Gender differences in the relationship between glycemic control and muscle mass in patients with type 2 diabetes mellitus：A cross-sectional study

Abstract

Abstract Background The presence of sarcopenia is significantly correlated with type 2 diabetes mellitus (T2DM). Persistent hyperglycemia and fluctuations in blood glucose levels can have an impact on the muscle mass. So far, no research has assessed potential gender disparities in the relationship between glycated hemoglobin (HbA1c) levels and muscle mass. Therefore, we set out to explore the association between HbA1c levels and muscle mass among T2DM patients. Methods This was a cross-sectional study involving 267 elderly hospitalized T2DM patients who were examined by dual-energy X-rays to obtain their muscle mass. They were divided by gender into male and female groups as well as by the appendicular skeletal muscle mass index into "normal muscle mass" or "low muscle mass". Results There was a linear correlation between HbA1c and muscle mass in men. HbA1c was significantly associated with low muscle mass, even after adjusted for age, BMI, nephropathy, retinopathy, peripheral neuropathy, hypertension, fasting glucose level, FT3, and TyG index (OR: 1.511 [95%CI: 1.052–2.171], p = 0.026). When HbA1c levels were further disaggregated, multiple regression analyses showed adverse effects on muscle mass when HbA1c was > 7% in men (7%< HbA1c < 8%, OR = 5.78 [95%CI: 1.024–32.596], p = 0.047; HbA1c > 8%, OR = 9.45 [95%CI: 1.978–45.105], p = 0.005). However, no association between HbA1c and muscle mass was observed among females. Conclusion High HbA1c levels were linked with low muscle mass in older men with T2DM, but not among women. It is imperative to achieve optimal glycemic control in clinical practice to mitigate the potential of low muscle mass, especially among older men with T2DM.