ArticleJournal of cachexia, sarcopenia and muscle2026
Associations of Body Composition and Physical Function With Incident Diabetes in Older Adults: A 14-Year Prospective Cohort Study.
Article in Journal of cachexia, sarcopenia and muscle, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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8 authors.
Funding
Abstract
backgroundLongitudinal associations between age-related changes in body composition, physical performance and incident diabetes mellitus (DM) in older adults and the mediating role of branched-chain amino acids (BCAAs) remain understudied.
methodsThis prospective cohort study included 4000 community-dwelling older adults at baseline. Longitudinal analysis of incident DM involved 3421 participants without baseline DM. Incident DM was identified through self-reported diagnosis, medication use, hospital records or fasting glucose ≥ 7.0 mmol/L. Body composition (PBF [percent body fat], FMI [fat mass index], ASM [appendicular skeletal muscle mass]) was measured using DXA. Associations of baseline body composition with incident DM were assessed using Cox regression in the full cohort, with sensitivity analysis accounting for competing risk of death. Associations in long-term subgroups and analysis of 14-year and prediabetes changes were evaluated using multivariable logistic regression. Serum BCAAs were quantified by LC-MS for mediation analysis.
resultsAmong 3421 participants (median age 72 years [IQR 68-76]; 50.1% female) without baseline DM, higher baseline adiposity (PBF: HR 1.613; FMI: HR 1.684; waist: 1.587) and ASM/ht
conclusionsIn older adults, higher baseline adiposity and lower relative muscle mass were associated with long-term DM risk, while preserved muscle mass and faster gait speed were linked to a lower risk. These associations, partially mediated by BCAAs, advance the understanding of DM risk pathways and highlight the potential clinical relevance of weight- or BMI-adjusted relative muscle mass assessment in this population.
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