Bedside tests of muscle mass in older adults with Type 2 diabetes

Abstract

Diabetes and sarcopenia often coexist in older adults, suggesting a possible bidirectional association. Available bedside measures of muscle mass consist of bedside ultrasound (MT, quadriceps muscle thickness) and Bioelectrical Impedance Analysis (BIA). We examined the association between ultrasound measures and BIA measures of muscle in older adults with measures of strength, performance and frailty in older adults with diabetes.

Cross-sectional study.

81 subjects (age ≥ 65; mean age 80.8 ± 0.6 years, 27 women, 53 men) were recruited sequentially from geriatric medicine clinics. Each subject had Lean Body Mass (LBM, by BIA, in kg), grip strength, gait speed, Cardiovascular Health Study index (frailty) and MT (in cm) measured. All initial models were adjusted for biological sex.

In our final parsimonious models, only MT (as opposed to LBM) showed a significant correlation with grip strength (Standardized β = 0.217 ± 0.078; p = 0.007) and frailty (Standardized β = 0.276 ± 0.109; p = 0.013). Neither MT or LBM showed a significant association with subject performance (gait speed).

Unlike BIA, bedside ultrasound measures of muscle thickness showed strong associations with both grip strength and frailty in the older adult population with diabetes, suggesting that bedside measures of MT might be a more clinically useful modality to assess muscularity in this patient population. Neither BIA or MT measures of subject muscularity showed any association with our performance indicator (gait speed).