Background: Skeletal muscle mass was negatively associated with the prevalence of diabetes in previous cross-sectional studies. The aim of the study was to investigate the impact of baseline relative skeletal muscle mass on the development of diabetes in a large population-based 7-year longitudinal study.

Methods: A total of 18,269 individuals who underwent medical health check-up examination in a university-affiliated tertiary hospital without diabetes were included. Skeletal muscle mass was estimated by bioelectrical impedance analysis and presented as appendicular skeletal muscle mass (ASM) / body mass index (BMI). We analyzed hazard ratio for developing diabetes associated with ASM/BMI using Cox regression models and evaluated the effects of preexisting impaired fasting glucose (IFG).

Results: Compared to subjects in the lowest baseline sex-specific ASM/BMI tertile, those in the highest ASM/BMI tertile were significantly associated with a decreased adjusted HR (AHR=0.69, 95% CI=0.59-0.81, P <0.001) for incident diabetes after adjusting for age, family history of diabetes, smoking status, regular exercise, metabolic syndrome, and CRP. The reduction in the risk of developing diabetes was also significant in the highest tertile of sex-specific ASM/BMI tertile in the presence (AHR=0.81, 95% CI=0.68-0.97, P<0.001) and in the absence of IFG (AHR=0.51, 95% CI=0.39-0.67, P<0.001) compared to the lowest tertile.

Conclusion: The large relative skeletal muscle mass has a potential preventive effect on developing diabetes, independently of glycometabolic parameters. In particular, in subjects with IFG who are at high risk for diabetes, larger relative skeletal muscle mass may provide a substantial benefit to prevent diabetes.


G. Kim: None. M. Choi: None. S. Jin: None. M. Lee: None. J. Kim: None.

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