The effect of diabetes mellitus on age-associated lean mass loss in 3153 older adults

Aims: Diabetes mellitus may be associated with excessive lean mass loss. Other diabetes-related conditions may also play a role. We assessed body composition changes associated with diabetes in older adults with adjustment for diabetes-related co-morbidities.

Methods: Three thousand, one hundred and fifty-three community-living adults aged ≥ 65 years were examined for lifestyle factors, diabetes-related medical conditions and body composition by dual energy X-ray absorptiometry at baseline and 4 years later. Body composition changes were compared between participants with diabetes and those without diabetes. Multivariate linear regression was used to examine the relationship between appendicular lean mass loss and confounders.

Results: Appendicular lean mass loss in men with diabetes was two times that of men without diabetes (-1.5% in 'no diabetes' vs. -3.0% in 'diabetes') and in women with diabetes was 1.8 times that of those without diabetes (-1.9% in 'no diabetes' vs. -3.4% in 'diabetes') over 4 years. Men with diabetes also had higher total body mass loss and higher total body fat loss than men without diabetes. Women with diabetes had higher total body mass loss but total body fat loss was similar. After adjusting for age, body mass index, diabetes-related conditions, lifestyle factors and total body mass loss, diabetes remained an independent predictor of appendicular lean mass loss in both men and women.

Conclusion: Diabetes was associated with higher body mass loss and higher appendicular lean mass loss in older adults. In men, diabetes was also associated with total body fat loss.