Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Dec 15, 2021; 12(12): 2119-2129
Published online Dec 15, 2021. doi: 10.4239/wjd.v12.i12.2119
Skeletal muscle loss is associated with diabetes in middle-aged and older Chinese men without non-alcoholic fatty liver disease
Ling-Yan Chen, Ming-Feng Xia, Li Wu, Qian Li, Yu Hu, Hui Ma, Xin Gao, Huan-Dong Lin
Ling-Yan Chen, Yu Hu, Hui Ma, Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Ming-Feng Xia, Xin Gao, Huan-Dong Lin, Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Li Wu, Qian Li, Fudan Institute for Metabolic Diseases, Shanghai 200032, China
Author contributions: Chen LY did the study design and literature research, wrote the manuscript, and made critical editing; Chen LY and Lin HD made definition of intellectual content and did data analysis; Chen LY, Xia MF, Wu L, Li Q, Hu Y, Ma H, Gao X, and Lin HD participated in the data acquisition and clinical study; Gao X and Lin HD contributed to study concept and did the critical review and editing of the manuscript; Gao X was the guarantor of integrity of the entire study; Lin HD contributed to statistical analysis; all authors approved the final draft of the manuscript and agreed to submit it for publication.
Supported by the National Key Basic Research Program of China, No. 2012CB524906 and No. 2011CB504004; the Shanghai Municipal Health Bureau Foundation, No. 12GWZX0103; and the Science and Technology Commission of Shanghai Municipality, No. 10411956400.
Institutional review board statement: The present study was approved by the Ethics Committee of Zhongshan Hospital of Fudan University (No. 2008-119). The research was carried out in accordance with the World Medical Association Declaration of Helsinki.
Informed consent statement: All participants provided written informed consent before their inclusion in the study.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: The related dataset that do not identify participants’ privacy can be available from the corresponding author at linhuandong_endo@163.com
STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Huan-Dong Lin, MD, Associate Professor, Chief Doctor, Department of Endocrinology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China. linhuandong_endo@163.com
Received: July 2, 2021
Peer-review started: July 2, 2021
First decision: July 15, 2021
Revised: August 5, 2021
Accepted: November 25, 2021
Article in press: November 25, 2021
Published online: December 15, 2021
Processing time: 166 Days and 20.9 Hours
ARTICLE HIGHLIGHTS
Research background

Aging is getting worse in China. Sarcopenia has become a major focus of public health research on aging.

Research motivation

There seems to be a close relationship between non-alcoholic fatty liver disease (NAFLD), diabetes mellitus (DM), and skeletal muscle mass (SMM).

Research objectives

We tried to determine the association between SMM, DM, and NAFLD in a Chinese population.

Research methods

Three thousand nine hundred and sixty-nine participants > 45 years of age from Changfeng Community in Shanghai were recruited to conduct a large-scale community population study. All participants were interviewed and the medical histories were recorded by trained researchers using a standard questionnaire. Blood samples were collected after overnight fasting for at least 10 h from each participant. The data related to SMM, DM, and NAFLD were analyzed.

Research results

In the current study, the fasting blood glucose, 2-h postprandial blood glucose, and homeostasis model assessment for insulin resistance increased with the prevalence of DM while appendicular skeletal muscle mass (ASM)% decreased in male and female participants. The SMM, as measured by ASM%, was negatively associated with the blood glucose concentration, but logistic stepwise regression analysis showed that SMM loss may be associated with the presence of DM in males. The dissociation of SMM loss and DM in women is noteworthy, especially after adjustment for fat mass and lipid parameters.

Research conclusions

SMM loss was shown to be associated with the presence of DM in Chinese middle-aged and elderly males without NAFLD.

Research perspectives

Our results suggest a new practical strategy to facilitate personalized intervention of DM by increasing SMM in males without NAFLD.