An exploratory study of relationship between lower-limb muscle mass and diabetic polyneuropathy in patients with type 2 diabetes

Hiroaki Kataoka; Nobuyuki Miyatake; Naomi Kitayama; Satoshi Murao; Satoshi Tanaka

doi:10.1007/s40200-020-00505-4

An exploratory study of relationship between lower-limb muscle mass and diabetic polyneuropathy in patients with type 2 diabetes

J Diabetes Metab Disord. 2020 Feb 14;19(1):281-287. doi: 10.1007/s40200-020-00505-4. eCollection 2020 Jun.

Authors

Hiroaki Kataoka^{1

2

3}, Nobuyuki Miyatake³, Naomi Kitayama², Satoshi Murao⁴, Satoshi Tanaka⁵

Affiliations

¹ Department of Physical Therapy, Okayama Institute for Medical and Technical Sciences, 3-2-18, Daiku, Kitaku, Okayama-city, Okayama 700-0913 Japan.
² Rehabilitation Center, KKR Takamatsu Hospital, Takamatsu, Kagawa Japan.
³ Department of Hygiene, Faculty of Medicine, Kagawa University, Takamatsu, Kagawa Japan.
⁴ Department of Diabetes and Endocrinology, KKR Takamatsu Hospital, Takamatsu, Kagawa Japan.
⁵ Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima, Japan.

Abstract

Purpose: This exploratory study compared the lower-limb muscle mass (thigh muscle mass [TMM] and lower-leg muscle mass [LLMM]) in type 2 diabetic patients with and without diabetic polyneuropathy (DPN).

Methods: A total of 130 patients with type 2 diabetes, hospitalized for glycemic control, were enrolled in this cross-sectional study. TMM and LLMM were measured using the bioelectrical impedance method. The muscle mass value was normalized by the bodyweight, and the total muscle mass was calculated by combining the muscle mass on the left and right (%TMM and %LLMM). DPN was evaluated according to the Japanese criteria. Anthropometric parameters, blood pressure, laboratory data, exercise habits, medication, related index of diabetes, and diabetic complications were analyzed.

Results: Sixty patients, comprising of 32 males (47.8%) and 28 females (44.4%) with type 2 diabetes (46.2%), had DPN. The %TTM and %LLMM were significantly lower in type 2 diabetic patients with DPN than in those without DPN. Multiple regression analysis identified DPN, age, and hemoglobin A1c (HbA1c) as the determinants of %TMM, and DPN and HbA1c were identified as the determinants of %LLMM in type 2 diabetic patients.

Discussion: The %TMM and %LLMM were significantly decreased in type 2 diabetic patients with DPN. DPN was found to be the strongest determinant of %TMM and %LLMM. Preventing and improving DPN, through active physical therapy, may increase the muscle mass of the lower limbs.

Keywords: Diabetic polyneuropathy; Lower-leg muscle mass; Thigh muscle mass; Type 2 diabetes mellitus.