Comparing bone and muscle parameters in community-dwelling older adults with obesity, with or without type 2 diabetes mellitus

IF 3.9 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone Pub Date : 2026-01-01 Epub Date: 2025-10-11 DOI:10.1016/j.bone.2025.117680

Costas Glavas , Jakub Mesinovic , Peter R. Ebeling , Surbhi Sood , Elena S. George , Melkamu Tamir Hunegnaw , Ayse Zengin , Robin M. Daly , Paul Jansons , David Scott

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引用次数: 0

Abstract

Background

Obesity is common in type 2 diabetes mellitus (T2DM) and is associated with lower fracture risk. However, older adults with T2DM have higher fracture rates, suggesting distinct effects of T2DM on musculoskeletal health. We aimed to compare associations between components of T2DM and musculoskeletal health in community-dwelling older adults with obesity, with and without T2DM.

Methods

This cross-sectional study included adults aged ≥60 years with self-reported obesity (body mass index [BMI] ≥30 kg/m²). Physical function was assessed by short physical performance battery (SPPB), handgrip strength, stair-climb and jumping mechanography. Dual-energy X-ray absorptiometry (DXA) measured body composition and areal BMD (aBMD). High-resolution peripheral quantitative computed tomography (HR-pQCT) assessed tibial bone densitometry and microarchitecture.

Results

Among 116 participants, 40 (34 %) had T2DM with a higher proportion of females (80 %) compared to those without T2DM (63 %). T2DM participants had higher glucose (31 % mmol/L, p < 0.0001), HbA1c (15 %, p < 0.0001) and HOMA-IR (136 %, p < 0.0001), and exhibited lower hand grip strength (11 % ± 10 %, p = 0.036), SPPB scores (5 % ± 2 %, p = 0.044), stair-climb power (5 % ± 2 % W/kg, p = 0.010) and vertical jump power (2 % ± 8 % W/kg, p = 0.038) compared to counterparts. There were no differences between groups for bone outcomes except increased total hip aBMD (10 % ± 0.2 % g/cm², p = 0.026) and trabecular thickness (5 % ± 0.03 % mm, p = 0.017). In all participants, total fat mass was associated with impaired physical function, while appendicular lean mass was positively associated with muscle power but negatively associated with cortical BMD.

Conclusion

Older adults with obesity and T2DM demonstrate impaired muscle function and power, but have similar bone health and body composition, compared with those with obesity alone.

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比较社区居住老年肥胖伴或不伴2型糖尿病患者的骨骼和肌肉参数。

背景：肥胖在2型糖尿病（T2DM）中很常见，并且与较低的骨折风险相关。然而，老年T2DM患者骨折率较高，提示T2DM对肌肉骨骼健康有明显影响。我们的目的是比较T2DM组成部分与社区居住的肥胖老年人肌肉骨骼健康之间的关系，有和没有T2DM。方法：本横断面研究纳入年龄≥60 岁、自我报告肥胖（体重指数[BMI]≥30 kg/m2）的成年人。通过短物理性能电池（SPPB）、握力、爬楼梯和跳跃力学来评估身体机能。双能x射线吸收仪（DXA）测量了身体成分和面积骨密度（aBMD）。高分辨率外周定量计算机断层扫描（HR-pQCT）评估胫骨骨密度和微结构。结果：116名参与者中，40名（34 %）患有T2DM，其中女性（80 %）的比例高于非T2DM患者（63 %）。2型糖尿病受试者高葡萄糖(31 % 更易与L p 2,p = 0.026)和小梁厚度(5 % ±0.03  % mm, p = 0.017)。在所有参与者中，总脂肪量与身体功能受损有关，而阑尾瘦质量与肌肉力量呈正相关，但与皮质骨密度呈负相关。结论：老年肥胖和T2DM患者表现出肌肉功能和力量受损，但与单纯肥胖患者相比，骨骼健康和身体成分相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone 医学-内分泌学与代谢

CiteScore

8.90

自引率

4.90%

发文量

264

审稿时长

30 days

期刊介绍： BONE is an interdisciplinary forum for the rapid publication of original articles and reviews on basic, translational, and clinical aspects of bone and mineral metabolism. The Journal also encourages submissions related to interactions of bone with other organ systems, including cartilage, endocrine, muscle, fat, neural, vascular, gastrointestinal, hematopoietic, and immune systems. Particular attention is placed on the application of experimental studies to clinical practice.