Dynapenic obesity and the risk of incident type 2 diabetes: the English Longitudinal Study of Ageing
journal contributionposted on 2015-11-10, 13:58 authored by Daniel J. Cuthbertson, Joshua A. Bell, S.Y. Ng, Graham J. Kemp, Mika Kivimaki, Mark Hamer
Aim Obesity is a well-established risk factor for developing Type 2 diabetes. Evidence suggests that sarcopenia, the age-related decline in muscle mass and strength, may exacerbate diabetes risk in obese individuals. The aim of this study was to determine the combined effect of obesity and low muscle strength, dynapenia, on the risk of incident Type 2 diabetes in older adults. Methods Participants were 5953 (1670 obese) men and women from the English Longitudinal Study of Ageing without known Type 2 diabetes at baseline and for whom handgrip strength, biochemical and other clinical data were collected. A diagnosis of Type 2 diabetes was recorded from self-reported physician diagnosis over 6 years. Results For each unit increase in grip strength, there was a reduction in diabetes risk (age and sex, BMI adjusted HR; 0.98; 95% CI 0.96–0.99). The risk of Type 2 diabetes was elevated in all obese participants, but was greatest in those with low handgrip strength (HR = 4.93, 95% CI 2.85, 8.53) compared with non-obese individuals with high handgrip strength. Eleven per cent of the sample met the threshold for weakness (handgrip strength: men < 26 kg; women < 16 kg) that was associated with elevated Type 2 diabetes risk in obese (HR = 3.57, 95% CI 2.04, 6.24) but not in non-obese (HR = 0.86, 95% CI, 0.44, 1.68) compared with normal/non-obese participants. Conclusion Dynapenic obesity, determined by high BMI and low handgrip strength, is associated with increased risk of incident Type 2 diabetes in older people.
Funding for ELSA is provided by the National Institute on Aging in the United States (grants 2RO1AG7644-01A1 and 2RO1AG017644) and a consortium of UK government departments coordinated by the Office for National Statistics. JAB is supported by an Economic and Social Research Council (ESRC) studentship, MK by the Medical Research Council (K013351) and the Economic and Social Research Council, MH by the British Heart Foundation (RE/10/005/28296), and GJK and DJC by the Medical Research Council and Arthritis Research UK (MR/ K006312/1) as part of the MRC – Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA).
- Sport, Exercise and Health Sciences