Association of Muscle Quality With Glycemic Control and Functional Capacity in Adults With Type 2 Diabetes
DOI:
https://doi.org/10.61336/jdme.0402.01Keywords:
Type 2 diabetes mellitus, muscle quality, skeletal muscle, glycemic control, physical function, handgrip strength, gait speed, sarcopeniaAbstract
Muscle quality is increasingly recognized as an important determinant of metabolic and functional health in adults with type 2 diabetes mellitus (T2DM), although muscle quantity alone may not adequately reflect impaired muscle performance. This study investigated the association between muscle quality, glycemic control, and functional capacity in adults with T2DM. A cross-sectional study was conducted among 188 adults aged 40–75 years with established T2DM. Skeletal muscle mass was assessed using dual-energy X-ray absorptiometry, while muscle quality was estimated by combining appendicular lean mass with handgrip strength and lower-extremity performance. Glycemic status was evaluated using HbA1c, fasting glucose, and continuous glucose monitoring-derived time in range. Functional capacity was assessed using the Short Physical Performance Battery, five-times sit-to-stand test, usual gait speed, and six-minute walk test. Participants with lower muscle quality had higher HbA1c, greater glycemic exposure, lower time in range, and poorer functional performance than those with preserved muscle quality. Muscle quality demonstrated significant inverse correlations with HbA1c and fasting glucose and positive correlations with gait speed, six-minute walk distance, and Short Physical Performance Battery score. In multivariable analysis, lower muscle quality remained independently associated with poorer glycemic control and reduced functional capacity after adjustment for age, sex, body mass index, diabetes duration, physical activity, and comorbidity burden. Participants in the lowest muscle-quality tertile had approximately 2.8-fold greater odds of reduced functional capacity than those in the highest tertile. These findings suggest that muscle quality may provide clinically relevant information beyond skeletal muscle mass and may represent an important link between metabolic control and physical function in adults with T2DM.
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