Abstract
Objective
The aim of this study is to investigate whether muscle mass is associated with the prevalence and incidence of type 2 diabetes and whether this association differs within men and women of normal weight, overweight or obesity.
Research Design and Methods
Adult participants were included from the Lifelines cohort study, compromising of 167,729 participants. Low muscle mass was defined as < - 1SD of the gender-stratified creatinine excretion rate (CER), and was compared to the reference group (≥ -1SD). Loss of muscle mass after five years was defined as a decrease in CER. Multivariate logistic regression analysis was used to assess the association between muscle mass and the prevalence and incidence of type 2 diabetes, stratified by gender and BMI classes.
Results
Muscle mass was associated with the prevalence of type 2 diabetes both in men and in women (OR 1.51 [95%CI 1.32–1.72]; P<0.001 and OR 1.53 [1.36 – 1.73]; P<0.001) and was more pronounced in normal and overweight men and women. Incident type 2 diabetes was associated with a decreased muscle mass for both men and women (male; OR 1.22 [1.05 – 1.43]; P=0.01 and female; OR 1.36 [1.17 – 1.59]; P<0.001), and remained significant after adjustments in normal weight women (OR 1.77 [1.16 - 2.70]; P=0.008).
Conclusions
Both a low muscle mass and loss of muscle mass are associated with the prevalence and incidence of diabetes in the general population. This association is strongest in people with normal weight, and weakens in people within higher BMI subgroups.