A lower skeletal muscle mass and lower grip strength are both linked to an increased risk for cardiovascular disease in people with type 2 diabetes, according to a new study published in the Journal of Diabetes.
People with type 2 diabetes are at greater risk for various types of cardiovascular disease, including both microvascular (large blood vessel) complications like coronary artery disease (CAD) and microvascular (small blood vessel) complications like chronic kidney disease and diabetic retinopathy (eye disease). While a number of factors contribute to cardiovascular disease risk in people with diabetes — including blood glucose control, blood lipid (cholesterol and triglyceride) levels, blood pressure, and body weight — researchers have sometimes looked into potential indicators of cardiovascular disease that aren’t widely used, but might be useful to help screen people for their cardiovascular disease risk.
For the latest study, researchers in South Korea recruited 1,230 adults with type 2 diabetes who were older than 30 years old. Participants underwent many different health-related tests, including those that measure skeletal muscle mass (mass of bones attached to the skeleton) and grip strength. There also had their health history and lifestyle factors assessed. When looking at cardiovascular outcomes, cardiovascular disease was defined as CAD, a prior ischemic stroke, peripheral arterial disease (PAD), or any combination of these conditions.
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As noted in an article on the study at Healio, participants were divided into four different groups for analysis — those with low skeletal muscle mass and low grip strength (428 participants), low skeletal muscle mass and high grip strength (182 participants), high skeletal muscle mass and low grip strength (188 participants), and high skeletal muscle mass and high grip strength (432 participants). Compared with those who had high skeletal muscle mass and high grip strength, participants with low measures in both areas were more likely to have cardiovascular disease.
Low skeletal muscle, grip strength linked to increased cardiovascular risk
After adjusting for a wide range of factors — including age, sex, body-mass index (BMI, a measure of body weight that takes height into account), exercise habits, alcohol and tobacco use, blood pressure, A1C (a measure of long-term blood glucose control), and kidney function — the researchers found that participants who had low skeletal muscle mass and low grip strength were 2.9 times as likely to have cardiovascular disease — including 2.4 times as likely to have CAD and 5.8 times as likely to have PAD — as participants with high skeletal muscle mass and high grip strength. There was no evidence of an increased risk for ischemic stroke.
While a higher A1C level didn’t increase the risk for cardiovascular disease overall, it did affect this risk in certain groups of participants. Among participants with high skeletal muscle mass and low grip strength, those with an A1C level of 7.1% or higher were 3.7 times as likely to have cardiovascular disease — including 3.4 times as likely to have CAD. Among participants with low skeletal muscle mass and high grip strength, those with an A1C level of 7.1% or higher were 3.9 times as likely to have cardiovascular disease — including 2.5 times as likely to have CAD. And among participants with low skeletal muscle mass and low grip strength, those with an A1C level of 7.1% or higher were 7.3 times as likely to have cardiovascular disease — including 6.2 times as likely to have CAD.
The researchers concluded that the combination of low skeletal muscle mass and low grip strength was strongly linked to cardiovascular disease — CAD and PAD in particular — in people with type 2 diabetes, especially those with higher A1C levels. More research is needed, though, before any screening recommendations are updated to include skeletal muscle mass or grip strength as standard measurements used to predict the risk for cardiovascular disease.
Want to learn more about protecting your heart? Read “Be Heart Smart: Know Your Numbers,” “Does Diabetes Hurt Your Heart?” “Fight Off Heart Disease With These Five Heart-Healthy Foods” and “Lower Your Risk of Heart Disease.”
