Key result
Impaired fasting glucose and T2DM are linked to increased trunk fat without lean mass loss.
Why the study?
While type 2 diabetes mellitus is associated with muscle mass loss, the impact of fasting blood glucose on lean and fat mass distribution in pre-diabetic individuals remained underappreciated.
Is impaired fasting glucose and untreated type 2 diabetes mellitus associated with altered appendicular and trunk lean and fat mass distribution compared to normal glucose tolerance in middle-aged men and women?
Cross-Sectional (n=3,888)
Yes
Is impaired fasting glucose and untreated type 2 diabetes mellitus associated with altered appendicular and trunk lean and fat mass distribution compared to normal glucose tolerance in middle-aged men and women?
Answers are grounded in this paper and cite their sources.
Pre-diabetes with impaired fasting glucose is already associated with adverse central body composition remodeling (increased trunk fat mass and trunk-to-appendicular fat ratio) despite preserved appendicular muscle mass, supporting early lifestyle intervention prior to overt diabetes.
BACKGROUND: Previous studies suggest that type 2 diabetes mellitus (T2DM) is associated with a loss of muscle mass but the impact of fasting blood glucose (FBG) on body composition remains underappreciated in pre-diabetic subjects. The aim of this study was to determine the influence of FBG on lean mass (LM), fat mass (FM) and their distribution (trunk vs. appendicular), separately in middle-aged men and women. METHODS: One thousand nine hundred and eleven (1,911) men (63.9 ± 11.7 years) and 1,977 women (63.7 ± 12.1 years) from the National Health and Nutrition Examination Survey (1999 - 2004) were divided into four groups: normal glucose tolerance (NGT), low impaired fasting glucose (IFG), high IFG and T2DM. Body composition was obtained from dual X-ray absorptiometry (DXA). RESULTS: Of the patients, 68.7% had NGT, 16.1% low IFG, 9.4% high IFG and 5.8% T2DM. After adjustment for age, body mass index, ethnicity, smoking, alcohol and physical activity (PA), no change in appendicular LM was observed between groups, but significant increases in trunk FM (in both gender) and trunk LM (in women) were found with increased glucose intolerance (T2DM > IFG > NGT), as well as significant decreases in trunk and total LM/FM ratios (T2DM < IFG < NGT) and a significant increase in trunk/appendicular FM ratio (T2DM > IFG > NGT). CONCLUSIONS: Elevated FBG within the normal range is not associated with a significant loss of appendicular LM, but modifications in LM and FM trunk and total distribution with IFG suggest that nutritional and physical lifestyle strategies should be implemented in the pre-diabetic state.
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Julian et al. (2017) conducted a cross-sectional in Impaired fasting glucose (pre-diabetes) and untreated type 2 diabetes mellitus (n=3,888). Impaired fasting glucose and untreated type 2 diabetes mellitus (elevated fasting blood glucose) vs. Normal glucose tolerance (FBG < 5.6 mmol/L) was evaluated on Body composition (appendicular and trunk lean mass and fat mass distribution measured by DXA) (p=<0.05). Impaired fasting glucose and T2DM were associated with increased trunk fat mass and trunk/appendicular fat mass ratios (p<0.05) without loss of appendicular lean mass compared to normal glycemia.
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