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Explanators of Sarcopenia in Individuals With Diabesity: A Cross-Sectional Analysis.
- Source :
-
Journal of geriatric physical therapy (2001) [J Geriatr Phys Ther] 2017 Apr/Jun; Vol. 40 (2), pp. 86-94. - Publication Year :
- 2017
-
Abstract
- Background and Purpose: Excess lower extremity intermuscular adipose tissue (IMAT), reduced strength, and functional limitations are common in obese individuals with and without diabetes (the former termed diabesity). Individuals with diabesity are particularly susceptible to accelerated sarcopenia, which may be underdiagnosed. The purpose of this study was to determine critical values for leg IMAT volume, plantar flexor (PF) muscle strength, and physical performance that help identify individuals with diabesity who have sarcopenia.<br />Methods: Forty-three age- and sex-matched obese adults were studied: 12 with type 2 diabetes, 21 with diabetes and peripheral neuropathy, and 10 nondiabetic controls. Dual-energy x-ray absorptiometry-derived skeletal muscle index determined classification of sarcopenia. Leg fat (% IMAT), ankle (PF) peak torque, and power while ascending 10 steps, were used as explanators of sarcopenia. Receiver operating curves identified critical values for each explanator individually. Logistic regression models using all 3 explanators, and only PF torque and stair power, were also created. Receiver operating curve analyses identified the predicted probability that maximized each model's sensitivity and specificity. A leave-one-out cross validation was used to simulate the models' performance in an independent sample.<br />Results and Discussion: Thirty-two participants were sarcopenic, and 11 were not. Critical values for individual explanators were 21% IMAT, 68 Nm PF torque, and 441 watts of stair power. Predicted probabilities of .76 and .67 were chosen as the optimal cutoff probabilities for the model combining all 3 explanators, and the model combining PF torque and stair power, respectively. The cross-validation analysis produced an accuracy of 82.4%, using the cutoff probability of .5, and an accuracy of 76.5% using the cutoff of 0.76. The area under the curve for the cross validation receiver operating curve analysis was 0.82. Critical values of leg % IMAT, PF torque, and stair power can classify individuals with diabesity as sarcopenic. The results of the cross validation give us confidence that the sample used in this study was representative of the target population, and suggests models created from this sample may perform well in externally derived data sets.<br />Conclusion: Clinicians may be able to use these critical values to select interventions that specifically target sarcopenia. Measures of % IMAT, PF torque, and stair power may offer a customized alternative to traditional sarcopenic classification systems, which may not be optimally suited to the common impairments among individuals with diabesity.
- Subjects :
- Absorptiometry, Photon
Adult
Aged
Cross-Sectional Studies
Diabetes Mellitus, Type 2 rehabilitation
Diabetic Neuropathies epidemiology
Female
Humans
Male
Middle Aged
Muscle Strength physiology
Muscle, Skeletal physiology
Obesity rehabilitation
Sarcopenia rehabilitation
Torque
Diabetes Mellitus, Type 2 epidemiology
Obesity epidemiology
Sarcopenia epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 2152-0895
- Volume :
- 40
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of geriatric physical therapy (2001)
- Publication Type :
- Academic Journal
- Accession number :
- 26859462
- Full Text :
- https://doi.org/10.1519/JPT.0000000000000076