Low Muscle Mass is Independently Associated with an Increased Risk of Having Lower Limb Atherosclerosis in T2DM Patients.

Background and aims: Existing research suggests that low muscle mass is independently associated with carotid atherosclerosis, but its relationship with lower extremity arterial atherosclerosis in type 2 diabetes mellitus (T2DM) patients remains unclear. This study aims to investigate the association between low skeletal muscle mass and lower extremity arterial atherosclerosis in T2DM patients, in hopes of providing a scientific basis for early diagnosis and treatment.

Methods: This cross-sectional study recruited a total of 276 patients with T2DM who underwent bioelectrical impedance analysis, lower limb artery ultrasonography, brachial-ankle pulse wave velocity(baPWV) arterial stiffness measurement, and blood tests. An skeletal muscle index (SMI) < 7.0kg/m2 in men and an SMI< 5.7kg/m2 in women were defined as low skeletal muscle mass. Lower limb atherosclerosis was defined as the presence of atherosclerotic plaques in the lower extremity arteries.

Results: In our study of 276 T2DM patients, 224 (81.1%) presented with lower limb atherosclerosis: 194 (70.2%) with simple lower limb arterial plaques, 15 (5.4%) with lower limb arterial stenosis, and 15 (5.4%) with lower limb arterial occlusion. 52 (18.8%) were diagnosed with low skeletal muscle mass. Logistic regression analysis indicated the risk of having overall lower limbs atherosclerosis increased with the prevalence of low skeletal muscle (OR= 6.175,95% CI 1.328-28.711); Patients with a low skeletal muscle mass had a higher prevalence of simple arterial plaque (OR= 6.225,95% CI 1.339-28.935) and arterial occlusion (OR=12.345,95% CI 1.221-124.808); after the adjustment for clinical risk factors. Spearman's analysis showed significant negative correlations between total-P1NP and baPWV (r=-0.166, p=0.008), N-MID and baPWV (r=-0.163, p=0.009), and β-CTX and baPWV (r=-0.141, p=0.024).

Conclusion: Low muscle mass is independently associated with an increased risk of having lower limb atherosclerosis in T2DM patients. And there may be some relationship between BTMs and arteriosclerosis of the lower limb atherosclerosis in T2DM.