The association of low muscle mass with prevalence and incidence of type 2 diabetes in different BMI classes

Objective: The aim of this study is to investigate whether muscle mass is associated with the prevalence and incidence of type 2 diabetes and whether this association differs within men and women of normal weight, overweight or obesity. Methods: Adult participants were included from the Lifelines cohort study. Low muscle mass was defined as < -1SD of the gender-stratified creatinine excretion rate (CER). Multivariate logistic regression analysis was used to assess the association between muscle mass and the prevalence and incidence of type 2 diabetes. Results: Muscle mass was associated with the prevalence of type 2 diabetes both in men and in women (OR 1.51 [95 %CI 1.32–1.72]; P < 0.001 and OR 1.53 [1.36 – 1.73]; P < 0.001). Incident type 2 diabetes was associated with a decreased muscle mass for both men and women (male; OR 1.22 [1.05 – 1.43]; P = 0.01 and female; OR 1.36 [1.17 – 1.59]; P < 0.001), and remained significant after adjustments in normal weight women (OR 1.77 [1.16–2.70]; P = 0.008). Conclusions: Both a low muscle mass and loss of muscle mass are associated with the prevalence and incidence of diabetes in the general population. This association is strongest in people with normal weight, and weakens in people within higher BMI subgroups.