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Longitudinal association of type 2 diabetes and insulin therapy with muscle parameters in the KORA-Age study

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Abstract

Aims

The aim of the current study was to investigate the association of type 2 diabetes (T2D) and insulin treatment with changes in muscle mass, muscle strength, and physical performance in older adults.

Methods

In 731 participants of the population-based KORA-Age study aged 74.6 ± 6.2 years (T2D: n = 118; insulin treatment: n = 20), skeletal muscle index (SMI [kg/m2]), hand grip strength (GS [kg]), and a timed up and go test (TUG [s]) were performed at baseline and after a follow-up time of 3 years. The association of T2D and insulin therapy with changes in muscle parameters was analyzed using linear regression models.

Results

After adjustment for sex, age, BMI, physical activity, smoking, and multimorbidity, T2D was associated with the change in SMI during follow-up (β − 0.1 (95% CI − 0.3 to − 0.02) kg/m2; p = 0.02), but not with a change in GS (β − 0.9 (95% CI − 1.9 to 0.04) kg) or TUG (β − 0.1 (95% CI − 0.7 to 0.5) s). Insulin therapy was positively associated with change in SMI (β 0.6 (95% CI 0.3–0.9) kg/m2; p = 0.001), but not in GS (β − 1.6 (95% CI − 4.1 to 0.8) kg) or TUG (β 1.6 (95% CI − 0.2–3.4) s) in comparison with treatment with oral anti-diabetic medication alone.

Conclusions

Participants with T2D showed an accelerated decline in muscle mass compared to non-diabetic participants. Insulin therapy was associated with preserved muscle mass, but not muscle function parameters, indicating a discrepancy between muscle mass and function in this high-risk population.

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Acknowledgments

We gratefully acknowledge the contribution of all members of field staffs conducting the KORA-Age study and thank all study participants.

Funding

Funding

The KORA research platform studies were initiated and financed by the Helmholtz Zentrum München—German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education, Science, Research and Technology and by the State of Bavaria. The KORA-Age project was financed by the German Federal Ministry of Education and Research (BMBF FKZ 01ET0713 and 01ET1003A) as part of the ‘Health in old age’ program.

Author information

Author notes

  1. Uta Ferrari and Cornelia Then contributed equally.

Authors and Affiliations

  1. Geriatrie, Department of Medicine IV, University Hospital, LMU Munich, Ziemssenstraße 1, 80336, Munich, Germany

    Uta Ferrari, Cornelia Then, Marietta Rottenkolber, Canan Selte, Jochen Seissler & Michael Drey

  2. Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany

    Romy Conzade, Birgit Linkohr, Annette Peters & Barbara Thorand

  3. German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany

    Annette Peters & Barbara Thorand

Authors
  1. Uta Ferrari
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  2. Cornelia Then
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  3. Marietta Rottenkolber
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Contributions

Author contributions

Conceptualization was carried out by Barbara Thorand, Annette Peters, Birgit Linkohr, Jochen Seissler, and Michael Drey; Methodology was carried out by Barbara Thorand, Jochen Seissler, Michael Drey, Marietta Rottenkolber, Uta Ferrari, Cornelia Then, and Romy Conzade; Formal analysis and investigation was carried out by Marietta Rottenkolber, Canan Selte, and Romy Conzade; Writing–original draft preparation were carried out by Uta Ferrari and Cornelia Then; Writing–review and editing were carried out by all authors; Funding acquisition was done by Barbara Thorand and Annette Peters; Resources were done by Barbara Thorand, Annette Peters, and Birgit Linkohr; Supervision was done by Barbara Thorand and Michael Drey.

Corresponding author

Correspondence to Uta Ferrari.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

The study was approved by the Ethics Committee of the Bavarian Medical Association (reference number: 08064). All procedures were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national, Ethics Committee of the Bavarian Medical Association) and with the Helsinki Declaration of 1975, as revised in 2008.

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All participants gave written informed consent.

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Ferrari, U., Then, C., Rottenkolber, M. et al. Longitudinal association of type 2 diabetes and insulin therapy with muscle parameters in the KORA-Age study. Acta Diabetol 57, 1057–1063 (2020). https://doi.org/10.1007/s00592-020-01523-7

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