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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #178913
Title: ETHNIC COMPARISONS OF SARCOPENIA AND OBESITY IN DIABETES

Author
item JANSSEN, IAN - QUEEN'S UNIV, CANADA
item CASTANEDA-SCEPPA, CARMEN - TUFTS/HNRCA

Submitted to: Ethnicity and Disease
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/1/2004
Publication Date: 9/1/2005
Citation: Janssen, I., Castaneda-Sceppa, C. 2005. Ethnic comparisons of sarcopenia and obesity in diabetes. Ethnicity and Disease. 15:664-670.

Interpretive Summary: Abdominal obesity has been shown to be more strongly linked to insulin resistance, type 2 diabetes, and cardiovascular disease than total adiposity. However, the association between total and abdominal obesity with diabetes may vary by race and ethnicity. Poorly controlled diabetes may also be associated with muscle loss, which in turn may contribute to some of the disability observed with diabetes. We observed that the prevalence of diabetes and poor glycemic control in the Third National Health and Nutrition Examination Survey study of older adults (NHANES III) was highest among minority groups living in the U.S., specifically in Mexican-American men and women. Interestingly, this ethnic group also exhibited the lowest prevalence of low muscle mass or sarcopenia. Independent of ethnicity, obesity (as determine by waist circumference) was an independent positive predictor of diabetes and poor glycemic control, while sarcopenia (low muscle mass) was not a positive predictor of diabetes or poor glycemic control. The associations for obesity were strongest in non-Hispanic whites. Contrary to the expectation that ethnic minorities would have the greatest incidence of obesity and sarcopenia because they are more likely to have diabetes, be poor, less educated, and with low access to health care, we found that non-Hispanic whites exhibited the highest prevalence of obesity and sarcopenia despite having the lowest prevalence of diabetes. These findings corroborate that a high waist circumference is associated with metabolic health risk independent of ethnicity. Surprisingly, low muscle mass (or sarcopenia) was not associated with an increased likelihood of diabetes and poor glycemic control. These data suggest that interventions aimed at preventing and/or treating diabetes should focus on reducing total and abdominal fat. The role of genetically based, ethnic differences in body composition and diabetes risk should be taken into account when developing clinical guidelines such as the waist circumference cut-points used in this study.

Technical Abstract: Obesity is associated with type 2 diabetes. The prevalence of diabetes is greater in ethnic minorities. Our objective was to examine the association between obesity and low relative skeletal muscle mass (sarcopenia) with type 2 diabetes and poor glycemic control, and to determine whether these associations varied by ethnicity. Data from the Third National Health and Nutrition Examination Survey (NHANES III) was used (5,727 adults, 40-74 y: 26% Mexican-Americans, 25% non-Hispanic blacks, and 49% non-Hispanic whites). Sarcopenia was defined as a skeletal muscle [SM(kg) divided by height(m10**2)] <1 SD below the young adult mean. Obesity was defined as waist circumference >102 cm in men and >88 cm in women. The prevalence of diabetes was 40% higher in Mexican-American than non-Hispanic blacks or whites (P<0.05). The lowest prevalence of obesity and sarcopenia were observed in Mexican-Americans (except for obesity in women). Independent of ethnicity, subjects with a high waist circumference were more likely to have diabetes and poor glycemic control (P<0.05). These associations were strongest in non-Hispanic whites. Conversely, sarcopenia was not associated with diabetes or poor glycemic control in any ethnic group. Conclusions: Although the prevalence of type 2 diabetes was highest in Mexican-Americans, non-Hispanic whites exhibited the highest prevalence of obesity and sarcopenia. The role of genetically based, ethnic differences in body composition and diabetes risk needs to be taken into account when developing clinical guidelines such as the waist circumference cut-points used in this study.