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Loss of skeletal muscle mass and its predictors in type 2 diabetes patients under a multifaceted treatment approach

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Abstract

Background

Weight loss, which is an effective method for reducing visceral fat, may cause a concomitant loss of skeletal muscle mass. The aim of this study was to elucidate the changes in visceral fat and skeletal muscle mass in response to diabetes treatment including weight control.

Methods

For 6 months we observed the changes in the body compositions of 72 Japanese patients with type 2 diabetes who underwent multifaceted treatment including educational hospitalization. Visceral fat area (VFA) and appendicular skeletal muscle mass (ASM) were measured using a bioelectrical impedance method and dual-energy X-ray absorptiometry, respectively.

Results

During the follow-up period, VFA reduced significantly whereas the average ASM did not change. Changes in ASM were strongly positively associated with changes in body weight (r = 0.50). Additionally, in an analysis of covariance, an above-median BMI (27 kg/m2) and above-median VFA (110 cm2) at baseline were found to be independent predictors of ASM reduction prevention. Of the 55 patients who lost weight, those who had a baseline VFA of ≥110 cm2 had significantly greater reductions in VFA than those with a baseline VFA of <110 cm2 (p < 0.01). ASM reduced significantly in patients with a VFA of <110 cm2 (p < 0.01), but not in those with a VFA of ≥110 cm2 (p = 0.98).

Conclusions

Baseline accumulation of visceral fat may predict a preferential reduction of visceral fat rather than skeletal muscle during weight control programs in type 2 diabetes patients.

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Abbreviations

VFA:

Visceral fat area

ASM:

Appendicular skeletal muscle mass

ADA:

American Diabetes Association

BMI:

Body mass index

DXA:

Dual-energy X-ray absorptiometry

JDS:

Japan Diabetes Society

HbA1c:

Hemoglobin A1c

UCP:

Urinary C-peptide

eGFR:

Estimated glomerular filtration rate

SMI:

Skeletal muscle index

SFA:

Subcutaneous fat area

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Acknowledgements

This work was supported in part by Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan [Grant Number 25860403].

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Authors and Affiliations

  1. Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan

    Norihiko Ohara, Isao Minami, Ryotaro Bouchi, Hajime Izumiyama, Koshi Hashimoto, Takanobu Yoshimoto & Yoshihiro Ogawa

Authors
  1. Norihiko Ohara
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  2. Isao Minami
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  3. Ryotaro Bouchi
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  4. Hajime Izumiyama
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  7. Yoshihiro Ogawa
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Corresponding author

Correspondence to Isao Minami.

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Conflict of interest

None of the authors have any conflicts of interest associated with this research.

Ethical standards

This study was carried out in accordance with the Declaration of Helsinki of 1964 and later versions and approved by the ethics committee of Tokyo Medical and Dental University (approval no. M2000-1573, approval date: 23 July 2013).

Informed consent

The patients gave their written informed consent to participate in this study and for its results to be published.

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Ohara, N., Minami, I., Bouchi, R. et al. Loss of skeletal muscle mass and its predictors in type 2 diabetes patients under a multifaceted treatment approach. Diabetol Int 8, 366–374 (2017). https://doi.org/10.1007/s13340-017-0325-z

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