Uncontrolled Diabetes as an Associated Factor with Dynapenia in Adults Aged 50 Years or Older: Sex Differences

Author(s)

Nebuloni, Clarice Cavalero ^{[1, 2]} ; Maximo, Roberta de Oliveira ^[3] ; de Oliveira, Cesar ^[4] ; Alexandre, Tiago da Silva ^{[4, 3, 1, 5]}

Affiliation

^[1] Univ Fed Sao Carlos, Gerontol Grad Program, Sao Carlos - Brazil

^[2] Univ Fed Sao Carlos, Geriatr & Gerontol Sect, Sao Carlos - Brazil

^[3] Univ Fed Sao Carlos, Grad Program Phys Therapy, Sao Carlos, SP - Brazil

^[4] UCL, Dept Epidemiol & Publ Hlth, London - England

^[5] Univ Fed Sao Carlos, Gerontol Dept, Rodovia Washington Luis, Km 235, BR-13565905 Sao Carlos, SP - Brazil

• Document type: Journal article
• Source: JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES; v. 75, n. 6, p. 1191-1197, JUN 2020.
• Web of Science Citations: 0

Abstract

Background: Epidemiological studies demonstrate an association between diabetes and low neuromuscular strength (NMS). However, none have grouped participants into nondiabetics (ND), undiagnosed diabetics (UDD), controlled diabetics (CD), and uncontrolled diabetics (UCD) or investigated what glycated hemoglobin levels (HbA1c) are associated with low NMS (dynapenia) by sex. Methods: We analyzed the association between UDD, CD, and UCD and dynapenia, the extent to which the different groupings of these individuals modifies this association and the association between HbA1c levels and NMS, by sex, in a cross-sectional study involving 5,290 participants >= 50 years from the ELSA study. In the first two analyses, logistic regression models were used with dynapenia (grip strength <26 kg in men and <16 kg in women) as outcome and diabetes (ND, UDD, CD, and UCD) as exposure. Next, linear regression was performed with grip strength as the outcome, and the participants were classified based on HbA1c level as exposure. The models were adjusted by sociodemographic, behavioral, and clinical characteristics. Results: Compared to ND, only UCD was associated with dynapenia (men OR = 2.37 95% CI 1.36-4.14; women OR = 1.67 95% CI 1.01-2.79). This association was less clear, particularly in women, when CD and UCD groups were merged. HbA1c >= 6.5% in men and >= 8.0% in women were associated with lower NMS. Conclusions: UCD increases the chance of dynapenia in both sexes. The different groupings based on diabetes status modify the association between UCD and dynapenia. The threshold of HbA1c associated with reduced NMS is lower in men compared to women. (AU)

• FAPESP's process: 18/13917-3 - Musculoskeletal aging: metabolic and functional repercussions and mortality risk in people aged 50 and older
• Grantee: Tiago da Silva Alexandre
• Support Opportunities: Research Grants - Young Investigators Grants