Lower insulin level is associated with sarcopenia in community-dwelling frail and non-frail older adults
Background: Sarcopenia is common among older individuals with and without type 2 diabetes mellitus (T2DM). There are conflicting evidence in support of the role of insulin in the development of age-related and T2DM-related sarcopenia. We investigated the relationships between the levels of fasting i...
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sg-ntu-dr.10356-1645092023-03-05T16:54:17Z Lower insulin level is associated with sarcopenia in community-dwelling frail and non-frail older adults Lu, Yanxia Lim, Wee Shiong Jin, Xia Nyunt, Ma Schwe Zin Fulop, Tamas Gao, Qi Lim, Su Chi Larbi, Anis Ng, Tze Pin Lee Kong Chian School of Medicine (LKCMedicine) Tan Tock Seng Hospital Science::Medicine Sarcopenia Diabetes Background: Sarcopenia is common among older individuals with and without type 2 diabetes mellitus (T2DM). There are conflicting evidence in support of the role of insulin in the development of age-related and T2DM-related sarcopenia. We investigated the relationships between the levels of fasting insulin and other blood biomarkers related to insulin or lipid metabolism with the presence of sarcopenia in two independent studies. Materials and methods: In 246 pre-frail frail older individuals with (n = 41) and without T2DM (n = 205) in the Singapore Frailty Interventional Trial, sarcopenia was defined by low appendicular lean mass (ALM) relative to total body mass (skeletal muscle index, SMI = ALM/height2) and low lower limb strength or gait speed according to the Asian Working Group for Sarcopenia (AWGS) criteria released in 2019, and related to levels of fasting insulin and glucose, C-peptide, IGF-1, leptin, and active ghrelin. This investigation was validated in another independent study sample of 189 robust and pre-frail frail elderly in the Singapore Longitudinal Aging Study Wave 2 (SLAS-2). Results: Compared to non-sarcopenic individuals, those with sarcopenia and possible sarcopenia showed significantly lower fasting insulin (p < 0.05) in pre-frail/frail and non-frail older individuals. Consistent trends of relationships were observed for serum levels of C-peptide, IGF-1, leptin, and active ghrelin. In multivariable logistic regression models, sarcopenia was independently associated with low insulin (p < 0.05). Levels of fasting insulin, C-peptide, and leptin were also significantly associated with BMI, SMI, knee extension strength, gait speed, and physical activity score. Conclusion: Dysregulated insulin secretion in diabetic and non-diabetic older individuals may play an important role in age-related and diabetes-related sarcopenia. National Medical Research Council (NMRC) Published version This work was supported by a research grant from the National Medical Research Council (NMRC/1108/2007). 2023-01-30T04:48:41Z 2023-01-30T04:48:41Z 2022 Journal Article Lu, Y., Lim, W. S., Jin, X., Nyunt, M. S. Z., Fulop, T., Gao, Q., Lim, S. C., Larbi, A. & Ng, T. P. (2022). Lower insulin level is associated with sarcopenia in community-dwelling frail and non-frail older adults. Frontiers in Medicine, 9, 971622-. https://dx.doi.org/10.3389/fmed.2022.971622 2296-858X https://hdl.handle.net/10356/164509 10.3389/fmed.2022.971622 36482911 2-s2.0-85143352069 9 971622 en NMRC/1108/2007 Frontiers in Medicine © 2022 Lu, Lim, Jin, Zin Nyunt, Fulop, Gao, Lim, Larbi and Ng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. application/pdf |
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Science::Medicine Sarcopenia Diabetes Lu, Yanxia Lim, Wee Shiong Jin, Xia Nyunt, Ma Schwe Zin Fulop, Tamas Gao, Qi Lim, Su Chi Larbi, Anis Ng, Tze Pin Lower insulin level is associated with sarcopenia in community-dwelling frail and non-frail older adults |
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Background: Sarcopenia is common among older individuals with and without type 2 diabetes mellitus (T2DM). There are conflicting evidence in support of the role of insulin in the development of age-related and T2DM-related sarcopenia. We investigated the relationships between the levels of fasting insulin and other blood biomarkers related to insulin or lipid metabolism with the presence of sarcopenia in two independent studies. Materials and methods: In 246 pre-frail frail older individuals with (n = 41) and without T2DM (n = 205) in the Singapore Frailty Interventional Trial, sarcopenia was defined by low appendicular lean mass (ALM) relative to total body mass (skeletal muscle index, SMI = ALM/height2) and low lower limb strength or gait speed according to the Asian Working Group for Sarcopenia (AWGS) criteria released in 2019, and related to levels of fasting insulin and glucose, C-peptide, IGF-1, leptin, and active ghrelin. This investigation was validated in another independent study sample of 189 robust and pre-frail frail elderly in the Singapore Longitudinal Aging Study Wave 2 (SLAS-2). Results: Compared to non-sarcopenic individuals, those with sarcopenia and possible sarcopenia showed significantly lower fasting insulin (p < 0.05) in pre-frail/frail and non-frail older individuals. Consistent trends of relationships were observed for serum levels of C-peptide, IGF-1, leptin, and active ghrelin. In multivariable logistic regression models, sarcopenia was independently associated with low insulin (p < 0.05). Levels of fasting insulin, C-peptide, and leptin were also significantly associated with BMI, SMI, knee extension strength, gait speed, and physical activity score. Conclusion: Dysregulated insulin secretion in diabetic and non-diabetic older individuals may play an important role in age-related and diabetes-related sarcopenia. |
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Lee Kong Chian School of Medicine (LKCMedicine) |
author_facet |
Lee Kong Chian School of Medicine (LKCMedicine) Lu, Yanxia Lim, Wee Shiong Jin, Xia Nyunt, Ma Schwe Zin Fulop, Tamas Gao, Qi Lim, Su Chi Larbi, Anis Ng, Tze Pin |
format |
Article |
author |
Lu, Yanxia Lim, Wee Shiong Jin, Xia Nyunt, Ma Schwe Zin Fulop, Tamas Gao, Qi Lim, Su Chi Larbi, Anis Ng, Tze Pin |
author_sort |
Lu, Yanxia |
title |
Lower insulin level is associated with sarcopenia in community-dwelling frail and non-frail older adults |
title_short |
Lower insulin level is associated with sarcopenia in community-dwelling frail and non-frail older adults |
title_full |
Lower insulin level is associated with sarcopenia in community-dwelling frail and non-frail older adults |
title_fullStr |
Lower insulin level is associated with sarcopenia in community-dwelling frail and non-frail older adults |
title_full_unstemmed |
Lower insulin level is associated with sarcopenia in community-dwelling frail and non-frail older adults |
title_sort |
lower insulin level is associated with sarcopenia in community-dwelling frail and non-frail older adults |
publishDate |
2023 |
url |
https://hdl.handle.net/10356/164509 |
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1759857431373938688 |