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Diabetes Care. 2012 Aug;35(8):1672-9. doi: 10.2337/dc11-2202. Epub 2012 May 17.

Role of muscle mass and muscle quality in the association between diabetes and gait speed.

Author information

1
Section of Internal Medicine and Geriatrics, Department of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy. vlt@unife.it

Abstract

OBJECTIVE:

Older people with type 2 diabetes are at high risk of mobility disability. We investigated the association of diabetes with lower-limb muscle mass and muscle quality to verify whether diabetes-related muscle impairments mediate the association between diabetes and low walking speed.

RESEARCH DESIGN AND METHODS:

We performed a cross-sectional analysis of 835 participants (65 years old and older) enrolled in the InCHIANTI (Invecchiare in Chianti, aging in the Chianti area) population-based study. Total, muscular, and fat cross-sectional areas of the calf and relative muscle density were measured using peripheral quantitative computerized tomography. Indicators of muscle performance included knee-extension torque, ankle plantar flexion and dorsiflexion strength, lower-extremity muscle power, and ankle muscle quality (ratio of ankle strength to the muscle area [kilograms per centimeters squared]). Gait performance was assessed by 4- and 400-m walking speed. Diabetes was ascertained by standard American Diabetes Association criteria.

RESULTS:

Prevalence of diabetes was 11.4%. After adjustment for age and sex, participants with diabetes had lower muscle density, knee and ankle strength, and muscle power and worse muscle quality (all P < 0.05). Diabetic participants were also slower on both 4-m (β: -0.115 ± 0.024 m/s, P < 0.001) and 400-m (β:-0.053 ± 0.023 m/s, P < 0.05) walking tests. In multivariable linear regression models, lower-limb muscle characteristics accounted for 24.3 and 15.1% of walking speed difference comparing diabetic and nondiabetic subjects in the 4- and 400-m walks, respectively.

CONCLUSIONS:

In older persons, diabetes is associated with reduced muscle strength and worse muscle quality. These impairments are important contributors of walking limitations related to diabetes.

PMID:
22596176
PMCID:
PMC3402248
DOI:
10.2337/dc11-2202
[Indexed for MEDLINE]
Free PMC Article

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