Prediabetes Associates With Musculoskeletal Alterations Independent of Total Body Adiposity.

Appendicular muscle mass relative to the sarcopenia threshold was lower in the prediabetic group than the adiposity-matched normoglycaemic control group.

• Prediabetic group: -5.6% ± 2.5% vs. control group: 1.8% ± 2.0% (mean ± SEM) relative to the sarcopenia threshold
• Difference was statistically significant (p < 0.05)
• Groups were matched for sex, age, and adiposity (weight: 81 ± 11 kg prediabetes vs. 81 ± 12 kg controls)
• Prediabetic group: n = 12, 72% women, age 67 ± 6 years; control group: n = 18, 67% women, age 65 ± 6 years

Bone mineral density T-score was lower in the prediabetic group compared to the normoglycaemic control group.

• Prediabetic group T-score: -0.22 ± 0.41 vs. control group: 0.82 ± 0.33 (mean ± SEM)
• Difference was statistically significant (p < 0.05)
• Both groups were matched for total body adiposity, sex, and age

Myofibre cross-sectional area was approximately 25% smaller in the prediabetic group than in the control group.

• Difference was statistically significant (p < 0.05)
• This finding was independent of total body adiposity as groups were adiposity-matched
• Assessed via muscle biopsy histology

The prediabetic group had approximately 40% fewer Type 2 macrophages in muscle tissue compared to controls.

• Difference was statistically significant (p < 0.05)
• Type 2 macrophages were assessed in muscle biopsy samples
• This difference was independent of total body adiposity

Intramyocellular lipid content was more than 50% higher in the prediabetic group than in the control group.

• Difference was statistically significant (p < 0.05)
• Assessed in muscle biopsy samples
• Finding was independent of total body adiposity due to adiposity-matched study design

Maximal muscle strength did not differ between the prediabetic and control groups, but muscle strength during repeated maximum voluntary contractions declined more in the prediabetic group.

• No significant difference in maximal muscle strength between groups
• Muscle strength decline during repeated maximum voluntary contractions was greater in the prediabetic group (p < 0.05)
• This suggests impaired muscle fatigability rather than reduced peak strength in prediabetes

Musculoskeletal alterations in people with overweight/obesity and prediabetes occur independently of total body adiposity.

• Study design matched prediabetic and normoglycaemic participants for sex, age, and adiposity
• Prediabetic group: n = 12; control group: n = 18
• Both groups had similar body weight (81 ± 11 kg vs. 81 ± 12 kg)
• Comprehensive musculoskeletal assessment included muscle mass, bone mineral density, myofibre size, macrophage content, intramyocellular lipid, and muscle strength