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Sex differences in the association of fasting and postchallenge glucose levels with grip strength among older adults: the Rancho Bernardo Study.

Kalyani RR, Kim C, Ferrucci L, Laughlin GA, Kritz-Silverstein D, Kong S, Nan B, Barrett-Connor E - BMJ Open Diabetes Res Care (2015)

Bottom Line: Fasting plasma glucose (FPG) was measured in 1019 women and 636 men.Two-hour glucose (2HG) levels after a 75 g oral glucose tolerance test were also available (women, n=870; men, n=559).In age-adjusted analyses, elevated fasting glucose levels are associated with persistently lower grip strength in older men, but not women.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology, Diabetes & Metabolism, Department of Medicine , The Johns Hopkins University , Baltimore, Maryland , USA.

ABSTRACT

Objective: Persons with diabetes have accelerated muscle loss. The association of fasting and postchallenge glucose levels per se to grip strength, a clinical marker of poor physical function, and potential sex differences in this relationship has not been previously described.

Design: Longitudinal cohort.

Setting: USA.

Participants: Participants were community-dwelling older adults (mean age 71.3 years) without self-reported diabetes and/or use of diabetes medication with glucose measured at baseline (1992-1996).

Measurements: Fasting plasma glucose (FPG) was measured in 1019 women and 636 men. Two-hour glucose (2HG) levels after a 75 g oral glucose tolerance test were also available (women, n=870; men, n=559). Dominant hand grip strength was assessed using a hand-held dynamometer at 3.0±1.6 visits over a median 7.0 years. Mixed linear models examined the association of baseline glucose levels with grip strength, accounting for repeated visits, and adjusting for covariates.

Results: Sex-specific FPG quartiles were associated with unadjusted differences in grip strength among women (p=0.03) but not men (p=0.50). However, in men, adjusting for age, education, height, weight, peripheral neuropathy, physical activity, and comorbidities, each SD (SD=17 mg/dL) higher FPG was associated with persistently lower grip strength (-0.44±0.22 kg, p=0.049); 2HG (SD=50 mg/dL) was unrelated to grip strength (-0.39±0.25 kg, p=0.13). In women, neither FPG (SD=16 mg/dL) nor 2HG (SD=45 mg/dL) was associated with grip strength (0.02±0.12 kg, p=0.90; and -0.20±0.14 kg, p=0.14; respectively) after adjustment. The rate of change in grip strength did not differ across FPG or 2HG quartiles in either sex.

Conclusions: In age-adjusted analyses, elevated fasting glucose levels are associated with persistently lower grip strength in older men, but not women. Future studies are needed to elucidate reasons for these sex differences and may provide further insight into accelerated loss of muscle function as a complication of diabetes in older adults.

No MeSH data available.


Related in: MedlinePlus

Mean decline in grip strength with aging by baseline quartile of fasting plasma glucose (FPG). For men (A), grip strength was lower among men in the highest FPG quartile compared with those in lower FPG quartiles after approximately the age of 65 years. For women (B), grip strength tended to be slightly higher in women in the highest versus lowest FPG quartile until the age of 85 years, but differences narrowed beyond this age. However, the rate of grip strength decline with age did not significantly differ by FPG quartile for either men or women (both p values >0.05).
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BMJDRC2015000086F1: Mean decline in grip strength with aging by baseline quartile of fasting plasma glucose (FPG). For men (A), grip strength was lower among men in the highest FPG quartile compared with those in lower FPG quartiles after approximately the age of 65 years. For women (B), grip strength tended to be slightly higher in women in the highest versus lowest FPG quartile until the age of 85 years, but differences narrowed beyond this age. However, the rate of grip strength decline with age did not significantly differ by FPG quartile for either men or women (both p values >0.05).

Mentions: The age trajectory of grip strength, using both baseline and follow-up data were available for men and women categorized by baseline quartile of FPG and 2HG is shown in figure 1A (men) and 1B (women). Grip strength was lower among men in the highest FPG quartile compared with those in lower FPG quartiles after approximately the age of 65 years (figure 1A). Conversely, as shown in figure 1B, grip strength tended to be slightly higher in women in the highest versus lowest FPG quartile until the age of 85 years, but differences narrowed beyond this age. Figure 2A, B shows no consistent differences with aging for the highest versus lowest 2HG quartiles for men or women. However, there was no significant interaction with age by FPG (or 2HG) for either men or women (all p values >0.05).


Sex differences in the association of fasting and postchallenge glucose levels with grip strength among older adults: the Rancho Bernardo Study.

Kalyani RR, Kim C, Ferrucci L, Laughlin GA, Kritz-Silverstein D, Kong S, Nan B, Barrett-Connor E - BMJ Open Diabetes Res Care (2015)

Mean decline in grip strength with aging by baseline quartile of fasting plasma glucose (FPG). For men (A), grip strength was lower among men in the highest FPG quartile compared with those in lower FPG quartiles after approximately the age of 65 years. For women (B), grip strength tended to be slightly higher in women in the highest versus lowest FPG quartile until the age of 85 years, but differences narrowed beyond this age. However, the rate of grip strength decline with age did not significantly differ by FPG quartile for either men or women (both p values >0.05).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4419462&req=5

BMJDRC2015000086F1: Mean decline in grip strength with aging by baseline quartile of fasting plasma glucose (FPG). For men (A), grip strength was lower among men in the highest FPG quartile compared with those in lower FPG quartiles after approximately the age of 65 years. For women (B), grip strength tended to be slightly higher in women in the highest versus lowest FPG quartile until the age of 85 years, but differences narrowed beyond this age. However, the rate of grip strength decline with age did not significantly differ by FPG quartile for either men or women (both p values >0.05).
Mentions: The age trajectory of grip strength, using both baseline and follow-up data were available for men and women categorized by baseline quartile of FPG and 2HG is shown in figure 1A (men) and 1B (women). Grip strength was lower among men in the highest FPG quartile compared with those in lower FPG quartiles after approximately the age of 65 years (figure 1A). Conversely, as shown in figure 1B, grip strength tended to be slightly higher in women in the highest versus lowest FPG quartile until the age of 85 years, but differences narrowed beyond this age. Figure 2A, B shows no consistent differences with aging for the highest versus lowest 2HG quartiles for men or women. However, there was no significant interaction with age by FPG (or 2HG) for either men or women (all p values >0.05).

Bottom Line: Fasting plasma glucose (FPG) was measured in 1019 women and 636 men.Two-hour glucose (2HG) levels after a 75 g oral glucose tolerance test were also available (women, n=870; men, n=559).In age-adjusted analyses, elevated fasting glucose levels are associated with persistently lower grip strength in older men, but not women.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology, Diabetes & Metabolism, Department of Medicine , The Johns Hopkins University , Baltimore, Maryland , USA.

ABSTRACT

Objective: Persons with diabetes have accelerated muscle loss. The association of fasting and postchallenge glucose levels per se to grip strength, a clinical marker of poor physical function, and potential sex differences in this relationship has not been previously described.

Design: Longitudinal cohort.

Setting: USA.

Participants: Participants were community-dwelling older adults (mean age 71.3 years) without self-reported diabetes and/or use of diabetes medication with glucose measured at baseline (1992-1996).

Measurements: Fasting plasma glucose (FPG) was measured in 1019 women and 636 men. Two-hour glucose (2HG) levels after a 75 g oral glucose tolerance test were also available (women, n=870; men, n=559). Dominant hand grip strength was assessed using a hand-held dynamometer at 3.0±1.6 visits over a median 7.0 years. Mixed linear models examined the association of baseline glucose levels with grip strength, accounting for repeated visits, and adjusting for covariates.

Results: Sex-specific FPG quartiles were associated with unadjusted differences in grip strength among women (p=0.03) but not men (p=0.50). However, in men, adjusting for age, education, height, weight, peripheral neuropathy, physical activity, and comorbidities, each SD (SD=17 mg/dL) higher FPG was associated with persistently lower grip strength (-0.44±0.22 kg, p=0.049); 2HG (SD=50 mg/dL) was unrelated to grip strength (-0.39±0.25 kg, p=0.13). In women, neither FPG (SD=16 mg/dL) nor 2HG (SD=45 mg/dL) was associated with grip strength (0.02±0.12 kg, p=0.90; and -0.20±0.14 kg, p=0.14; respectively) after adjustment. The rate of change in grip strength did not differ across FPG or 2HG quartiles in either sex.

Conclusions: In age-adjusted analyses, elevated fasting glucose levels are associated with persistently lower grip strength in older men, but not women. Future studies are needed to elucidate reasons for these sex differences and may provide further insight into accelerated loss of muscle function as a complication of diabetes in older adults.

No MeSH data available.


Related in: MedlinePlus