System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Ahead of print

PubMed: 42660514 DOI: 10.4093/dmj.2025.1239

Thigh Muscle Quality Predicts the Incidence of Type 2 Diabetes Mellitus.

Diabetes Metab J

Authors: Hun Jee Choe, Steven B Heymsfield, Michael D Jensen, Soo Lim

Affiliations

  • Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Hwaseong, Korea.
  • Pennington Biomedical Research Center, Baton Rouge, LA, USA.
  • Endocrine Research Unit, Mayo Clinic, Rochester, MN, USA.
  • Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Abstract

BACKGROUND

Ectopic fat infiltration in skeletal muscle, particularly in the thigh, may impair muscle function and contribute to metabolic dysfunction. However, its predictive value for incident type 2 diabetes mellitus remains understudied.

METHODS

We conducted a prospective cohort study of 2,129 East Asian adults (mean age, 57.4±16.9 years; body mass index, 25.0±3.9 kg/m2; 48.5% male) with one or more cardiometabolic risk factors but no diabetes at baseline. Low-density muscle (LDM) area was quantified using non-contrast computed tomography at the midthigh level, with attenuation values of 0-30 Hounsfield units defined as LDM. The association between LDM area and incident diabetes was assessed over a median followup of 7.4 years.

RESULTS

During follow-up, 201 males (19.5%) and 156 females (14.1%) developed diabetes. Those who developed diabetes had higher baseline glycosylated hemoglobin levels (6.1%±0.3% vs. 5.7%±0.4%) and larger LDM areas (48.8±14.2 cm2 vs. 38.1±13.2 cm2, both P<0.05). In adjusted Cox models, a large LDM area was independently associated with incident diabetes (hazard ratio [HR], 2.36; 95% confidence interval [CI], 1.52-3.67 for males and HR, 2.15; 95% CI, 1.28-3.61 for females). Incorporating LDM area into models with traditional risk factors improved predictive accuracy (area under the curve increased from 0.810 to 0.838 in males and from 0.893 to 0.908 in females).

CONCLUSION

LDM area, an indicator of thigh muscle quality and intramuscular fat infiltration, is an independent predictor of incident diabetes.

MeSH

Diabetes Mellitus, Muscles, Incidence, Risk Factors, Diabetes Mellitus, Type 2