, majority being heart failure (57.4%). Most of them were contributed 46.3% and 38.9% by age group 50-59 years (46.3%) and 60-69 years (38.9%), 55.6% were smokers and 64.4% were overweight. 70.4% complained of stress in their daily life while 48.1% were unaware of their heart conditions until checkup. 18.5% of the patients also suffered from retinopathy and 37.03% from diabetic foot ulcer. 64% of them had hypertension and 67.2% had sedentary life style.Conclusions: Many modifiable and non-modifiable risk factors were found associated with cardiovascular morbidity among the type 2 diabetes mellitus patients. So a proper awareness and life style modifications might be necessary to decrease cardiovascular morbidity among them.


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