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Sarcopenia exacerbates obesity-associated insulin resistance and dysglycemia: findings from the National Health and Nutrition Examination Survey III.

AbstractBACKGROUND:
Sarcopenia often co-exists with obesity, and may have additive effects on insulin resistance. Sarcopenic obese individuals could be at increased risk for type 2 diabetes. We performed a study to determine whether sarcopenia is associated with impairment in insulin sensitivity and glucose homeostasis in obese and non-obese individuals.
METHODOLOGY:
We performed a cross-sectional analysis of National Health and Nutrition Examination Survey III data utilizing subjects of 20 years or older, non-pregnant (Nā€Š=ā€Š14,528). Sarcopenia was identified from bioelectrical impedance measurement of muscle mass. Obesity was identified from body mass index. Outcomes were homeostasis model assessment of insulin resistance (HOMA IR), glycosylated hemoglobin level (HbA1C), and prevalence of pre-diabetes (6.0≤ HbA1C<6.5 and not on medication) and type 2 diabetes. Covariates in multiple regression were age, educational level, ethnicity and sex.
PRINCIPAL FINDINGS:
Sarcopenia was associated with insulin resistance in non-obese (HOMA IR ratio 1.39, 95% confidence interval (CI) 1.26 to 1.52) and obese individuals (HOMA-IR ratio 1.16, 95% CI 1.12 to 1.18). Sarcopenia was associated with dysglycemia in obese individuals (HbA1C ratio 1.021, 95% CI 1.011 to 1.043) but not in non-obese individuals. Associations were stronger in those under 60 years of age. We acknowledge that the cross-sectional study design limits our ability to draw causal inferences.
CONCLUSIONS:
Sarcopenia, independent of obesity, is associated with adverse glucose metabolism, and the association is strongest in individuals under 60 years of age, which suggests that low muscle mass may be an early predictor of diabetes susceptibility. Given the increasing prevalence of obesity, further research is urgently needed to develop interventions to prevent sarcopenic obesity and its metabolic consequences.
AuthorsPreethi Srikanthan, Andrea L Hevener, Arun S Karlamangla
JournalPloS one (PLoS One) Vol. 5 Issue 5 Pg. e10805 (May 26 2010) ISSN: 1932-6203 [Electronic] United States
PMID22421977 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Topics
  • Adult
  • Age Factors
  • Aged
  • Comorbidity
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 (epidemiology)
  • Educational Status
  • Female
  • Glucose Intolerance (epidemiology)
  • Humans
  • Insulin Resistance
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nutrition Surveys
  • Obesity (epidemiology)
  • Prediabetic State (epidemiology)
  • Prevalence
  • Sarcopenia (epidemiology)
  • Sex Factors
  • United States (epidemiology)

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