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Body muscle-to-fat ratio gender-specific cut-off values for impaired insulin sensitivity in patients with treatment-naïve type 2 diabetes mellitus

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Abstract

Purpose

We previously reported that the body muscle-to-fat ratio (BMFR), measured using bioelectrical impedance, significantly correlated with whole-body insulin sensitivity. We examined BMFR gender-specific cut-off values for impaired insulin sensitivity in treatment-naïve type 2 diabetes mellitus (T2DM) patients.

Methods

Subjects included 101 untreated T2DM patients (male, 66; female, 35). We performed a hyperinsulinemic–euglycemic clamp examination to measure the steady-state glucose infusion rate (M value) as an indicator of whole-body insulin resistance. We defined the M value divided by the steady-state serum insulin value as the M/I value. We defined the existence of insulin resistance using an M/I ratio <9.0. The optimal cut-off value for BMFR was calculated by receiver operating characteristics (ROC) analysis.

Results

The cut-off value of the BMFR for insulin resistance was 2.75 (area under the curve [AUC] = 0.83, sensitivity 75%, and specificity 76%, P < 0.001) for males and 1.65 (AUC = 0.87, sensitivity 84%, and specificity 81%, P < 0.001) for females. Simple linear regression analysis showed that BMFR was significantly correlated with the M/I value in both genders (males, B = 0.77, P< 0.01; females, B = 0.83, P< 0.01).

Conclusions

BMFR cut-off values for impaired insulin sensitivity in treatment-naïve T2DM patients were 2.75 for males and 1.65 for females.

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References

  1. E.S. Ford, Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the US. Diabetes Care 28, 2745–2749 (2005)

    Article  Google Scholar 

  2. A. Galassi, K. Reynolds, J. He, Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am. J. Med. 119, 812–819 (2006)

    Article  CAS  Google Scholar 

  3. A.S. Gami, B.J. Witt, D.E. Howard, P.J. Erwin, L.A. Gami et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J. Am. Coll. Cardiol. 49, 403–414 (2007)

    Article  CAS  Google Scholar 

  4. N. Kurinami, S. Sugiyama, A. Yoshida, K. Hieshima, F. Miyamoto et al. Correlation of body muscle/fat ratio with insulin sensitivity using hyperinsulinemic–euglycemic clamp in treatment-naïve type 2 diabetes mellitus. Diabetes Res. Clin. Pract. 120, 65–72 (2016)

    Article  CAS  Google Scholar 

  5. S. Kawanabe, Y. Nagai, Y. Nakamura, A. Nishine, T. Nakagawa et al. Association of the muscle/fat mass ratio with insulin resistance in gestational diabetes mellitus. Endocr. J. 66, 75–80 (2019)

    Article  CAS  Google Scholar 

  6. G. Enzi, M. Gasparo, P.R. Biondetti, D. Fiore, M. Semisa et al. Subcutaneous and visceral fat distribution according to sex, age, and overweight, evaluated by computed tomography. Am. J. Clin. Nutr. 44, 739–746 (1986)

    Article  CAS  Google Scholar 

  7. H. Jinnouchi, S. Sugiyama, K. Hieshima, N. Kurinami, K. Kajiwara et al. Liraglutide, a glucagon-like peptide-1 analog, increased insulin sensitivity assessed by hyperinsulinemic-euglycemic clamp examination in patients with uncontrolled type 2 diabetes mellitus. J. Diabetes Res. 706416 (2015). https://doi.org/10.1155/2015/706416.

    Article  Google Scholar 

  8. H. Yki-Järvinen, V.A. Koivisto, Insulin sensitivity in newly diagnosed type 1 diabetics after ketoacidosis and after three months of insulin therapy. J. Clin. Endocrinol. Metab. 59, 371–378 (1984)

    Article  Google Scholar 

  9. R.A. DeFronzo, J.D. Tobin, R. Andres, Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am. J. Physiol. 273, E214–E223 (1979)

    Google Scholar 

  10. N. Kurinami, S. Sugiyama, H. Nishimura, A. Morita, A. Yoshida et al. Clinical factors associated with initial decrease in body-fat percentage induced by add-on sodium-glucose co-transporter 2 inhibitors in patients with type 2 diabetes mellitus. Clin. Drug Investig. 38, 19–27 (2018)

    Article  CAS  Google Scholar 

  11. N. Kurinami, S. Sugiyama, A. Yoshida, K. Hieshima, F. Miyamoto et al. Dapagliflozin significantly reduced liver fat accumulation associated with a decrease in abdominal subcutaneous fat in patients with inadequately controlled type 2 diabetes mellitus. Diabetes Res. Clin. Pract. 142, 254–263 (2018)

    Article  CAS  Google Scholar 

  12. K. Cha, G.M. Chertow, J. Gonzalez, J.M. Lazarus, D.W. Wilmore, Multifrequency bioelectrical impedance estimates the distribution of body water. J. Appl. Physiol. 79, 1316–1319 (1995)

    Article  CAS  Google Scholar 

  13. K. Cha, S. Shin, C. Shon, S. Choi, D.W. Wilmore, Evaluation of segmental bioelectrical impedance analysis (SIBA) for measuring muscle distribution. J. ICHPER SD 1, 11–14 (1997)

    Google Scholar 

  14. A. Fürstenberg, A. Davenport, Comparison of multifrequency bioelectrical impedance analysis and dual-energy X-ray absorptiometry assessments in outpatient hemodialysis patients. Am. J. Kidney Dis. 57, 123–129 (2011)

    Article  Google Scholar 

  15. Q. Guo, C. Yi, J. Li, X. Wu, X. Yang et al. Prevalence and risk factors of fluid overload in Southern Chinese continuous ambulatory peritoneal dialysis patients. PLoS ONE 8, e53294 (2013)

    Article  CAS  Google Scholar 

  16. J. Cobb, W. Gall, K.P. Adam, P. Nakhle, E. Button et al. A novel fasting blood test for insulin resistance and prediabetes. J. Diabetes Sci. Technol. 7, 100–110 (2013)

    Article  Google Scholar 

  17. J.P. Frias, G.B. Macaraeg, J. Ofrecio, J.G. Yu, J.M. Olefsky et al. Decreased susceptibility to fatty acid-induced peripheral tissue insulin resistance in women. Diabetes 50, 1344–1350 (2001)

    Article  CAS  Google Scholar 

  18. A.M. Lundsgaard, B. Kiens, Gender differences in skeletal muscle substrate metabolism—molecular mechanisms and insulin sensitivity. Front. Endocrinol. 5, 195 (2014)

    Article  Google Scholar 

  19. J. Park, S. Kim, Validity of muscle-to-fat ratio as a predictor of adult metabolic syndrome. J. Phys. Ther. Sci. 28, 1036–1045 (2016)

    Article  Google Scholar 

  20. N. Kurinami, S. Sugiyama, M. Ayami, A. Yoshida, K. Hieshima et al. Ratio of muscle mass to fat mass assessed by bioelectrical impedance analysis is significantly correlated with liver fat accumulation in patients with type 2 diabetes mellitus. Diabetes Res. Clin. Pract. 139, 122–130 (2018)

    Article  Google Scholar 

  21. N. Kurinami, S. Sugiyama, H. Ijima, A. Yoshida, K. Hieshima et al. Clinical usefulness of the body muscle-to-fat ratio for screening obstructive sleep apnea syndrome in patients with inadequately controlled type 2 diabetes mellitus. Diabetes Res. Clin. Pract. 143, 134–139 (2018)

    Article  Google Scholar 

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Acknowledgements

We thank Jodi Smith and Charles Allan from Edanz Group (www.edanzediting.com/ac) for editing a draft of this paper.

Authors’ contributions

NK, SS, and HJ contributed to the analysis design, acquisition and interpretation of data, and reviewed/edited the paper. AY, KH, FM, KK, KJ, and TJ contributed to the interpretation of data and reviewed/edited the paper. All authors read and approved the final paper.

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Correspondence to Hideaki Jinnouchi.

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Conflict of interest

HJ has received honoraria from Novo Nordisk, Sanofi, AstraZeneca Pharmaceuticals, Astellas Pharma, Boehringer Ingelheim, Daiichi-Sankyo, Eli Lilly, Takeda, and Novartis Pharmaceuticals. SS has received honoraria from MSD, AstraZeneca Pharmaceuticals, Ono Pharmaceutical, Bayer Yakuhin, Ltd, and Novo Nordisk. The other authors declare that they have no conflict of interest.

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The article does not contain any studies with animals performed by any of the authors. The study received institutional ethical review and all participants provided informed consent. As such, this study conforms to the ethical standards of the Declaration of Helsinki.

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Kurinami, N., Sugiyama, S., Yoshida, A. et al. Body muscle-to-fat ratio gender-specific cut-off values for impaired insulin sensitivity in patients with treatment-naïve type 2 diabetes mellitus. Endocrine 66, 503–508 (2019). https://doi.org/10.1007/s12020-019-02092-8

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