Diabetes is associated with increased risks of low lean mass and slow gait speed only in the presence of peripheral vascular disease

Abstract

INTRODUCTION: Controversial findings have been reported between the association of diabetes with lean mass and gait speed. Such discrepancies could be due to the confounding effect of comorbidities such as peripheral arterial disease (PAD). The aim of the current study was to evaluate the independent relationship of diabetes and PAD with lean mass and gait speed. METHODS: This was a cross-sectional study of the US population in 1999 through 2004, including 4769 participants aged ≥40 years of the National Health and Nutrition Examination Survey 1999-2004. Appendicular lean mass divided by body mass index (ALMBMI) and gait speed were analysed. Low lean mass was defined as ALMBMI of < 0.512 in women and < 0.789 in men, whereas mobility impairment was defined as gait speed of < 0.8 m/s. RESULTS: In the fully adjusted model, participants with both diabetes and PAD had a higher odds of low lean mass (odds ratio [OR]=2.21; 95% confidence interval [CI], 1.07-4.57) and mobility impairment (OR=4.8; 95% CI, 1.93- 11.97) when compared with participants with neither diabetes nor PAD. No significant association of diabetes alone or PAD alone with low lean mass or mobility impairment was observed. Participants with diabetes and PAD had significantly lower ALMBMI and gait speed when compared with all other participants. CONCLUSIONS: People with both diabetes and PAD had a higher likelihood of low lean mass and mobility impairment; such association was not observed in people with either diabetes or PAD alone.