A new, alternative risk score for sarcopenia in Chinese patients with type 2 diabetes mellitus.

OBJECTIVE: To develop a new, alternative sarcopenia risk score to screen for sarcopenia in type 2 diabetes patients in China and to demonstrate its validity. RESEARCH DESIGN AND METHODS: The data for this study came from a multicenter, cross-sectional study that had been designed to estimate the prevalence of sarcopenia among adults with type 2 diabetes and had been conducted in several hospitals in Beijing, China. A total of 1125 participants were randomly divided into two groups: an exploratory population and a validation population. A multivariable logistic regression model using the backward stepwise likelihood ratio method to estimate the probability of sarcopenia was fitted with candidate variables in the exploratory population. A new, alternative sarcopenia risk score was developed based on the multivariable model. The internal and external validations were performed in the exploratory and validation populations. The study was registered at Chinese Clinical Trial Registry (ChiCTR-EOC-15006901). RESULTS: The new, alternative sarcopenia risk score included five variables: age, gender, BMI, total energy intake per day, and the proportion of calories supplied by protein. The score ranged from - 2 to 19. The area under the receiver operating characteristic (ROC) curve of the risk score for the prediction of sarcopenia in type 2 diabetes patients was 0.806 (95% CI 0.741-0.872) and 0.836 (95% CI 0.781-0.892) in the exploratory and validation populations, respectively. At the optimal cutoff value of 12, the sensitivity and specificity of the score for the prediction of sarcopenia were 70.9% and 81.0% in the exploratory population and 53.7% and 88.8% in the validation population, respectively. The Hosmer-Lemeshow goodness-of-fit test showed a good calibration with the risk score in external validation (χ2 = 4.459, P = 0.813). CONCLUSIONS: The new, alternative sarcopenia risk score appears to be an effective screening tool for identification of sarcopenia in Chinese patients with type 2 diabetes in clinical practice. Clinical trial registration Chinese Clinical Trial Registry, ChiCTR-EOC-15006901.

Metabolic and Nutritional Characteristics in Middle-Aged and Elderly Sarcopenia Patients with Type 2 Diabetes.

Sarcopenia is considered to be a new complication of type 2 diabetes (T2DM) leading to increased risk of adverse outcome. We performed a survey to evaluate glucose metabolism and nutritional status in sarcopenia patients with T2DM. Diabetic participants aged ≥50 years were grouped into a probable sarcopenia group with low muscle strength (n = 405) and a nonsarcopenia group with normal muscle strength (n = 720) according to the revised recommendations from EWGSOP2 (2018). Compared to the controls, the probable sarcopenia participants were older and had lower waist-to-hip ratio and BMI, longer diabetes duration, higher fasting plasma glucose level and glycosylated hemoglobin (HbA1c), decreased estimated glomerular filtration rate and lower bone mineral content, lower fatless upper arm circumference, lower appendicular skeletal muscle mass index (ASMI), and muscle quality in both genders. Multivariable logistic regression analysis showed increased age, male, low BMI, and increased HbA1c, combined with diabetic nephropathy and decreased serum albumin levels, were risk factors associated with low muscle strength in diabetes patients. In conclusion, diabetic patients with sarcopenia had worse glucose metabolism and nutritional status, decreased renal function and reduced muscle quality ,and muscle mass with a greater likelihood of osteoporosis, who need an overall health management to improve outcomes. This clinical trial registration is registered with the Chinese Clinical Trial Registry, ChiCTR-EOC-15006901.

Convenient food made of extruded adzuki bean attenuates inflammation and improves glycemic control in patients with type 2 diabetes: a randomized controlled trial.

OBJECTIVE: Extrusion is a widely used food processing technology. The aim of this study was to investigate the effects of extruded adzuki bean convenient food (EABCF) on glycemic and inflammation control in type 2 diabetes mellitus (T2DM) patients. PATIENTS AND METHODS: In a randomized controlled trial, 120 T2DM patients were randomly assigned to a control diet group (the low glycemic index [LGI] group, assigned the traditional diabetic low glycemic index diet) or an intervention group (the EABCF group, assigned daily consumption of EABCF). Diet information and blood samples were collected at baseline and after a 4-week intervention. After excluding exogenous insulin users, a subgroup analysis based on baseline fasting insulin (FINS) levels was conducted, and Homeostasis Model Assessment (HOMA) was the target indicator. RESULTS: A total of 106 patients completed the trial, and 89 participants were included in the subgroup analysis. After the intervention, glycemic control improved in both groups compared to baseline, but the difference was not statistically significant (p>0.05). However, the EABCF group showed decreased inflammation with significantly lower tumor necrosis factor alpha (TNF-α) level compared to the control group (adjusted p<0.01). There was also a slight increase in the interleukin-6 (IL-6) level in the EABCF group (adjusted p=0.004). Moreover, the subgroup analysis found that, after 4 weeks, a diet consisting of EABCF increased insulin secretion to normal levels in the group with hypoinsulinism (baseline FINS<5.2 mU/L). However, the difference only showed a trend toward statistical significance (0.05

Dietary black-grained wheat intake improves glycemic control and inflammatory profile in patients with type 2 diabetes: a randomized controlled trial.

INTRODUCTION: Although black-grained wheat (BGW) is recognized as a nutritional food for humans in China, it has yet to be utilized well for industrial applications, which can be attributed to the limited research data available on its health benefits. Thus, the hypothesis was tested that a daily substitution of BGW for a partial staple food would improve glycemia and inflammatory profile of type 2 diabetes mellitus (T2DM) patients by a randomized controlled trial. MATERIALS AND METHODS: A total of 120 patients were randomly divided between control group (diet control and nutritional education) and BGW group (daily substitution of BGW for a partial staple food). RESULTS: Based on the significant difference between BGW and control groups (P<0.05), the primary outcomes were that BGW treatment in diet resulted in a significant lowering of glycated albumin (GA, 18.05 to 16.06 mmol/L) level in T2DM patients after a 5-week intervention, and this treatment regimen was much more efficient than the strategy of diet control alone. In addition, BGW supplementation prevented the increase in tumor necrosis factor (TNF)-α and interleukin (IL)-6 induced by T2DM. There were no significant differences in blood glucose, glycated hemoglobin or insulin levels between the 2 groups. The subgroup analyses of the BGW daily intake showed that, except the TNF-α, significant improvements in GA and IL-6 were observed when the BGW intake dose was >69 g/day. CONCLUSION: These findings support the hypothesis that BGW may improve glycemia and the inflammatory profile in T2DM patients.

Protective effect of tartary buckwheat on renal function in type 2 diabetics: a randomized controlled trial.

Tartary buckwheat (TB) has been reported to be associated with a decreased risk of type 2 diabetes mellitus (T2DM), and T2DM has had a major impact on the development of diabetic kidney disease (DKD). Thus, the hypothesis that a daily intake of TB will improve DKD risk factors, including urinary albumin to creatinine ratio (UACR), urea nitrogen (UN), serum creatinine, and uric acid was tested. In a parallel, randomized, open-label controlled trial, 104 T2DM patients were randomly assigned to a diet control group (systematic diet plans and intensive nutritional education) or a TB intervention group (daily replacement of a portion of staple foods with TB foods). Blood samples and dietary information were collected at baseline and the end of the 4-week study. The primary outcomes were that TB significantly decreased the rela tive changes in UACR (2.43-2.35, logarithmic transformed mg/g creatinine) and UN (5.12-4.91 mmol/L) in the TB intervention group vs the diet control group at 4 weeks (P<0.05), without obvious effect on blood glucose during the 4-week study. In addition, subgroup analyses based on different DKD stages also showed a significant reduction in UACR and UN for the T2DM patients with normoalbuminuria and microalbuminuria (P<0.05). These results support the hypothesis that TB as a replacement of staple food probably alleviates renal dysfunction in T2DM patients.

Dietary tartary buckwheat intake attenuates insulin resistance and improves lipid profiles in patients with type 2 diabetes: a randomized controlled trial.

Tartary buckwheat (TB) is rich in protein, dietary fiber, and flavonoids and has been reported to affect type 2 diabetes mellitus (T2DM) in animal experiments, but limited information on the benefit of TB as a whole food in T2DM patients is available. Thus, we tested the hypothesis that a daily replacement of a portion of the staple food with TB will improve risk factors of T2DM, including fasting glucose, insulin resistance, and lipid profile. In a parallel, randomized, open-label, controlled trial, 165 T2DM patients were randomly assigned to a control diet group (DC group; systematic diet plans and intensive nutritional education) or a TB intervention group (TB group; daily replacement of a portion of staple food with TB food). Blood samples and diet information were collected at baseline and after 4 weeks of intervention. The TB group decreased fasting insulin (2.46-2.39 Ln mU/L), total cholesterol (5.08-4.79 mmol/L), and low-density lipoprotein cholesterol (3.00-2.80 mmol/L) compared with the DC group at 4 weeks (P<.05). No significant differences in blood glucose or glycated hemoglobin levels were noted between the TB and DC groups. In addition, subgroup analyses based on daily TB intake dose showed a reduction in insulin, total cholesterol, and low-density lipoprotein cholesterol, but also insulin resistance was observed when TB intake dose was greater than 110 g/d. These results support the hypothesis that TB may improve insulin resistance and lipid profile in T2DM patients.