Bedside tests of muscle mass in older adults with Type 2 diabetes

Kenneth M. Madden; Boris Feldman; Shane Arishenkoff; Graydon S. Meneilly; Kenneth M. Madden; Boris Feldman; Shane Arishenkoff; Graydon S. Meneilly

doi:10.3934/medsci.2022022

AIMS Medical Science

2022, Volume 9, Issue 3: 433-446. doi: 10.3934/medsci.2022022

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Research article

Bedside tests of muscle mass in older adults with Type 2 diabetes

Running title: Bedside measures of muscularity

1.
Gerontology and Diabetes Research Laboratory, Division of Geriatric Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
2.
Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada
3.
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

Received: 07 June 2022 Revised: 27 July 2022 Accepted: 04 August 2022 Published: 24 August 2022

Objective
Diabetes and sarcopenia often coexist in older adults, suggesting a possible bidirectional association. Available bedside measures of muscle mass consist of bedside ultrasound (MT, quadriceps muscle thickness) and Bioelectrical Impedance Analysis (BIA). We examined the association between ultrasound measures and BIA measures of muscle in older adults with measures of strength, performance and frailty in older adults with diabetes.

Design
Cross-sectional study.

Methods
81 subjects (age ≥ 65; mean age 80.8 ± 0.6 years, 27 women, 53 men) were recruited sequentially from geriatric medicine clinics. Each subject had Lean Body Mass (LBM, by BIA, in kg), grip strength, gait speed, Cardiovascular Health Study index (frailty) and MT (in cm) measured. All initial models were adjusted for biological sex.

Results
In our final parsimonious models, only MT (as opposed to LBM) showed a significant correlation with grip strength (Standardized β = 0.217 ± 0.078; p = 0.007) and frailty (Standardized β = 0.276 ± 0.109; p = 0.013). Neither MT or LBM showed a significant association with subject performance (gait speed).

Conclusions
Unlike BIA, bedside ultrasound measures of muscle thickness showed strong associations with both grip strength and frailty in the older adult population with diabetes, suggesting that bedside measures of MT might be a more clinically useful modality to assess muscularity in this patient population. Neither BIA or MT measures of subject muscularity showed any association with our performance indicator (gait speed).
- sarcopenia,
- bedside ultrasound,
- bioelectrical impedance analysis,
- diabetes,
- geriatric medicine,
- frailty
Citation: Kenneth M. Madden, Boris Feldman, Shane Arishenkoff, Graydon S. Meneilly. Bedside tests of muscle mass in older adults with Type 2 diabetes[J]. AIMS Medical Science, 2022, 9(3): 433-446. doi: 10.3934/medsci.2022022

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Abstract

Objective

Diabetes and sarcopenia often coexist in older adults, suggesting a possible bidirectional association. Available bedside measures of muscle mass consist of bedside ultrasound (MT, quadriceps muscle thickness) and Bioelectrical Impedance Analysis (BIA). We examined the association between ultrasound measures and BIA measures of muscle in older adults with measures of strength, performance and frailty in older adults with diabetes.

Design

Cross-sectional study.

Methods

81 subjects (age ≥ 65; mean age 80.8 ± 0.6 years, 27 women, 53 men) were recruited sequentially from geriatric medicine clinics. Each subject had Lean Body Mass (LBM, by BIA, in kg), grip strength, gait speed, Cardiovascular Health Study index (frailty) and MT (in cm) measured. All initial models were adjusted for biological sex.

Results

In our final parsimonious models, only MT (as opposed to LBM) showed a significant correlation with grip strength (Standardized β = 0.217 ± 0.078; p = 0.007) and frailty (Standardized β = 0.276 ± 0.109; p = 0.013). Neither MT or LBM showed a significant association with subject performance (gait speed).

Conclusions

Unlike BIA, bedside ultrasound measures of muscle thickness showed strong associations with both grip strength and frailty in the older adult population with diabetes, suggesting that bedside measures of MT might be a more clinically useful modality to assess muscularity in this patient population. Neither BIA or MT measures of subject muscularity showed any association with our performance indicator (gait speed).

Abbreviations

DXA

Dual-energy X-ray absorptiometry

LBM

Lean body mass

BIA

Bioelectrical impedance analysis

CHS Index

Cardiovascular health study Index

Quadriceps muscle tissue thickness

AIC

Akaike's Information Criterion

Hg_A1c

Glycated hemoglobin

BMI

Body mass index

Acknowledgments

This work was supported by the Allan M. McGavin Foundation, who had no involvement in the study or in the preparation of the manuscript.

Conflict of interest

All authors declare no conflicts of interest in this paper. The sponsor (the Allan M. McGavin Foundation) had no role in the study design, analysis or writing of the paper.

Authors' contributions

Kenneth Madden designed the study, gathered the raw data, performed the data analysis, wrote the manuscript, and edited the manuscript; Boris Feldman gathered the raw data and edited the manuscript; Shane Arishenkoff participated in study design, reviewed the ultrasound images and edited the manuscript; Graydon S. Meneilly participated in study design and editing the manuscript.

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