Distal lower limb strength is reduced in subjects with impaired glucose tolerance and is related to elevated intramuscular fat level and vitamin D deficiency

Almurdhi, MM, Reeves, ND, Bowling, FL, Boulton, AJM, Jeziorska, M and Malik, RA (2017) Distal lower limb strength is reduced in subjects with impaired glucose tolerance and is related to elevated intramuscular fat level and vitamin D deficiency. Diabetic Medicine, 34 (3). pp. 356-363. ISSN 0742-3071

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Official URL: https://doi.org/10.1111/dme.13163

Abstract

Aim: To quantify muscle strength and size in subjects with impaired glucose tolerance (IGT) in relation to intramuscular non-contractile tissue, the severity of neuropathy and vitamin D level. Methods: A total of 20 subjects with impaired glucose tolerance and 20 control subjects underwent assessment of strength and size of knee extensor, flexor and ankle plantar and dorsi-flexor muscles, as well as quantification of intramuscular non-contractile tissue and detailed assessment of neuropathy and serum 25-hydroxy vitamin D levels. Results: In subjects with impaired glucose tolerance, proximal knee extensor strength (P = 0.17) and volume (P = 0.77), and knee flexor volume (P = 0.97) did not differ from those in control subjects. Ankle plantar flexor strength was significantly lower (P = 0.04) in the subjects with impaired glucose tolerance, with no difference in ankle plantar flexor (P = 0.62) or dorsiflexor volume (P = 0.06) between groups. Intramuscular non-contractile tissue level was significantly higher in the ankle plantar flexors and dorsiflexors (P = 0.03) of subjects with impaired glucose tolerance compared with control subjects, and it correlated with the severity of neuropathy. Ankle plantar flexor muscle strength correlated significantly with corneal nerve fibre density (r = 0.53; P = 0.01), a sensitive measure of small fibre neuropathy, and was significantly lower in subjects with vitamin D deficiency (P = 0.02). Conclusions: People with impaired glucose tolerance have a significant reduction in distal but not proximal leg muscle strength, which is not associated with muscle atrophy, but with increased distal intramuscular non-contractile tissue, small fibre neuropathy and vitamin D deficiency.

Item Type:	Article
Peer-reviewed:	Yes
Date Deposited:	17 Jun 2016 08:27
Publisher:	Wiley
Additional Information:	This is an Author's Accepted Manuscript provided by Wiley of a paper accepted for publication in Diabetic Medicine.
Divisions:	Faculties > Science and Engineering
Subject terms:	Science & Technology, Life Sciences & Biomedicine, Endocrinology & Metabolism, DIABETIC-NEUROPATHY, INSULIN-RESISTANCE, METABOLIC SYNDROME, SKELETAL-MUSCLE, OBESITY, ASSOCIATION, PERFORMANCE, PREVALENCE, MELLITUS, ATROPHY, Ankle, Knee, Leg, Muscle, Skeletal, Humans, Muscle Weakness, Polyneuropathies, Glucose Intolerance, Vitamin D Deficiency, Calcifediol, 25-Hydroxyvitamin D 2, Magnetic Resonance Imaging, Early Diagnosis, Severity of Illness Index, Aged, Middle Aged, Female, Male, Adiposity, Lipid Metabolism, Muscle Strength, Small Fiber Neuropathy, 25-Hydroxyvitamin D 2, Adiposity, Aged, Ankle, Calcifediol, Early Diagnosis, Female, Glucose Intolerance, Humans, Knee, Leg, Lipid Metabolism, Magnetic Resonance Imaging, Male, Middle Aged, Muscle Strength, Muscle Weakness, Muscle, Skeletal, Polyneuropathies, Severity of Illness Index, Small Fiber Neuropathy, Vitamin D Deficiency, 1103 Clinical Sciences, 1117 Public Health and Health Services, 1701 Psychology, Endocrinology & Metabolism
URI:	https://e-space.mmu.ac.uk/id/eprint/613528
DOI:	https://doi.org/10.1111/dme.13163
ISSN	0742-3071
e-ISSN	1464-5491

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