Background: Type 2 diabetes (T2DM) and sarcopenia have a reciprocal association and could cause a vicious cycle. Resistance training has been proposed to prevent the cycle. It has been postulated that the associated factors with upper limb muscle volume (MV) and lower limb MV were different in T2DM. For efficient resistance training programs, it is needed to understand the factors affect to the imbalance between upper and lower limb MV in T2DM. Aim: We aimed to clarify the clinical associated factors for lower-to-upper limb MV ratio in T2DM.

Method: We assessed in 505 patients with T2DM visited at Osaka City Hospital (male: n=303, mean ages 63.5±13.1, female: n=202, mean ages 64.3±13.4). MV in upper and lower limb were measured by a bioelectrical impedance analysis. The association between lower-to-upper limb MV ratio and clinical parameters were investigated.

Results: Mean body mass index (BMI) were 26.2±5.0kg/m2 in male and 26.8±5.5kg/m2 in female. Mean lower-to-upper limb MV ratio were significantly lower in male than female (male: 2.9±0.3 vs. female: 3.2±0.5, p<0.001). Mean lower-to-upper limb MV ratio in male was correlated with age, BMI, visceral fat area (VFA), estimated GFR (eGFR), hemoglobin (Hb), C reactive protein (CRP). In female, that was correlated with age, BMI, VFA, Hb, CRP and HbA1c. Multiple regression analysis showed that BMI and Hb were the negative independent factors, and VFA and systolic blood pressure were the positive independent factors for lower-to-upper limb MV ratio in male T2DM (R2=0.262, p<0.001). In female T2DM, BMI was the negative independent factor for lower-to-upper limb MV ratio. Notably, VFA exhibit positive correlation to lower-to-upper limb MV ratio in male obese T2DM (r=-0.252, p=0.001), but VFA negatively correlated in male non-obese T2DM (r=0.244, p=0.006).

Conclusions: Gender, blood pressure, Hb and especially visceral obesity, were the important relevant factors for imbalance between upper and lower limb muscle volume in type 2 diabetes.


K. Motoyama: None. S. Tazoe: None. A. Tamai: None. T. Sakura: None. M. Ohara: None. Y. Yakushiji: None. M. Fukumoto: None. M. Hosoi: Speaker's Bureau; Self; Eli Lilly and Company.

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