TY - JOUR
T1 - More appendicular lean mass relative to body mass index is associated with lower incident diabetes in middle-aged adults in the CARDIA study
AU - Haines, Melanie S.
AU - Leong, Aaron
AU - Porneala, Bianca C.
AU - Zhong, Victor W.
AU - Lewis, Cora E.
AU - Schreiner, Pamela J.
AU - Miller, Karen K.
AU - Meigs, James B.
AU - Carnethon, Mercedes R.
N1 - Funding Information:
The Coronary Artery Risk Development in Young Adults Study (CARDIA) is supported by the National Heart, Lung, and Blood Institute [grant numbers HHSN268201800003I , HHSN268201800004I , HHSN268201800005I , HHSN268201800006I , and HHSN268201800007I ]. 20 Year Changes in Fitness & Cardiovascular Disease Risk was supported by the NHLBI [grant number RO1HL078972 ]. Support was also provided by the National Institutes of Health [grant numbers K23DK115903 (MSH) , K24HL092902 (KKM) , UM1DK078616 (JBM) , R01HL151855 (JBM) ]. Additional support was provided by the Doris Duke Charitable Foundation [grant number 2020096 (AL) ] and the Program for Young Eastern Scholar at Shanghai Institutions of Higher Education [grant number QD2020027 (VWZ) ]. This manuscript has been reviewed by CARDIA for scientific content. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the study funders. The study sponsors/funders were not involved in the design of the study; the collection, analysis, and interpretation of data; writing the report; and did not impose any restrictions regarding the publication of the report.
Publisher Copyright:
© 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University
PY - 2023/1
Y1 - 2023/1
N2 - Background and aims: Although lower lean mass is associated with greater diabetes prevalence in cross-sectional studies, prospective data specifically in middle-aged Black and White adults are lacking. Relative appendicular lean mass (ALM), such as ALM adjusted for body mass index (BMI), is important to consider since muscle mass is associated with overall body size. We investigated whether ALM/BMI is associated with incident type 2 diabetes in the Coronary Artery Risk Development in Young Adults study. Methods and results: 1893 middle-aged adults (55% women) were included. ALM was measured by DXA in 2005-06. Incident type 2 diabetes was defined in 2010–11 or 2015–16 as fasting glucose ≥7 mmol/L (126 mg/dL), 2-h glucose on OGTT ≥11.1 mmol/L (200 mg/dL) (2010–11 only), HbA1C ≥48 mmol/mol (6.5%) (2010–11 only), or glucose-lowering medications. Cox regression models with sex stratification were performed. In men and women, ALM/BMI was 1.07 ± 0.14 (mean ± SD) and 0.73 ± 0.12, respectively. Seventy men (8.2%) and 71 women (6.8%) developed type 2 diabetes. Per sex-specific SD higher ALM/BMI, unadjusted diabetes risk was lower by 21% in men [HR 0.79 (0.62–0.99), p = 0.04] and 29% in women [HR 0.71 (0.55–0.91), p = 0.008]. After adjusting for age, race, smoking, education, physical activity, and waist circumference, the association was no longer significant. Adjustment for waist circumference accounted for the attenuation in men. Conclusion: Although more appendicular lean mass relative to BMI is associated with lower incident type 2 diabetes in middle-aged men and women over 10 years, its effect may be through other metabolic risk factors such as waist circumference, which is a correlate of abdominal fat mass.
AB - Background and aims: Although lower lean mass is associated with greater diabetes prevalence in cross-sectional studies, prospective data specifically in middle-aged Black and White adults are lacking. Relative appendicular lean mass (ALM), such as ALM adjusted for body mass index (BMI), is important to consider since muscle mass is associated with overall body size. We investigated whether ALM/BMI is associated with incident type 2 diabetes in the Coronary Artery Risk Development in Young Adults study. Methods and results: 1893 middle-aged adults (55% women) were included. ALM was measured by DXA in 2005-06. Incident type 2 diabetes was defined in 2010–11 or 2015–16 as fasting glucose ≥7 mmol/L (126 mg/dL), 2-h glucose on OGTT ≥11.1 mmol/L (200 mg/dL) (2010–11 only), HbA1C ≥48 mmol/mol (6.5%) (2010–11 only), or glucose-lowering medications. Cox regression models with sex stratification were performed. In men and women, ALM/BMI was 1.07 ± 0.14 (mean ± SD) and 0.73 ± 0.12, respectively. Seventy men (8.2%) and 71 women (6.8%) developed type 2 diabetes. Per sex-specific SD higher ALM/BMI, unadjusted diabetes risk was lower by 21% in men [HR 0.79 (0.62–0.99), p = 0.04] and 29% in women [HR 0.71 (0.55–0.91), p = 0.008]. After adjusting for age, race, smoking, education, physical activity, and waist circumference, the association was no longer significant. Adjustment for waist circumference accounted for the attenuation in men. Conclusion: Although more appendicular lean mass relative to BMI is associated with lower incident type 2 diabetes in middle-aged men and women over 10 years, its effect may be through other metabolic risk factors such as waist circumference, which is a correlate of abdominal fat mass.
KW - Diabetes epidemiology
KW - Muscle mass
KW - Type 2 diabetes mellitus
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U2 - 10.1016/j.numecd.2022.09.017
DO - 10.1016/j.numecd.2022.09.017
M3 - Article
C2 - 36435699
AN - SCOPUS:85142672772
SN - 0939-4753
VL - 33
SP - 105
EP - 111
JO - Nutrition, Metabolism and Cardiovascular Diseases
JF - Nutrition, Metabolism and Cardiovascular Diseases
IS - 1
ER -
