Why the study?
T2DM is associated with altered skeletal muscle quantity and quality, but the relationship between qualitative skeletal muscle changes and exercise function in cardiac rehabilitation patients with versus without diabetes remained unclear.
Does the presence of Type 2 Diabetes Mellitus reduce skeletal muscle quality and exercise function in patients with cardiovascular disease undergoing cardiac rehabilitation?
Does the presence of Type 2 Diabetes Mellitus reduce skeletal muscle quality and exercise function in patients with cardiovascular disease undergoing cardiac rehabilitation?
In patients with cardiovascular disease undergoing cardiac rehabilitation, the coexistence of Type 2 Diabetes Mellitus is associated with decreased skeletal muscle quality (measured by phase angle) and lower exercise capacity (peak oxygen uptake).
T2DM associated with poorer muscle quality and capacity in CR; hypothesis-generating, prospective studies needed before practice change.
Background Type 2 diabetes mellitus (T2DM) is associated with changes in skeletal muscle quantity and quality, such as increased ectopic fat. Cardiac rehabilitation (CR) aims to improve the exercise capacity and muscle strength. This study aimed to determine the relationship between qualitative changes in the skeletal muscles and exercise function in patients with and without diabetes mellitus. Methods The study included patients with cardiovascular diseases who entered CR. Of 72 CR patients (68.1±9.0 years) who underwent a cardiopulmonary exercise test and skeletal muscle assessment at discharge, 15 patients with T2DM and 15 without DM were selected using propensity score matching by age and gender. Results No significant differences in the skeletal muscle echo intensity (EI) (T2DM: 58.4, Non-DM: 53.4, p=0.32), skeletal muscle index (T2DM: 7.5 kg/m2, Non-DM: 7.2 kg/m2, p=0.36), or the weight-bearing index (WBI)(T2DM: 0.44, Non-DM: 0.50, p=0.35) existed between the two groups. The phase angle (PhA) (T2DM: 3.67°, Non-DM: 4.49°, p<0.05) and peak oxygen uptake (T2DM: 12.3 mL/kg/min, Non-DM: 14.8 mL/kg/min, p<0.05) were significantly lower in the T2DM group. PhA values showed a significant correlation with the WBI, a parameter of lower limb muscle strength (r=0.50, p<0.05). Conclusion The coexistence of cardiovascular disease and T2DM resulted in a decrease in the PhA, indicating a qualitative decrease in skeletal muscle mass. The PhA is also associated with lower limb muscle strength.
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Takahashi et al. (2024) studied this question.
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