The Role of Muscle Decline in Type 2 Diabetes Development: A 5-Year Prospective Observational Cohort Study

Nutrients. 2019 Apr 12;11(4):834. doi: 10.3390/nu11040834.


The major risk factors of T2DM (type 2 diabetes mellitus) development are still under investigation. We evaluate the possible risk factors associated with type 2 diabetes (T2DM) in adult subjects during a five-year prospective cohort study. We recruited 1160 subjects who underwent oral glucose tolerance test, anthropometric measurements, and body composition and body fat distribution analysis at a baseline visit and again at follow-up after approximately five years. The conclusions of this study are based on observation of 219 subjects who attended both the first and follow-up visits. The fasting serum insulin was measured, and HOMA-IR (homeostatic model assessment of insulin resistance) was calculated. During the follow-up period, T2DM was diagnosed in 7.4% of participants, impaired fasting glucose in 37.7%, and impaired glucose tolerance in 9.3%. Logistic regression models, adjusted for age, were constructed. The changes in glucose concentration, visceral fat tissue content, insulin resistance, and %loss of muscle mass were chosen as the potential predictors for T2DM development. A set of independent variables was extracted. The constructed feature set comprised change in HOMA-IR (OR (odds ratio) = 1.01, p < 0.01) and change in %loss of muscle mass (OR = 0.84, p < 0.03). With an aim to validate the prediction capability using the selected attributes, a support vector machine classifier and leave-one-out cross-validation procedure was applied, yielding 92.78% classification accuracy. Our results show the correlation between the %loss of muscle mass and T2DM development in adults, independent of changes in insulin resistance.

Keywords: Type 2 diabetes; insulin resistance; muscle decline; observational cohort study.

Publication types

  • Observational Study

MeSH terms

  • Adipose Tissue
  • Adult
  • Blood Glucose / metabolism
  • Body Composition
  • Diabetes Mellitus, Type 2 / etiology*
  • Diabetes Mellitus, Type 2 / metabolism
  • Fasting
  • Follow-Up Studies
  • Glucose Intolerance
  • Glucose Tolerance Test
  • Humans
  • Insulin / blood
  • Insulin Resistance*
  • Intra-Abdominal Fat / metabolism
  • Logistic Models
  • Male
  • Middle Aged
  • Muscle, Skeletal / metabolism*
  • Muscular Atrophy / complications*
  • Odds Ratio
  • Prospective Studies
  • Risk Factors


  • Blood Glucose
  • Insulin