175-LB: The Impact of Glucose Metabolism Abnormality on the Reduced Muscle Strength Is Higher in Elderly Women than Men: The Bunkyo Health Study
Authors: KAGA HIDEYOSHI , TAMURA YOSHIFUMI , SOMEYA YUKI , KADOWAKI SATOSHI , SUGIMOTO DAISUKE , SUZUKI RURIKO , SATO MOTONORI , YAMASAKI NOZOMU , KIYA MAI , KAWAMORI RYUZO , WATADA HIROTAKA 
Published: June 2020

Decreased muscle strength in lower extremities is a major cause of disability in elderly. It has been shown that type 2 diabetes (DM) is a risk factor for reduced muscle strength; however, it remains unclear whether impaired glucose tolerance (IGT) as well as DM is also a risk factor for reduced muscle strength. To address this, we evaluated hand grip strength and knee extensor and flexor muscle strengths in 1,629 older adults living in an urban area of Tokyo, Japan. The reduced muscle strength of hand grip was defined by sarcopenia criteria, and the reduced muscle strength in knee extensor and flexor muscle strengths was defined as mean value -1 SD or less. Adjustments for potential confounders were performed by age, physical activity, BMI, smoking, hypertension and dyslipidemia. The mean age of subjects was 73.1±5.4 years. In men, 43.5% was normal glucose tolerance (NGT), 38.1% was IGT, and 18.3% was DM, and in women, those were 55.8%, 35.2% and 8.9%, respectively. In men, after multivariate adjustment, the odds ratio for the reduced muscle strength of hand grip was higher in DM compared to NGT (NGT;1.00 (reference), IGT; 1.38 (95%CI: 0.88-2.16), DM; 1.87 (95%CI: 1.08-3.22)), while the odds ratios for muscle weakness of knee extensor and flexor were not elevated in DM and IGT compared to NGT. In women, the odds ratios for the reduced muscle strength in hand grip and knee extensor were higher in DM compared to NGT (Hand grip; NGT;1.00, IGT; 0.96 (0.64-1.46), DM; 2.69 (1.52-4.75), Knee extensor; NGT;1.00, IGT; 1.00 (0.66-1.51), DM; 1.93 (1.06-3.53)), while the odds ratio for the reduced muscle strength of knee flexor was higher in both IGT and DM compared to NGT (NGT;1.00, IGT;1.63 (1.15-2.31), DM;1.88(1.08-3.26)).
In conclusion, DM is an independent risk factor for reduced muscle strength of handgrip, knee extensor and flexor in elderly women, but not in elderly men. In elderly women, IGT is also an independent risk factor for reduced muscle strength in knee flexor.

Disclosure
H. Kaga: None. Y. Tamura: Advisory Panel; Self; Astellas Pharma Inc. Research Support; Self; Kowa Company, Ltd. Speaker’s Bureau; Self; Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd. Y. Someya: None. S. Kadowaki: None. D. Sugimoto: None. R. Suzuki: None. M. Sato: None. N. Yamasaki: None. M. Kiya: None. R. Kawamori: None. H. Watada: Advisory Panel; Self; Abbott, Ajinomoto, Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Fuji Film, Janssen Pharmaceuticals, Inc., Kowa Company, Ltd., Kyowa Hakko Kirin Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi-Aventis, Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. Research Support; Self; Astellas Pharma Inc., Bayer Yakuhin, Ltd., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo, Eli Lilly Japan K.K., Kissei Pharmaceutical Co., Ltd., Kowa Company, Ltd., Kyowa Hakko Kirin Co., Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharma K.K., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Otsuka Pharmaceutical Co., Ltd., Pfizer Japan Inc., Sanofi-Aventis, Sanwa Kagaku Kenkyusho, Shionogi & Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited, Yakult. Speaker’s Bureau; Self; Astellas Pharma Inc., AstraZeneca, Bayer Yakuhin, Ltd., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo, Eli Lilly Japan K.K., Kissei Pharmaceutical Co., Ltd., Kowa Company, Ltd., Kyowa Hakko Kirin Co., Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi-Aventis, Sanwa Kagaku Kenkyusho, Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited.

Funding
Strategic Research Foundation at Private Universities (S1411006); Ministry of Education, Culture, Sports, Science and Technology of Japan (18H03184); Mizuno Sports Promotion Foundation; Mitsui Life Social Welfare Foundation