Adipose tissue content, muscle performance and physical function in obese adults with type 2 diabetes mellitus and peripheral neuropathy

J Diabetes Complications. 2015 Mar;29(2):250-7. doi: 10.1016/j.jdiacomp.2014.11.003. Epub 2014 Nov 13.


Aims: To determine leg intermuscular (IMAT) and subcutaneous (SQAT) adipose tissue and their relationships with muscle performance and function in obese adults with and without type 2 diabetes and peripheral neuropathy (T2DMPN).

Methods: Seventy-nine age-matched obese adults were studied, 13 T2DM, 54 T2DMPN, and 24 obese controls. Leg fat (%IMAT, %SQAT) volumes were quantified using MRI. Ankle plantar flexion (PF) torque and power were assessed with isokinetic dynamometry. Physical function was assessed with 9-item Physical Performance Test (PPT), 6-minute walk distance, single-limb balance, and time to ascend 10 stairs. One-way ANOVAs determined group differences, and multiple regression predicted PPT score from disease status, % IMAT, and PF power.

Results: T2DMPN participants had 37% greater IMAT volumes and 15% lower SQAT volumes than controls (p =. 01). T2DMPN and T2DM showed reduced PF torque and power compared to controls. T2DMPN participants had lower PPT score, 6-minute walk, single-limb balance, and stair climbing than controls (all p<.05). %IMAT volume correlated inversely, and %SQAT correlated directly, with PPT. Leg %IMAT and disease status predicted 49% of PPT score.

Conclusions: T2DMPN may represent a shift in adipose tissue accumulation from SQAT to IMAT depots, which is inversely associated with muscle performance and physical function.

Keywords: Adipose tissue; Diabetes; Muscle; Neuropathy; Physical function.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adipose Tissue, White / pathology*
  • Adiposity*
  • Aged
  • Body Mass Index
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Neuropathies / complications
  • Diabetic Neuropathies / pathology
  • Diabetic Neuropathies / physiopathology*
  • Female
  • Humans
  • Leg
  • Magnetic Resonance Imaging
  • Male
  • Matched-Pair Analysis
  • Middle Aged
  • Muscle Development
  • Muscle Strength
  • Muscle, Skeletal / innervation
  • Muscle, Skeletal / pathology
  • Muscle, Skeletal / physiopathology*
  • Obesity / complications*
  • Psychomotor Performance*
  • Severity of Illness Index
  • Subcutaneous Fat / pathology