PMID- 26740641 OWN - NLM STAT- MEDLINE DCOM- 20161213 LR - 20220408 IS - 1935-5548 (Electronic) IS - 0149-5992 (Print) IS - 0149-5992 (Linking) VI - 39 IP - 3 DP - 2016 Mar TI - Reduced Lower-Limb Muscle Strength and Volume in Patients With Type 2 Diabetes in Relation to Neuropathy, Intramuscular Fat, and Vitamin D Levels. PG - 441-7 LID - 10.2337/dc15-0995 [doi] AB - OBJECTIVE: Muscle weakness and atrophy of the lower limbs may develop in patients with diabetes, increasing their risk of falls. The underlying basis of these abnormalities has not been fully explained. The aim of this study was to objectively quantify muscle strength and size in patients with type 2 diabetes mellitus (T2DM) in relation to the severity of neuropathy, intramuscular noncontractile tissue (IMNCT), and vitamin D deficiency. RESEARCH DESIGN AND METHODS: Twenty patients with T2DM and 20 healthy control subjects were matched by age, sex, and BMI. Strength and size of knee extensor, flexor, and ankle plantar and dorsiflexor muscles were assessed in relation to the severity of diabetic sensorimotor polyneuropathy (DSPN), amount of IMNCT, and serum 25-hydroxyvitamin D (25OHD) levels. RESULTS: Compared with control subjects, patients with T2DM had significantly reduced knee extensor strength (P = 0.003) and reduced muscle volume of both knee extensors (P = 0.045) and flexors (P = 0.019). Ankle plantar flexor strength was also significantly reduced (P = 0.001) but without a reduction in ankle plantar flexor (P = 0.23) and dorsiflexor (P = 0.45) muscle volumes. IMNCT was significantly increased in the ankle plantar (P = 0.006) and dorsiflexors (P = 0.005). Patients with DSPN had significantly less knee extensor strength than those without (P = 0.02) but showed no difference in knee extensor volume (P = 0.38) and ankle plantar flexor strength (P = 0.21) or volume (P = 0.96). In patients with <25 nmol/L versus >25 nmol/L 25OHD, no significant differences were found for knee extensor strength and volume (P = 0.32 vs. 0.18) and ankle plantar flexors (P = 0.58 vs. 0.12). CONCLUSIONS: Patients with T2DM have a significant reduction in proximal and distal leg muscle strength and a proximal but not distal reduction in muscle volume possibly due to greater intramuscular fat accumulation in distal muscles. Proximal but not distal muscle strength is related to the severity of peripheral neuropathy but not IMNCT or 25OHD level. CI - (c) 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. FAU - Almurdhi, Monirah M AU - Almurdhi MM AD - Centre for Endocrinology and Diabetes, Institute of Human Development, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K. FAU - Reeves, Neil D AU - Reeves ND AD - School of Healthcare Science, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, U.K. FAU - Bowling, Frank L AU - Bowling FL AD - Centre for Endocrinology and Diabetes, Institute of Human Development, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K. FAU - Boulton, Andrew J M AU - Boulton AJ AD - Centre for Endocrinology and Diabetes, Institute of Human Development, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K. FAU - Jeziorska, Maria AU - Jeziorska M AD - Centre for Endocrinology and Diabetes, Institute of Human Development, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K. FAU - Malik, Rayaz A AU - Malik RA AD - Centre for Endocrinology and Diabetes, Institute of Human Development, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K. Weill Cornell Medical College, Doha, Qatar ram2045@qatar-med.cornell.edu. LA - eng GR - Wellcome Trust/United Kingdom GR - R01 NS046259/NS/NINDS NIH HHS/United States GR - 5R01NS46259-03/NS/NINDS NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20160106 PL - United States TA - Diabetes Care JT - Diabetes care JID - 7805975 RN - 1406-16-2 (Vitamin D) SB - IM CIN - Diabetes Care. 2016 Oct;39(10 ):e183. PMID: 27660128 CIN - Diabetes Care. 2016 Oct;39(10 ):e184-5. PMID: 27660129 MH - Adiposity/*physiology MH - Aged MH - Diabetes Mellitus, Type 2/blood/*physiopathology MH - Diabetic Neuropathies/blood/*physiopathology MH - Female MH - Humans MH - Lower Extremity/innervation/physiopathology MH - Male MH - Middle Aged MH - Muscle Strength/*physiology MH - Muscle Weakness/blood/physiopathology MH - Muscle, Skeletal/physiology MH - Muscular Atrophy/blood/physiopathology MH - Range of Motion, Articular MH - Vitamin D MH - Vitamin D Deficiency/blood/*physiopathology PMC - PMC5317239 EDAT- 2016/01/08 06:00 MHDA- 2016/12/15 06:00 PMCR- 2017/03/01 CRDT- 2016/01/08 06:00 PHST- 2015/05/11 00:00 [received] PHST- 2015/11/24 00:00 [accepted] PHST- 2016/01/08 06:00 [entrez] PHST- 2016/01/08 06:00 [pubmed] PHST- 2016/12/15 06:00 [medline] PHST- 2017/03/01 00:00 [pmc-release] AID - dc15-0995 [pii] AID - 0995 [pii] AID - 10.2337/dc15-0995 [doi] PST - ppublish SO - Diabetes Care. 2016 Mar;39(3):441-7. doi: 10.2337/dc15-0995. Epub 2016 Jan 6.