Low-attenuation muscle is a predictor of diabetes mellitus: A population-based cohort study.
OBJECTIVES
Diabetes mellitus is a major global public health issue. Cross-sectional studies have demonstrated that skeletal muscle quality and quantity by computed tomography (CT) is related to glucose metabolism. However, to our knowledge, no longitudinal study has yet to elucidate the association between muscle quality determined by CT and glucose metabolism. Thus, the aim of this study was to evaluate the association between muscle quality and glucose metabolism.


METHODS
In this retrospective study, we evaluated data from 621 middle-aged Japanese individuals without diabetes mellitus from a cohort of employees undergoing annual physical examinations. The cross-sectional skeletal muscle area was determined based on CT data at the level of the third lumbar vertebrae, and the skeletal muscle index (SMI) and density (SMD) were calculated. Low-attenuation muscle (LAM) and normal-attenuation muscle (NAM) were identified and quantified using thresholds of -29 to +29 HU and +30 to +150 HU, respectively.


RESULTS
We followed the individuals for a mean period of 3 y, and 27 of them developed diabetes mellitus during this period. Multiple Cox regression analyses revealed that, even after adjustment for visceral fat area index, the LAM index (hazard ratio [HR], 3.07; 95% confidence interval [CI], 1.00-7.52) showed an increased adjusted HR for incident diabetes mellitus. When total SMI and SMD were used in the same models, only total SMD (HR, 0.90; 95% CI, 0.81-0.99) showed a decreased adjusted HR for incident diabetes mellitus.


CONCLUSIONS
Both LAM index and total SMD were associated with a higher risk for incident diabetes mellitus, whereas NAM index and total SMI were not.
['Tanaka|Muhei|M|', 'Okada|Hiroshi|H|', 'Hashimoto|Yoshitaka|Y|', 'Kumagai|Muneaki|M|', 'Nishimura|Hiromi|H|', 'Fukui|Michiaki|M|']
D015331:Cohort Studies D003430:Cross-Sectional Studies D003920:Diabetes Mellitus D006801:Humans D008875:Middle Aged D018482:Muscle, Skeletal D012189:Retrospective Studies
Diabetes mellitus Muscle quality Muscle attenuation Muscle mass Obesity