Observational Study
Copyright ©The Author(s) 2021.
World J Diabetes. Dec 15, 2021; 12(12): 2119-2129
Published online Dec 15, 2021. doi: 10.4239/wjd.v12.i12.2119
Table 1 Characteristics of male participants according to appendicular skeletal muscle mass (%) quartiles, n (%)
MaleQuartiles of ASM%
P valueFemaleQuartiles of ASM%
P value
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4

n = 343
n = 343
n = 343
n = 342


n = 649
n = 651
n = 649
n = 650

Age (yr)61.6 ± 8.863.2 ± 8.9a63.2 ± 8.9a69.4 ± 10.1a< 0.001Age, yr60.8 ± 8.761.7 ± 8.8a62.9 ± 9.4a64.8 ± 9.7a< 0.001
BMI (kg/m2)22.7 ± 2.924.3 ± 3.4a24.3 ± 3.4a25.6 ± 2.9a< 0.001Weight, kg55.1 ± 8.158.0 ± 8.3a59.8 ± 8.6a62.6 ± 9.7a< 0.001
WC, cm80.6 ± 9.185.8 ± 7.7a85.8 ± 7.7a91.7 ± 8.5a< 0.001BMI, kg/m222.0 ± 2.723.5 ± 2.9a24.4 ± 3.1a26.0 ± 3.7a< 0.001
FM, kg17.9 ± 4.620.3 ± 4.3a20.3 ± 4.3a24.5 ± 4.9a< 0.001WC, cm76.4 ± 7.980.5 ± 8.6a82.8 ± 8.5a87.5 ± 9.4a< 0.001
FM%22.4 ± 4.227.2 ± 3.2a27.2 ± 3.2a33.1 ± 3.3a< 0.001FM, kg20.0 ± 4.122.5 ± 4.2a24.8 ± 4.8a27.6 ± 5.8a< 0.001
ASM%32.6 ± 1.930.6 ± 1.0a30.6 ± 1.0a27.2 ± 1.6a< 0.001FM%32.2 ± 3.936.3 ± 2.9a38.8 ± 3.0a42.4 ± 3.4a< 0.001
SBP, mmHg129 ± 18134 ± 17a134 ± 17a141 ± 19a< 0.001ASM%27.7 ± 2.025.7 ± 0.8a24.5 ± 0.6a22.8 ± 1.1a< 0.001
DBP, mmHg76 ± 1178 ± 11a78 ± 11a77 ± 100.014SBP, mmHg129 ± 20132 ± 19a135 ± 20a138 ± 19a< 0.001
FBG, mmol/L5.4 ± 1.45.7 ± 1.7a5.7 ± 1.7a6.0 ± 1.7a< 0.001DBP, mmHg72 ± 1074 ± 10a75 ± 976 ± 10a< 0.001
2hBG, mmol/L6.7 ± 2.57.6 ± 2.9a7.6 ± 2.9a8.9 ± 3.7a< 0.001FBG, mmol/L5.3 ± 1.05.4 ± 1.2a5.5 ± 1.3a5.7 ± 1.7a< 0.001
HOMA-IR1.2 (0.8-1.9)1.8 (1.2-2.5)a1.8 (1.2-2.5)a2.5 (1.7-3.9)a< 0.0012hBG, mmol/L6.8 ± 2.67.2 ± 2.5a7.7 ± 4.0a8.3 ± 3.4a< 0.001
TG, mmol/L1.2 (0.9-1.8)1.4 (1.0-2.0)a1.4 (1.0-2.0)a1.6 (1.2-2.2)a< 0.001HOMA-IR1.6 (1.0-2.3)1.8 (1.2-2.6)a2.1 (1.4-3.2)a2.3 (1.6-3.6)a< 0.001
TC, mmol/L4.6 ± 0.84.7 ± 0.8a4.7 ± 0.8a4.7 ± 0.8a0.049TG, mmol/L1.2 (0.9-1.8)1.4 (1.0-2.0)a1.5 (1.1-2.1)1.6 (1.2-2.2)a< 0.001
HDL-C, mmol/L1.40 ± 0.371.26 ± 0.29a1.26 ± 0.29a1.20 ± 0.25a< 0.001TC, mmol/L5.2 ± 0.85.3 ± 0.95.3 ± 0.95.4 ± 1.0a< 0.001
LDL-C, mmol/L2.59 ± 0.722.75 ± 0.742.75 ± 0.742.72 ± 0.72a0.004HDL-C, mmol/L1.64 ± 0.421.54 ± 0.37a1.48 ± 0.341.46 ± 0.33a< 0.001
LFC%3.9 (1.9-7.8)5.0 (2.3-10.8)a5.0 (2.3-10.8)a6.3 (2.6-13.3)a< 0.001LDL-C, mmol/L2.86 ± 0.753.02 ± 0.79a3.04 ± 0.83a3.14 ± 0.86a< 0.001
NAFLD n (%)68 (19.9)107 (31.2)a107 (31.2)a141 (41.2)a< 0.001LFC, %4.8 (2.5-9.7)5.8 (2.7-11.6)a5.9 (2.7-11.8)a7.1 (3.2-13.6)a< 0.001
DM n (%)42 (12.3)81 (23.6)a81 (23.6)a123 (35.8)a< 0.001NAFLD n (%)171 (26.3)214 (32.9)a219 (33.7)a275 (42.3)a< 0.001
DM n (%)88 (13.6)106 (16.3)152 (23.4)a158 (24.3)a< 0.001
Table 2 Spearman analysis of appendicular skeletal muscle mass (%) and other clinical parameters
ASM%

Male (r, P value)
Female (r, P value)
Age (years)-0.317, < 0.001-0.164, < 0.001
BMI (kg/m2)-0.347, < 0.001-0.441, < 0.001
WC (cm)-0.452, < 0.001-0.448, < 0.001
FM (kg)-0.605, < 0.001-0.590, < 0.001
FM (%)-0.792, < 0.001-0.799, < 0.001
FBG (mmol/L)-0.177, < 0.001-0.106, < 0.001
2hBG (mmol/L)-0.254, < 0.001-0.201,< 0.001
HOMA-IR-0.385, < 0.001-0.264, < 0.001
TG (mmol/L)-0.198, < 0.001-0.193, < 0.001
TC (mmol/L)-0.049, 0.071-0.087, < 0.001
HDL-C (mmol/L)0.213, < 0.0010.162, < 0.001
LDL-C (mmol/L)-0.075, 0.006-0.119, < 0.001
SBP (mm Hg)-0.244, < 0.001-0.192, < 0.001
DBP (mm Hg)-0.075, 0.006-0.139, < 0.001
LFC (%)-0.149, < 0.001-0.113, < 0.001
Table 3 Multivariate-adjusted associations of appendicular skeletal muscle mass (%) quartiles with diabetes mellitus
Male
Female

OR (95%CI, P value)
OR (95%CI, P value)
Unadjusted0.6650.775
(0.592-0.746, < 0.001)(0.710-0.847, < 0.001)
Model 10.5270.505
(0.336-0.826, 0.005)(0.342-0.745, 0.001)
Model 20.6400.728
(0.401-1.020, 0.051)(0.481-1.101, 0.133)
Model 30.5370.985
(0.312-0.923, 0.024)(0.614-1.580, 0.950)
Table 4 Multivariate-adjusted associations of appendicular skeletal muscle mass (%) quartiles with diabetes mellitus in participants with or without non-alcoholic fatty liver disease
Male
Female
OR (95%CI, P value)
OR (95%CI, P value)

Non-NAFLD (n = 2658)
Unadjusted0.6350.770
(0.548-0.736, < 0.001)(0.682-0.870, < 0.001)
Model 10.4030.581
(0.221-0.735, 0.003)(0.344-0.981, 0.042)
Model 20.4550.807
(0.246-0.842, 0.012)(0.463-1.409, 0.452)
Model 30.3300.800
(0.157-0.694, 0.003)(0.416-1.537, 0.503)
NAFLD (n = 1311)
Unadjusted0.7890.845
(0.650-0.956, 0.016)(0.739-0.966, 0.014)
Model 11.2590.508
(0.542-2.924, 0.592)(0.265-0.975, 0.042)
Model 21.9540.710
(0.788-4.851, 0.148)(0.355-1.418, 0.332)
Model 31.3281.106
(0.435-4.055, 0.619)(0.485-2.523, 0.810)
Table 5 Multivariate-adjusted associations of appendicular skeletal muscle mass (%) quartiles with diabetes mellitus in participants with different liver fat content, n (%)
LFC
DM
OR (95%CI, P value)
OR (95%CI, P value)
Male UnadjustedAfter adjusted
Q1 (n = 389)82 (21.1)0.635 (0.504-0.799, < 0.001)0.308 (0.102-0.932, 0.032)
Q2 (n = 350)66 (18.8)0.540 (0.416-0.700, < 0.001)0.184 (0.049-0.685, 0.012)
Q3 (n = 306)74 (24.2)0.760 (0.599-0.963, 0.023)0.678 (0.158-2.908, 0.601)
Q4(n = 325)116 (35.7)0.830 (0.665-1.035, 0.099)1.561 (0.440-5.539, 0.491)
Female
Q1 (n = 605)84 (13.9)0.828 (0.672-1.021, 0.077)0.964 (0.311-2.990, 0.949)
Q2 (n = 642)92 (14.3)0.745 (0.609-0.913, 0.004)0.517 (0.170-1.578, 0.247)
Q3 (n = 685)118 (17.2)0.739 (0.615-1.887, 0.091)0.750 (0.274-2.048, 0.574)
Q4 (n = 667)210 (31.5)0.871 (0.750-1.011, 0.070)1.122 (0.445-2.830, 0.808)