Limits...
Insulin sensitizers may attenuate lean mass loss in older men with diabetes.

Lee CG, Boyko EJ, Barrett-Connor E, Miljkovic I, Hoffman AR, Everson-Rose SA, Lewis CE, Cawthon PM, Strotmeyer ES, Orwoll ES, Osteoporotic Fractures in Men (MrOS) Study Research Gro - Diabetes Care (2011)

Bottom Line: A total of 3,752 ambulatory men aged ≥ 65 years at baseline participated in a multicenter longitudinal cohort study.There remained a significantly greater percentage loss in appendicular lean mass for these groups even after adjustment for medical comorbidities or lifestyle factors.These findings suggest that insulin sensitizers may attenuate muscle loss.

View Article: PubMed Central - PubMed

Affiliation: Oregon Health and ScienceUniversity, Portland,Oregon, USA. leechr@ohsu.edu

ABSTRACT

Objective: To examine longitudinal changes in total and appendicular lean body mass in older men with impaired fasting glucose (IFG) or diabetes and to determine whether these changes differ by diabetes treatment.

Research design and methods: A total of 3,752 ambulatory men aged ≥ 65 years at baseline participated in a multicenter longitudinal cohort study. Baseline glycemic status was categorized as normoglycemia, IFG, undiagnosed/untreated diabetes, or treated diabetes. Insulin sensitizer medication use (metformin and/or thiazolidinediones) was assessed by prescription medication inventory. The change in total lean and appendicular lean mass was derived from dual X-ray absorptiometry scans taken at baseline and 3.5 ± 0.7 years later.

Results: This male cohort included 1,853 individuals with normoglycemia, 1,403 with IFG, 234 with untreated diabetes, 151 with diabetes treated with insulin sensitizers, and 111 with diabetes treated without insulin sensitizers. Men with untreated diabetes, diabetes treated without insulin sensitizers, or IFG had greater percentage loss in total or appendicular lean mass (P ≤ 0.05 in comparison to normoglycemic men). There remained a significantly greater percentage loss in appendicular lean mass for these groups even after adjustment for medical comorbidities or lifestyle factors. In contrast, the percentage loss in total or appendicular lean mass in men with diabetes treated with insulin sensitizers was significantly less than that in normoglycemic men in minimally and fully adjusted models.

Conclusions: Skeletal muscle loss was accelerated in men with IFG and diabetes, except when the latter was treated with insulin sensitizers. These findings suggest that insulin sensitizers may attenuate muscle loss.

Show MeSH

Related in: MedlinePlus

Number of men in glycemic and diabetes treatment categories. DM, diabetes mellitus; MET, metformin; TZD, thiazolidinedione.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3198278&req=5

Figure 1: Number of men in glycemic and diabetes treatment categories. DM, diabetes mellitus; MET, metformin; TZD, thiazolidinedione.

Mentions: Categories of baseline glycemic status were created using fasting glucose levels, self-reported diagnosis of diabetes, and the medication inventory (Fig. 1). Men without self-reported diabetes or use of diabetes medications were considered to have normoglycemia if their fasting glucose level was <100 mg/dL and IFG if their fasting glucose level was 100–125 mg/dL. Men with a fasting glucose ≥126 mg/dL and/or self-reported diabetes were considered to have undiagnosed/untreated diabetes if they did not use medications to treat diabetes and treated diabetes if they used medication(s) to treat diabetes. Men with treated diabetes were further characterized as using insulin sensitizers (metformin and/or thiazolidinediones) at baseline or not, since studies using hyperinsulinemic-euglycemic clamps demonstrated improved peripheral insulin sensitivity with these medications (12–15). Additional diabetes medications taken by participants included insulin (n = 42), sulfonylureas (n = 158), and meglitinides (n = 4). There were no participants on α-glucosidase inhibitors.


Insulin sensitizers may attenuate lean mass loss in older men with diabetes.

Lee CG, Boyko EJ, Barrett-Connor E, Miljkovic I, Hoffman AR, Everson-Rose SA, Lewis CE, Cawthon PM, Strotmeyer ES, Orwoll ES, Osteoporotic Fractures in Men (MrOS) Study Research Gro - Diabetes Care (2011)

Number of men in glycemic and diabetes treatment categories. DM, diabetes mellitus; MET, metformin; TZD, thiazolidinedione.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3198278&req=5

Figure 1: Number of men in glycemic and diabetes treatment categories. DM, diabetes mellitus; MET, metformin; TZD, thiazolidinedione.
Mentions: Categories of baseline glycemic status were created using fasting glucose levels, self-reported diagnosis of diabetes, and the medication inventory (Fig. 1). Men without self-reported diabetes or use of diabetes medications were considered to have normoglycemia if their fasting glucose level was <100 mg/dL and IFG if their fasting glucose level was 100–125 mg/dL. Men with a fasting glucose ≥126 mg/dL and/or self-reported diabetes were considered to have undiagnosed/untreated diabetes if they did not use medications to treat diabetes and treated diabetes if they used medication(s) to treat diabetes. Men with treated diabetes were further characterized as using insulin sensitizers (metformin and/or thiazolidinediones) at baseline or not, since studies using hyperinsulinemic-euglycemic clamps demonstrated improved peripheral insulin sensitivity with these medications (12–15). Additional diabetes medications taken by participants included insulin (n = 42), sulfonylureas (n = 158), and meglitinides (n = 4). There were no participants on α-glucosidase inhibitors.

Bottom Line: A total of 3,752 ambulatory men aged ≥ 65 years at baseline participated in a multicenter longitudinal cohort study.There remained a significantly greater percentage loss in appendicular lean mass for these groups even after adjustment for medical comorbidities or lifestyle factors.These findings suggest that insulin sensitizers may attenuate muscle loss.

View Article: PubMed Central - PubMed

Affiliation: Oregon Health and ScienceUniversity, Portland,Oregon, USA. leechr@ohsu.edu

ABSTRACT

Objective: To examine longitudinal changes in total and appendicular lean body mass in older men with impaired fasting glucose (IFG) or diabetes and to determine whether these changes differ by diabetes treatment.

Research design and methods: A total of 3,752 ambulatory men aged ≥ 65 years at baseline participated in a multicenter longitudinal cohort study. Baseline glycemic status was categorized as normoglycemia, IFG, undiagnosed/untreated diabetes, or treated diabetes. Insulin sensitizer medication use (metformin and/or thiazolidinediones) was assessed by prescription medication inventory. The change in total lean and appendicular lean mass was derived from dual X-ray absorptiometry scans taken at baseline and 3.5 ± 0.7 years later.

Results: This male cohort included 1,853 individuals with normoglycemia, 1,403 with IFG, 234 with untreated diabetes, 151 with diabetes treated with insulin sensitizers, and 111 with diabetes treated without insulin sensitizers. Men with untreated diabetes, diabetes treated without insulin sensitizers, or IFG had greater percentage loss in total or appendicular lean mass (P ≤ 0.05 in comparison to normoglycemic men). There remained a significantly greater percentage loss in appendicular lean mass for these groups even after adjustment for medical comorbidities or lifestyle factors. In contrast, the percentage loss in total or appendicular lean mass in men with diabetes treated with insulin sensitizers was significantly less than that in normoglycemic men in minimally and fully adjusted models.

Conclusions: Skeletal muscle loss was accelerated in men with IFG and diabetes, except when the latter was treated with insulin sensitizers. These findings suggest that insulin sensitizers may attenuate muscle loss.

Show MeSH
Related in: MedlinePlus