More appendicular lean mass relative to body mass index is associated with lower incident diabetes in middle-aged adults in the CARDIA study

Melanie S. Haines; Aaron Leong; Bianca C. Porneala; Victor W. Zhong; Cora E. Lewis; Pamela J. Schreiner; Karen K. Miller; James B. Meigs; Mercedes R. Carnethon

doi:10.1016/j.numecd.2022.09.017

More appendicular lean mass relative to body mass index is associated with lower incident diabetes in middle-aged adults in the CARDIA study

Melanie S. Haines
, Aaron Leong
, Bianca C. Porneala
, Victor W. Zhong
, Cora E. Lewis
, Pamela J. Schreiner
, Karen K. Miller
, James B. Meigs
, Mercedes R. Carnethon

Epidemiology & Community Health

Research output: Contribution to journal › Article › peer-review

13 Scopus citations

Abstract

Background and aims: Although lower lean mass is associated with greater diabetes prevalence in cross-sectional studies, prospective data specifically in middle-aged Black and White adults are lacking. Relative appendicular lean mass (ALM), such as ALM adjusted for body mass index (BMI), is important to consider since muscle mass is associated with overall body size. We investigated whether ALM/BMI is associated with incident type 2 diabetes in the Coronary Artery Risk Development in Young Adults study. Methods and results: 1893 middle-aged adults (55% women) were included. ALM was measured by DXA in 2005-06. Incident type 2 diabetes was defined in 2010–11 or 2015–16 as fasting glucose ≥7 mmol/L (126 mg/dL), 2-h glucose on OGTT ≥11.1 mmol/L (200 mg/dL) (2010–11 only), HbA_1C ≥48 mmol/mol (6.5%) (2010–11 only), or glucose-lowering medications. Cox regression models with sex stratification were performed. In men and women, ALM/BMI was 1.07 ± 0.14 (mean ± SD) and 0.73 ± 0.12, respectively. Seventy men (8.2%) and 71 women (6.8%) developed type 2 diabetes. Per sex-specific SD higher ALM/BMI, unadjusted diabetes risk was lower by 21% in men [HR 0.79 (0.62–0.99), p = 0.04] and 29% in women [HR 0.71 (0.55–0.91), p = 0.008]. After adjusting for age, race, smoking, education, physical activity, and waist circumference, the association was no longer significant. Adjustment for waist circumference accounted for the attenuation in men. Conclusion: Although more appendicular lean mass relative to BMI is associated with lower incident type 2 diabetes in middle-aged men and women over 10 years, its effect may be through other metabolic risk factors such as waist circumference, which is a correlate of abdominal fat mass.

Original language	English (US)
Pages (from-to)	105-111
Number of pages	7
Journal	Nutrition, Metabolism and Cardiovascular Diseases
Volume	33
Issue number	1
DOIs	https://doi.org/10.1016/j.numecd.2022.09.017
State	Published - Jan 2023

Bibliographical note

Funding Information:
The Coronary Artery Risk Development in Young Adults Study (CARDIA) is supported by the National Heart, Lung, and Blood Institute [grant numbers HHSN268201800003I , HHSN268201800004I , HHSN268201800005I , HHSN268201800006I , and HHSN268201800007I ]. 20 Year Changes in Fitness & Cardiovascular Disease Risk was supported by the NHLBI [grant number RO1HL078972 ]. Support was also provided by the National Institutes of Health [grant numbers K23DK115903 (MSH) , K24HL092902 (KKM) , UM1DK078616 (JBM) , R01HL151855 (JBM) ]. Additional support was provided by the Doris Duke Charitable Foundation [grant number 2020096 (AL) ] and the Program for Young Eastern Scholar at Shanghai Institutions of Higher Education [grant number QD2020027 (VWZ) ]. This manuscript has been reviewed by CARDIA for scientific content. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the study funders. The study sponsors/funders were not involved in the design of the study; the collection, analysis, and interpretation of data; writing the report; and did not impose any restrictions regarding the publication of the report.

Publisher Copyright:
© 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Diabetes epidemiology
Muscle mass
Type 2 diabetes mellitus

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10.1016/j.numecd.2022.09.017

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Haines, M. S., Leong, A., Porneala, B. C., Zhong, V. W., Lewis, C. E., Schreiner, P. J., Miller, K. K., Meigs, J. B., & Carnethon, M. R. (2023). More appendicular lean mass relative to body mass index is associated with lower incident diabetes in middle-aged adults in the CARDIA study. Nutrition, Metabolism and Cardiovascular Diseases, 33(1), 105-111. https://doi.org/10.1016/j.numecd.2022.09.017

Haines, MS, Leong, A, Porneala, BC, Zhong, VW, Lewis, CE, Schreiner, PJ, Miller, KK, Meigs, JB & Carnethon, MR 2023, 'More appendicular lean mass relative to body mass index is associated with lower incident diabetes in middle-aged adults in the CARDIA study', Nutrition, Metabolism and Cardiovascular Diseases, vol. 33, no. 1, pp. 105-111. https://doi.org/10.1016/j.numecd.2022.09.017

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title = "More appendicular lean mass relative to body mass index is associated with lower incident diabetes in middle-aged adults in the CARDIA study",

abstract = "Background and aims: Although lower lean mass is associated with greater diabetes prevalence in cross-sectional studies, prospective data specifically in middle-aged Black and White adults are lacking. Relative appendicular lean mass (ALM), such as ALM adjusted for body mass index (BMI), is important to consider since muscle mass is associated with overall body size. We investigated whether ALM/BMI is associated with incident type 2 diabetes in the Coronary Artery Risk Development in Young Adults study. Methods and results: 1893 middle-aged adults (55\% women) were included. ALM was measured by DXA in 2005-06. Incident type 2 diabetes was defined in 2010{\textendash}11 or 2015{\textendash}16 as fasting glucose ≥7 mmol/L (126 mg/dL), 2-h glucose on OGTT ≥11.1 mmol/L (200 mg/dL) (2010{\textendash}11 only), HbA1C ≥48 mmol/mol (6.5\%) (2010{\textendash}11 only), or glucose-lowering medications. Cox regression models with sex stratification were performed. In men and women, ALM/BMI was 1.07 ± 0.14 (mean ± SD) and 0.73 ± 0.12, respectively. Seventy men (8.2\%) and 71 women (6.8\%) developed type 2 diabetes. Per sex-specific SD higher ALM/BMI, unadjusted diabetes risk was lower by 21\% in men [HR 0.79 (0.62{\textendash}0.99), p = 0.04] and 29\% in women [HR 0.71 (0.55{\textendash}0.91), p = 0.008]. After adjusting for age, race, smoking, education, physical activity, and waist circumference, the association was no longer significant. Adjustment for waist circumference accounted for the attenuation in men. Conclusion: Although more appendicular lean mass relative to BMI is associated with lower incident type 2 diabetes in middle-aged men and women over 10 years, its effect may be through other metabolic risk factors such as waist circumference, which is a correlate of abdominal fat mass.",

keywords = "Diabetes epidemiology, Muscle mass, Type 2 diabetes mellitus",

author = "Haines, \{Melanie S.\} and Aaron Leong and Porneala, \{Bianca C.\} and Zhong, \{Victor W.\} and Lewis, \{Cora E.\} and Schreiner, \{Pamela J.\} and Miller, \{Karen K.\} and Meigs, \{James B.\} and Carnethon, \{Mercedes R.\}",

note = "Funding Information: The Coronary Artery Risk Development in Young Adults Study (CARDIA) is supported by the National Heart, Lung, and Blood Institute [grant numbers HHSN268201800003I , HHSN268201800004I , HHSN268201800005I , HHSN268201800006I , and HHSN268201800007I ]. 20 Year Changes in Fitness \& Cardiovascular Disease Risk was supported by the NHLBI [grant number RO1HL078972 ]. Support was also provided by the National Institutes of Health [grant numbers K23DK115903 (MSH) , K24HL092902 (KKM) , UM1DK078616 (JBM) , R01HL151855 (JBM) ]. Additional support was provided by the Doris Duke Charitable Foundation [grant number 2020096 (AL) ] and the Program for Young Eastern Scholar at Shanghai Institutions of Higher Education [grant number QD2020027 (VWZ) ]. This manuscript has been reviewed by CARDIA for scientific content. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the study funders. The study sponsors/funders were not involved in the design of the study; the collection, analysis, and interpretation of data; writing the report; and did not impose any restrictions regarding the publication of the report. Publisher Copyright: {\textcopyright} 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University",

year = "2023",

month = jan,

doi = "10.1016/j.numecd.2022.09.017",

language = "English (US)",

volume = "33",

pages = "105--111",

journal = "Nutrition, Metabolism and Cardiovascular Diseases",

issn = "0939-4753",

publisher = "Elsevier B.V.",

number = "1",

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TY - JOUR

T1 - More appendicular lean mass relative to body mass index is associated with lower incident diabetes in middle-aged adults in the CARDIA study

AU - Haines, Melanie S.

AU - Leong, Aaron

AU - Porneala, Bianca C.

AU - Zhong, Victor W.

AU - Lewis, Cora E.

AU - Schreiner, Pamela J.

AU - Miller, Karen K.

AU - Meigs, James B.

AU - Carnethon, Mercedes R.

N1 - Funding Information: The Coronary Artery Risk Development in Young Adults Study (CARDIA) is supported by the National Heart, Lung, and Blood Institute [grant numbers HHSN268201800003I , HHSN268201800004I , HHSN268201800005I , HHSN268201800006I , and HHSN268201800007I ]. 20 Year Changes in Fitness & Cardiovascular Disease Risk was supported by the NHLBI [grant number RO1HL078972 ]. Support was also provided by the National Institutes of Health [grant numbers K23DK115903 (MSH) , K24HL092902 (KKM) , UM1DK078616 (JBM) , R01HL151855 (JBM) ]. Additional support was provided by the Doris Duke Charitable Foundation [grant number 2020096 (AL) ] and the Program for Young Eastern Scholar at Shanghai Institutions of Higher Education [grant number QD2020027 (VWZ) ]. This manuscript has been reviewed by CARDIA for scientific content. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the study funders. The study sponsors/funders were not involved in the design of the study; the collection, analysis, and interpretation of data; writing the report; and did not impose any restrictions regarding the publication of the report. Publisher Copyright: © 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University

PY - 2023/1

Y1 - 2023/1

N2 - Background and aims: Although lower lean mass is associated with greater diabetes prevalence in cross-sectional studies, prospective data specifically in middle-aged Black and White adults are lacking. Relative appendicular lean mass (ALM), such as ALM adjusted for body mass index (BMI), is important to consider since muscle mass is associated with overall body size. We investigated whether ALM/BMI is associated with incident type 2 diabetes in the Coronary Artery Risk Development in Young Adults study. Methods and results: 1893 middle-aged adults (55% women) were included. ALM was measured by DXA in 2005-06. Incident type 2 diabetes was defined in 2010–11 or 2015–16 as fasting glucose ≥7 mmol/L (126 mg/dL), 2-h glucose on OGTT ≥11.1 mmol/L (200 mg/dL) (2010–11 only), HbA1C ≥48 mmol/mol (6.5%) (2010–11 only), or glucose-lowering medications. Cox regression models with sex stratification were performed. In men and women, ALM/BMI was 1.07 ± 0.14 (mean ± SD) and 0.73 ± 0.12, respectively. Seventy men (8.2%) and 71 women (6.8%) developed type 2 diabetes. Per sex-specific SD higher ALM/BMI, unadjusted diabetes risk was lower by 21% in men [HR 0.79 (0.62–0.99), p = 0.04] and 29% in women [HR 0.71 (0.55–0.91), p = 0.008]. After adjusting for age, race, smoking, education, physical activity, and waist circumference, the association was no longer significant. Adjustment for waist circumference accounted for the attenuation in men. Conclusion: Although more appendicular lean mass relative to BMI is associated with lower incident type 2 diabetes in middle-aged men and women over 10 years, its effect may be through other metabolic risk factors such as waist circumference, which is a correlate of abdominal fat mass.

AB - Background and aims: Although lower lean mass is associated with greater diabetes prevalence in cross-sectional studies, prospective data specifically in middle-aged Black and White adults are lacking. Relative appendicular lean mass (ALM), such as ALM adjusted for body mass index (BMI), is important to consider since muscle mass is associated with overall body size. We investigated whether ALM/BMI is associated with incident type 2 diabetes in the Coronary Artery Risk Development in Young Adults study. Methods and results: 1893 middle-aged adults (55% women) were included. ALM was measured by DXA in 2005-06. Incident type 2 diabetes was defined in 2010–11 or 2015–16 as fasting glucose ≥7 mmol/L (126 mg/dL), 2-h glucose on OGTT ≥11.1 mmol/L (200 mg/dL) (2010–11 only), HbA1C ≥48 mmol/mol (6.5%) (2010–11 only), or glucose-lowering medications. Cox regression models with sex stratification were performed. In men and women, ALM/BMI was 1.07 ± 0.14 (mean ± SD) and 0.73 ± 0.12, respectively. Seventy men (8.2%) and 71 women (6.8%) developed type 2 diabetes. Per sex-specific SD higher ALM/BMI, unadjusted diabetes risk was lower by 21% in men [HR 0.79 (0.62–0.99), p = 0.04] and 29% in women [HR 0.71 (0.55–0.91), p = 0.008]. After adjusting for age, race, smoking, education, physical activity, and waist circumference, the association was no longer significant. Adjustment for waist circumference accounted for the attenuation in men. Conclusion: Although more appendicular lean mass relative to BMI is associated with lower incident type 2 diabetes in middle-aged men and women over 10 years, its effect may be through other metabolic risk factors such as waist circumference, which is a correlate of abdominal fat mass.

KW - Diabetes epidemiology

KW - Muscle mass

KW - Type 2 diabetes mellitus

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AN - SCOPUS:85142672772

SN - 0939-4753

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JO - Nutrition, Metabolism and Cardiovascular Diseases

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IS - 1

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More appendicular lean mass relative to body mass index is associated with lower incident diabetes in middle-aged adults in the CARDIA study

Abstract

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