Minato-Inokawa Satomi, Tsuboi-Kaji Ayaka, Honda Mari, Takeuchi Mika, Kitaoka Kaori, Kurata Miki, Wu Bin, Kazumi Tsutomu, Fukuo Keisuke
Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan.
Laboratory of Community Health and Nutrition, Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Ehime, Japan.
Metabol Open. 2024 Jul 30;23:100306. doi: 10.1016/j.metop.2024.100306. eCollection 2024 Sep.
We tested whether skeletal muscle mass is associated with insulin sensitivity, pancreatic β-cell function, and postglucose glycemia.
Appendicular skeletal muscle mass (ASM) (relative to body size, %ASM) by DXA, surrogate measures of insulin sensitivity, insulin secretion and the disposition index (insulin sensitivity adjusted insulin secretion: a product of the insulinogenic index and Matsuda insulin sensitivity index) inferred from serum insulin kinetics during a 75 g oral glucose tolerance test (OGTT) were evaluated in 168 young and 65 middle-aged women, whose BMI averaged <23.0 kg/m and HbA1c ≦ 5.5 %.
In two groups of women, %ASM was associated negatively with homeostasis model assessment insulin resistance (HOMA-IR) and 2-h insulin (both p < 0.01 or less). In middle-aged women not in young women, %ASM was associated inversely with the Matsuda index (p < 0.001). In middle-aged women only, it also showed a positive association with the disposition index (p = 0.02) and inverse associations with 1-h and 2-h glucose (both p < 0.01) and area under the glucose concentration curve during OGTT (p = 0.006). On multivariate linear regression analyses, 2-h insulin emerged as a determinant of %ASM independently of HOMA-IR in young women (standardized β: 0.287, p < 0.001, R = 0.077). In middle-aged women, the Matsuda index emerged as a determinant of %ASM (standardized β: 0.476, p < 0.001) independently of HOMA-IR, log ODI and AUCg and explained 21.3 % of %ASM variability. Post-glucose glycemia and AUCg were higher and log ODI was lower in middle-aged women with low compared with high %ASM.
Low skeletal muscle mass (relative to body size) was associated with low insulin sensitivity in young and middle-aged Japanese women who were neither obese nor diabetic. Middle-aged women with low muscle mass had low disposition index, an early marker of inadequate pancreatic β-cell compensation, and hence high glucose excursion. Low skeletal muscle mass may be associated with the development of type 2 diabetes at a much lower BMI in Japanese people.
我们测试了骨骼肌质量是否与胰岛素敏感性、胰腺β细胞功能及葡萄糖耐量后血糖相关。
通过双能X线吸收法（DXA）测量四肢骨骼肌质量（ASM）（相对于体型，%ASM），在168名年轻女性和65名中年女性中评估胰岛素敏感性、胰岛素分泌及处置指数（胰岛素敏感性调整后的胰岛素分泌：胰岛素生成指数与松田胰岛素敏感性指数的乘积）的替代指标，这些女性的BMI平均<23.0kg/m²且糖化血红蛋白（HbA1c）≤5.5%，胰岛素敏感性、胰岛素分泌及处置指数通过75g口服葡萄糖耐量试验（OGTT）期间的血清胰岛素动力学推断得出。
在两组女性中，%ASM与稳态模型评估胰岛素抵抗（HOMA-IR）和2小时胰岛素均呈负相关（均为p<0.01或更低）。在中年女性而非年轻女性中，%ASM与松田指数呈负相关（p<0.001）。仅在中年女性中，%ASM还与处置指数呈正相关（p=0.02），与1小时和2小时血糖均呈负相关（均为p<0.01），并与OGTT期间葡萄糖浓度曲线下面积呈负相关（p=0.006）。在多变量线性回归分析中，在年轻女性中，2小时胰岛素独立于HOMA-IR成为%ASM的一个决定因素（标准化β：0.287，p<0.001，R²=0.077）。在中年女性中，松田指数独立于HOMA-IR、对数处置指数（log ODI）和葡萄糖曲线下面积（AUCg）成为%ASM的一个决定因素（标准化β：0.476，p<0.001），并解释了%ASM变异性的21.3%。与高%ASM的中年女性相比，低%ASM的中年女性葡萄糖耐量后血糖和AUCg更高，log ODI更低。
在既不肥胖也无糖尿病的年轻和中年日本女性中，低骨骼肌质量（相对于体型）与低胰岛素敏感性相关。肌肉质量低的中年女性处置指数低，这是胰腺β细胞代偿不足的早期标志物，因此血糖波动大。在日本人中，低骨骼肌质量可能在BMI低得多的情况下与2型糖尿病的发生有关。
