Background: Loss of muscle mass may increase risk for type 2 diabetes (T2D), but few prospective studies have examined this association. The objective of this study was to determine whether loss of muscle mass (approximated with fat free mass [FFM]) is associated with risk for prediabetes and T2D in a population disproportionately burdened by T2D.
Methods: Participants were Hispanic/Latino adults (aged 18-74 years) in the Hispanic Community Health Study/Study of Latinos (6.1-year follow-up), a multi-site, community-based cohort in the United States. Eligible participants were free of T2D at baseline (2008-2011; n=6264). Fasting glucose, HbA1c, and fasting insulin were measured. Diabetes was defined according to American Diabetes Association criteria. Analysis:Survey-weighted Poisson regression models examined the association of percent change in relative FFM (FFM/total body weight; %∆FFM) with incident prediabetes and T2D. Survey-weighted linear regression models examined associations of %∆FFM with changes in glucose and insulin measures. Models were adjusted for age, sex, Hispanic/Latino background, site, nativity, education, income, physical activity, years between visits, and diabetic medication use (for lab values only).
Results: Relative FFM declined by 2.1% between visits. %∆FFM was inversely associated with incident prediabetes (p-for-trend=0.001) but not T2D. %∆FFM was inversely associated with changes in glucose and insulin measures (p-for-trend<0.0001). After adjustment for 1) fat mass index or 2) BMI and waist circumference, only the association with HOMA-IR remained significant. Associations were generally stronger for individuals who were overweight/obese at baseline (p<0.05).
Conclusions: Findings suggest that muscle mass maintenance/accumulation during adulthood may reduce T2D risk (primarily insulin resistance), particularly among individuals who are overweight/obese.
M.N. LeCroy: None. S. Hua: None. R. Kaplan: None. D. Sotres-Alvarez: None. Q. Qi: None. B. Thyagarajan: None. L. Gallo: None. A. Pirzada: None. M.L. Daviglus: None. G.A. Talavera: None. C.R. Isasi: None.
National Heart, Lung, and Blood Institute (N01HC65233, N01HC65234, N01HC65235, HHSN268201300003I, N01HC65236, N01HC65237, T32HL144456)