MedNet.nl: Weight reduction has a beneficial impact on health outcomes, but not if it comes at the expense of muscle mass. Low muscle mass is associated with twice the risk of death from heart disease in people with diabetes.
This study included 1514 US diabetic patients aged ≥20 years. Of these participants, 196 (55.6% female) had low muscle mass: < 7 kg/m2 on the Appendicular Skeletal Muscle Index (ASMI) in men and < 5.5 kg/m2 in women. These individuals were 63.5 years on average and had a diabetes duration of 14.5 years. No distinction was made between type 1 and type 2 diabetes. 1318 participants (48.3% female) had normal muscle mass. Their mean age was 54 years and mean diabetes duration was 10.4 years.
The follow-up period averaged 9.3 years. During that time, 413 people died (all-cause mortality), of whom 106 had low muscle mass and 307 had normal muscle mass. 147 of these deaths were due to cardiovascular disease: 42 with low muscle mass, 105 with normal muscle mass.
There was a clear association between low muscle mass and a higher risk of all-cause mortality (HR 1.41; 95%-BI 1.08-1.84) and cardiovascular death (HR 2.03; 95%-BI 1.32-3.13). Participants with low muscle mass were 44% more likely to die of any cause during follow-up than those with normal muscle mass. They were also twice as likely to die of cardiovascular disease than those with normal muscle mass.
Importantly, results were adjusted for age, sex, race/ethnicity, smoking status, alcohol use, obesity, history of cancer, hypertension, dyslipidemia, and previous cardiovascular events, including heart attacks, diabetes, microvascular complications and HbA1c .
A follow-up analysis showed that low muscle mass regardless of HbA1c and microvascular complications was associated with all-cause mortality and cardiovascular death.
This article was originally published in Dutch on MedNet.nl