Background

Patients with diabetes are at an increased risk of deterioration in muscle mass and quality which impacts physical performance. We investigated the relationship of grip strength, muscle mass and quality with glycemia and metabolic parameters in Asian Indian adults.

Methods

This cross-sectional study included 123 adults between 30 to 60 years of age with normal glucose tolerance (group 1, n=43), prediabetes (group 2, n=40) and diabetes mellitus (group 3, n=40). Measures of muscle mass included anthropometry and whole body DEXA scan. Measures of muscle quality included grip strength and physical performance (Timed Up and Go test and 6 Minute Walk Test). ANOVA and multivariate regression analyses were conducted to establish significant differences among the genders and the three groups.

Results

Group 3 had significantly lower thigh and mid-arm circumference (p<0.05 for both genders), higher %body fat (p<0.05 for both genders) and lower Appendicular Lean Mass(ALM)/Height² (p<0.05 for both genders) as compared to group 1. In males, mean non-dominant grip strength was 26.7±7 kg, 27.8±7.3 kg and 18.6±5.6 kg among group 1, group 2 and group 3, respectively (p<0.05). In females, the values were 16±4.2 kg, 12.7±3.9 kg and 11.2±3.7 kg among group 1, group 2 and group 3, respectively (p<0.05). Group 3 had significantly higher times for Timed Up and Go test in both genders (p<0.05). The grip strength correlated significantly with ALM/Height² in both genders (r=0.66 and r=0.47, respectively; p<0.05). Timed Up and Go test correlated inversely with ALM/Height² in both genders (r=-0.42 and r=-0.71, respectively; p<0.05).

Conclusions

Patients with diabetes had a significantly higher % body fat and lower muscle mass and quality as compared to those with normal glucose tolerance and prediabetes. Strategies to improve the lean muscle mass as well as quality may be helpful in prevention and management of diabetes.